Network Goals & Objectives
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| GOAL A | Patient Choice. The Network will encourage the informed participation of the patient in the selection of a renal treatment that will promote optimal outcome for that individual. Goal A will be met through one or more of the following objectives. |
| Objective |
New England patients with ESRD will be informed of all medically appropriate treatment options. Such discussions will be documented in the patient’s medical record at least annually in accordance with the ESRD conditions for Coverage. |
| Objective | The Network will continuously monitor, through data analysis, the utilization of home dialysis and/or transplantation as a first choice for treatment modality. A benchmark of 10% utilization of either home dialysis or transplantation in the New England ESRD incident population will be the target. |
| Objective | The Network will promote greater local access to home dialysis training opportunities through the use of back up agreements between providers. |
| Objective |
The Network will promote early live donor related transplantation within the first three months of ESRD because it is the treatment option with demonstrated quality of life improvement for most patients. |
| GOAL B | Patient Complaints and Grievances. The Network will strive to assist providers and patients by proactively facilitating resolution of patient complaints or grievances. Goal B will be met through one or more of the following objectives. |
| Objective | The Network will provide ESRD patients with a method for evaluating and resolving grievances outside the facility process. Notification of this policy will be posted in public areas of dialysis clinics. The Network will respond to 100% of patient complaints and grievances received and will seek to resolve a minimum of 75% of these cases. Confidential documentation is stored in Network data system. |
| Objective | The Network will encourage the utilization of the CMS developed Decreasing Patient Provider Conflict Toolkit (DPC) through ongoing emphasis of its use by New England facilities. |
| GOAL C | CQI Methodology. The Network will administer a continuous quality improvement (CQI) management program to evaluate the quality of care for chronic kidney disease patients. Goal C will be met through one or more of the following objectives. |
| Objective | The Network will provide QI tools and Quality Improvement expertise to ESRD facilities in the development of provider based CQI programs. |
| Objective | Clinical indicator data will be periodically analyzed to assess the quality of patient care at the provider level. Educational interventions, including rapid cycle techniques or site visits, will be undertaken as indicated by this assessment process (Network indicator measures on Network website). |
| Objective | Special clinical studies as determined by CMS, the Network, or its Medical Review Board will be conducted as directed. |
| Objective | The Network of New England will strive to reach an AVF (placed and functional) rate as required by the CMS contract for its prevalence hemodialysis population. |
| GOAL D | Patient Rehabilitation and Restoration of Functional Status. The Network will encourage patient participation in rehabilitation programs and activities that will restore patient’s functional status to the extent possible. Goal D will be met through one or more of the following objectives. |
| Objective | The Network will inform ESRD facilities of rehabilitative resources that exist for ESRD patients in each of the six New England states. This information will be posted on the Network website and included in New Facility packets. |
| Objective | The Network Staff and Board will annually review data compiled from the Rehabilitation Survey. This survey reports by provider the number of ESRD patients working, in school or referred to Vocational Rehabilitation Programs. Comparative feedback reports drawn from the survey data will be distributed to New England facilities for self-assessment and interventions as indicated. |
| GOAL E | Information Technology System. The Network will manage a computer information system to support quality improvement activities and provide data to CMS, ESRD providers, physicians and other organizations appropriate under HIPAA guidelines. Goal E will be met through one or more of the following objectives. |
| Objective | Facility specific data report profiles will be shared with providers as directed by CMS. |
| Objective | The Network will monitor and distribute facility specific data based on the timely and accurate submissions of CMS required data. |
| Objective | The Network will promote and assist providers in the implementation and utilization of CMS software for the support of the renal registry, Medicare Entitlement, and quality improvement activities. |
| Objective | An annual report consisting of Network activities and statistics will be provided to CMS, ESRD Providers and other appropriate agencies. |
| GOAL F | Community Collaboration. The Network will work collaboratively with government and non-government agencies in the pursuit of quality care for ESRD patients. Goal F will be met through one or more of the following objectives. |
| Objective | Releasable aggregate data, educational materials and technical assistance will be disseminated to State Health Departments (DPH) and other appropriate agencies involved in providing ESRD patient services. The Network will maintain ongoing communication with DPH representatives. |
| Objective | The Network will seek collaborative opportunities to work with other organizations to improve quality of care for patients with chronic kidney disease (CKD). |
| GOAL G | Patient Safety. The Network will promote a culture of safety within the ESRD facilities by providing tools, educational resources and technical assistance to foster a safe environment. Goal G will be met through one or more of the following objectives. |
| Objective | The Network will distribute to all New England ESRD providers disaster relevant information in print and electronic format. The Network will give technical assistance to providers for development of internal emergency plans. The Network will support the National Coalition for ESRD Disaster Management in its efforts to respond to major emergency situations. |
| Objective | The Network will continue to support and expand the safety educational program (5 Diamond Safety Project) in partnership with Network #5. |
Reference: Network Organizations
Section 1881(c) of the Social Security Act, Sections 9335(d) through (h) of the Omnibus Budget Reconciliation Act of 1986, federal regulations, the Medicare ESRD Network Organizations Manual, and other CMS instructions provide additional details concerning Network functions, activities and responsibilities.
