The following are some specific things surgeons can do to begin to increase AV fistula use in dialysis patients. These are actions that can be taken immediately and will require the cooperation between and, perhaps, changes in practice of, all providers in the system.

1. Know the rates of AV fistula use and incidence for your patients.
2. Review the recommended strategies from the Fistula First Change Package and choose those that make the most sense for your practice. For example, consider the following changes:

• Change Concept 5 – Full Range of Appropriate Surgical Approaches to AVF Evaluation and Placement
• Change Concept 6 – Secondary AVF Placement in Patients with AV Grafts
• Change Concept 7 – AVF Placement in Patients with Catheters Where Indicated
• Change Concept 9 – Monitoring and Maintenance to Ensure Adequate Access Function
• Change Concept 11 – Outcomes Feedback to Guide Practice