Indian Health Service (IHS)
Quality Improvement/Evidence of Therapy
This section describes current quality improvement and evidence of therapy programs of the Federal government related to chronic kidney disease.
The IHS Kidney Disease Program is working to broaden the Diabetes Standards of Care to include identification and treatment of complications of chronic kidney disease (CKD) (e.g. anemia, bone disease), patient education, and preparation for renal replacement therapy.
The program is also building implementation tools, clinical documentation, and quality improvement procedures into the medical information system. It is also incorporating new data to validate the Modification of Diet in Renal Disease study equation in American Indians and Alaskan Natives. Additionally, IHS developed several CKD encounter form templates as well as referral forms for nephrology consultation, renal nutrition, and vascular access placement to better treat patients.
Contact Information
Andrew S. Narva, MD, FACP
Chief Clinical Consultant for Nephrology
Phone: 301-594-8864
Email: narvaa@niddk.nih.gov
Web: www.ihs.gov/medicalprograms/kidney/providers_index.asp
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Public Education & Outreach
This section describes current patient outreach and education programs of the Federal government related to chronic kidney disease.
The IHS Kidney Disease Program provides information for patients, families, and communities about dialysis and transplantation, as well as links to other organizations and agencies. IHS’s Division of Diabetes Treatment and Prevention provides educational resources about kidney disease in their online catalog, such as Taking Care of Your Kidneys, a 15-page booklet that informs patients on kidney damage due to bladder and kidney infections.
Contact Information
Andrew S. Narva, MD, FACP
Chief Clinical Consultant for Nephrology
Phone: 301-594-8864
Email: narvaa@niddk.nih.gov
Web: www.ihs.gov/MedicalPrograms/Diabetes/RESOURCES/Catalog/rde/index.cfm?module=home
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Delivery & Payment of CKD Care
This section describes delivery and payment of care related to chronic kidney disease.
The IHS's Division of Diabetes Treatment and Prevention has published Indian Health Diabetes Best Practices: Chronic Kidney Disease and Diabetes, which outlines for IHS providers the best methods for identifying and evaluating patients with chronic kidney disease (CKD), managing and monitoring patients with CKD and diabetes, and evaluating the progression of CKD. IHS also has written best practices for health care organizations, essential elements of best practices for CKD programs, and guidance on evaluating and sustaining CKD programs.
Individuals living on reservations receive care for diabetes and hypertension, two leading causes of kidney failure, in IHS clinics across the United States. Those who progress to kidney failure are covered by the Medicare ESRD program and, if eligible, IHS contract health services.
Contact Information
Andrew S. Narva, MD, FACP
Chief Clinical Consultant for Nephrology
Phone: 301-594-8864
Email: narvaa@niddk.nih.gov
Web: www.ihs.gov/MedicalPrograms/Diabetes/
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Professional Education & Outreach
This section describes education and outreach to health professionals of the Federal government related to chronic kidney disease.
The IHS Kidney Disease Program implements continuing education programs for physicians, advanced practice nurses, physicians assistants, nutrition professionals, pharmacists, and laboratory professionals. IHS has also developed concise summaries of evidence-based guidelines on treatment of chronic kidney disease (CKD) and complications, including Indian Health Diabetes Best Practices: Chronic Kidney Disease and Diabetes. IHS has also published a collection of 13 brief articles describing a primary care approach to how to treat a patient with CKD.
The program also promotes case management of CKD within the diabetes program. An annual three-day CKD case-management workshop was established and is open to any health professional who is interested and has the support of his/her supervisor to implement change. Additionally, several CKD case-management models, coordinated by a variety of health care professionals, were established throughout IHS. IHS also offers clinical guidelines, protocols for patient education, and treatment protocols for anemia, which are available online for health professionals to facilitate implementation of care.
Contact Information
Andrew S. Narva, MD, FACP
Chief Clinical Consultant for Nephrology
Phone: 301-594-8864
Email: narvaa@niddk.nih.gov
Web: www.ihs.gov/medicalprograms/kidney/providers_index.asp
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Surveillance
This section describes surveillance activities and programs of the Federal government related to chronic kidney disease.
The burden of kidney disease among diabetics has been monitored for several years by the IHS Diabetes Program through a yearly chart audit, and includes measure of kidney function, abnormal protein excretion, and blood pressure control. The IHS Diabetes Care and Outcomes Audit (“the Audit”) is a process for assessing diabetes care and health outcomes for American Indians and Alaska Natives with diagnosed diabetes. IHS, Tribal, and Urban Indian health care facilities nationwide voluntarily participate in this process each year by performing a self-audit of medical records for their patients with diabetes. By carefully reviewing the results of individual audits, facilities can identify areas for improvement and implement strategies to work toward the goal of providing all diabetes patients with the highest quality of care, as outlined in the IHS Standards of Care for Patients with Type 2 Diabetes.
Contact Information
Karen L. Sheff, MS
Biostatistician/Data Manager
Phone: 505-248-4965
Email: Karen.Sheff@ihs.gov
Web: www.ihs.gov/MedicalPrograms/Diabetes/index.cfm?module=resourcesAudit
This information was reviewed by KICC agency representatives. It may not reflect new or future agency activities. For more information, please contact the listed representatives. |
