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.
Agency for Healthcare Research and Quality (AHRQ)
AHRQ offers many databases that may be of interest to the kidney community including: the National Healthcare Quality Report, National Healthcare Disparities Report, Medical Expenditure Panel Survey, and Healthcare Cost and Utilization Project.
Additionally, AHRQ has established Evidence-Based Practice Centers (EPCs) that produce evidence-based reports and technology assessments under contract to AHRQ. EPCs inform and develop coverage decisions, quality measures, educational materials and tools, guidelines, research agendas, and conduct research on methodology of systematic reviews. Additionally, AHRQ leads the Accelerating Change and Transformation in Organizations and Networks (ACTION) program (www.ahrq.gov/research/ACTION.htm). ACTION-funded contracts promote demand-driven innovation in health care delivery and focus on generalizability to promote spread to other settings.
AHRQ has awarded grants that focus on chronic kidney disease (CKD) and dialysis, including the “Making CKD Guidelines Work in Underserved Practices” grant. This grant strives to estimate the effects of patient outcomes resulting from implementing CKD guidelines. It also aims to assess the usefulness of primary care provider-directed telephonic case management for CKD guideline utilization in primary care settings located in medically underserved communities.
Contact Information
Cynthia Palmer, MSc
ACTION Program Officer
Phone: 301-427-1441
Email: cynthia.palmer@ahrq.hhs.gov
Web: www.ahrq.gov
Back to Top
Centers for Disease Control and Prevention (CDC)
CDC’s CKD Health Evaluation Risk Information Sharing (CHERISH) is designed to test the feasibility of implementing a chronic kidney disease (CKD) detection/screening program in four states, to assess the degree of kidney disease in a high-risk population, to determine participant’s subsequent access to care, and to address the likelihood of disease progression in those with evidence of CKD. This study is being conducted in collaboration with the National Kidney Foundation.
Contact Information
Desmond Williams, MD, PhD
CKD Initiative Team Lead, CDC Division of Diabetes Translation
Phone: 770–488–1158
Email: DEWilliams@cdc.gov
Web: www.cdc.gov/diabetes/projects/kidney.htm
CDC is promoting methicillin-resistant Staphylococcus aureus (MRSA) and S. aureus bloodstream infections (BSI) surveillance and prevention among hemodialysis facilities. This project will be conducted as part of a larger prevention collaborative involving a group of hospitals that are currently using a Positive Deviance Model as a behavior-based social change approach to eliminating healthcare-associated MRSA. In addition to examining the impact within the acute healthcare facilities where Positive Deviance is being applied, CDC will assess the impact on MRSA infection in outpatient dialysis centers that share patients with participating acute healthcare facilities.
Contact Information
Priti Patel, MD, MPH
CDC Division of Healthcare Quality Promotion
Phone: 404–639–4273
Email: PPatel@cdc.gov
Web: www.cdc.gov/diabetes/projects/kidney.htm
CDC in collaboration with the Veterans Affairs - Puget Sound Health Care System will examine the natural history of chronic kidney disease (CKD) and evaluate the rate of progression through the stages of CKD and development of complications.
Contact Information
Meda Pavkov, MD, PhD
Phone: 770–488–1160
Email: MPavkov@cdc.gov
Web: www.cdc.gov/diabetes/projects/kidney.htm
CDC’s Cost-Effectiveness Study is using a lifetime simulation model to assess the costs and benefits of various interventions. The purpose of this project is to investigate the cost-effectiveness of interventions to prevent, delay, and treat CKD and its complications, and to develop a model that will not only help predict the progression of CKD, but will also test the effectiveness of various public health interventions.
CDC is researching the cost of illness through its Cost of Illness Study; including direct and indirect costs. The purpose of the Cost of Illness Study is to document the direct and indirect costs of CKD and other diseases/conditions.
