Change Concept 1
Routine CQI
 

Change Concept 2
Referral to nephrologist
 

Change Concept 3
Referral to surgeon
 

Change Concept 4
Surgeon selection
 

Change Concept 5
Surgical approaches
 

Change Concept 6
Secondary AVF
 

Change Concept 7
AVF placement in patients with catheters
 

Change Concept 8
Cannulation training
 

Change Concept 9
Monitoring and maintenance
 

Change Concept 10
Education for care givers and patients
 

Change Concept 11
Outcomes feedback
 

Change Concept 12
Modify hospital systems
 

Change Concept 13
Patient self-management
 

Change Concept 11

 

Outcomes feedback to guide practice

  • Networks work with dialysis providers to give specific feedback to all decision-makers on incident and prevalent rates of AVF, AVG, and catheter use.
  • Review data monthly or quarterly in facility staff meetings. Present and evaluate data trended over time for incident and prevalent rates of AVF, AVG, and catheter use.

Facilities can start by measuring performance on a monthly basis by access type - catheter, AV graft, and AV fistula - since access type is the major determinant of outcomes and directly affects dialysis delivery and adequacy.  It is also important to focus specifically on native AV fistula outcomes and performance, including tracking the monthly AV fistula placement and failure rate in incident as well as prevalent patients.

 

Changes for Improvement:

 

Provide Specific Outcomes Feedback to All Decision Makers

Provide specific outcomes feedback to all decision makers, including incident and prevalent rates of AV fistula, AV graft, and catheter use. The ESRD Networks are currently working with dialysis providers to collect and provide this information regularly to each facility.


Review Data Monthly or Quarterly in Facility Staff Meetings

Discuss and evaluate data trended over time for incident and prevalent rates of AV fistula, AV graft, and catheter use. Track and disseminate all vascular access-related outcomes.

 

Related Tools

 

Monthly Performance Tracking Tool

Excel spreadsheet which can be used to track trends in data on a monthly basis.
Directions

 

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