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Change Concept #1
Routine CQI Review of Vascular Access
Dialysis facilities should incorporate vascular access into their continuous quality improvement (CQI) processes. Planning and care for vascular access spans many disciplines and settings; breakdowns in communication put patients at risk for sub-optimal treatment. In order to identify patients who will benefit from secondary arteriovenous (AV) fistula placement, facilities need processes that facilitate multidisciplinary communication, assign responsibility for vascular access information coordination, and regularly collect and use data to identify problems and opportunities for improvement.
Changes for Improvement
Frequently Asked Questions
Related Literature
Related Tools
Related Resources
Changes for Improvement:
Designate a Vascular Access Coordinator
Designate a staff member in the dialysis facility who will be responsible for vascular access. Designate a registered nurse (RN) if possible; if not, choose any renal care professional.Related Literature
Investing in the lifeline: The value of a vascular access coordinator
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Changes for Improvement:Assemble a Multidisciplinary Vascular Access Team
Assemble a multidisciplinary vascular access CQI team in your facility or hospital. At a minimum, this team should include the medical director and vascular access coordinator. Ideally, representatives from all disciplines, including access surgeons and interventionalists, should be on the team.
Vascular Access CQI Team
1 Nephrologist must become informed, take lead role in AVF initiative, encourage patients, and develop relationship with surgeons.
2 Access Manager needs to be empowered by Medical Director and team.
Note: AVF initiative is introduced at a multidisciplinary conference, following which the vascular access team is assembled and a database is established.
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