Contact Information
Desmond Williams, MD, PhD
CKD Initiative Team Lead, CDC Division of Diabetes Translation
Phone: 770–488–1158
Email: DEWilliams@cdc.gov
Web: www.cdc.gov/diabetes/projects/kidney.htm
Back to Top
Centers for Medicare & Medicaid Services (CMS)
The Dialysis Facility Compare (DFC) contains information about Medicare certified dialysis facilities. Included is facility and contact information, location, types of services, and certification date; as well as quality outcome data for anemia, adequacy of hemodialysis, and survival rates for each facility. DFC allows patients and their family members, as well as professionals, to compare the quality of dialysis facilities across the country, and to access a variety of kidney and dialysis resources. Users are also able to find facility services and quality measures.
The facility information and data comes from two CMS Administrative Data sources: Standard Information Management Systems (SIMS) and Renal Management Information System (REMIS). The quality measure data for anemia and adequacy of hemodialysis comes from end-stage renal disease (ESRD) claims data and the survival data calculated using SIMS and REMIS. The ESRD Networks verify, update, and send data in SIMS to Medicare monthly. REMIS is a database maintained by Medicare with data about dialysis facilities. It includes demographic, medical claims, payment, and entitlement data on people with Medicare who have ESRD; certification and other information for Medicare-certified ESRD providers; and aggregate ESRD patient information.
Contact Information
Name: Thomas Dudley
Phone: 410-786-1442
Email: Thomas.dudley@cms.hhs.gov
Web: www.medicare.gov/dialysis
The Prevention Quality Improvement Organization Support Center (QIOSC) as contracted by the Centers for Medicare & Medicaid Services (CMS) provides technical assistance and support to select Quality Improvement Organizations (QIOs) that are partnering with community representatives, primary care physicians, nephrologists and vascular surgeons to improve care for patients with chronic kidney disease (CKD). QIOs working on this project represent beneficiaries in Florida, Georgia, Missouri, Montana, Nevada, New York, Rhode Island, Tennessee, Texas, and Utah as well as the United States Virgin Islands.
The CKD Quality Improvement Project promotes early detection of CKD and proper medication treatment to slow the progression of the disease. It also addresses the need for patients who are approaching kidney failure to receive timely counseling to enable safer, higher-quality access to dialysis through a fistula.
The Prevention QIOSC facilitates this important work of the CKD QIOs by:
- Engaging expert stakeholders and partners
- Developing and/or disseminating tools
- Providing educational information and resources
- Identifying QIO barriers, lessons learned, and success stories
- Synthesizing and disseminating “what works” information
- Making the “business case”
Additionally, the Prevention QIOSC supports the goals of the End Stage Renal Disease Networks through partnering with the Fistula First Breakthrough Initiative (FFBI) contractor, Mid-Atlantic Renal Coalition.
The Prevention QIOSC contract is held by Virginia Health Quality Center.
Contact Information
Robin Weil, MSHA, RN, CPHQ
Phone: 804-289-5351
Email: rweil@vaqio.sdps.org
Back to Top
Health Resources and Services Administration (HRSA)
Funded by HRSA, the Organ Procurement and Transplantation Network (OPTN) is the unified transplant network established by the U.S. Congress under the National Organ Transplant Act (NOTA) of 1984. The OPTN is a unique public-private partnership that links all of the professionals involved in the donation and transplantation system. The primary goals of the OPTN are to increase the effectiveness and efficiency of organ sharing and equity in the national system of organ allocation by establishing and maintaining policies and procedures for the field of transplantation, and to increase the supply of donated organs available for transplantation.
The OPTN efforts related to quality improvement include providing data to the government, the public, students, researchers, and the Scientific Registry of Transplant Recipients for use in improving the field of solid organ allocation and transplantation.
NOTA also established the Scientific Registry of Transplant Recipients (SRTR), which is a national database of statistics related to solid organ transplantation. Its purpose is to support the development of sound policy, to encourage research on issues of importance to the transplant community, and to facilitate responsible analysis of transplant programs and organ procurement organizations. The registry covers the full range of transplant activity, from organ donation and waiting list candidates to transplant recipients and survival statistics.
Contact Information
Richard Durbin
Acting Director, Division of Transplantation
Phone: 301–443–6804
Email: RDurbin@hrsa.gov
Web: www.ask.hrsa.gov/Organ.cfm
Back to Top
Indian Health Service (IHS)
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
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. |
