Goals and Objectives

Strategic Goals of ESRD Networks

In keeping with the legislative mandate for the ESRD Network program, the goals of CMS to include ensuring the right care for every person every time, and sound medical practice, the strategic goals of the ESRD Network Program are to:

  • Improve the quality and safety of dialysis related services provided for individuals with ESRD.
  • Improve independence and quality of life of individuals through use of self-care modalities (such as transplantation, peritoneal dialysis, home hemodialysis), and self directed care, as appropriate, through the end of life.
  • Improve patient perception of care and experience of care and resolution of patient's complaints and grievances.
  • Improve the individuals with ESRD rate of transplantation and use of self-care and self-directed modalities, through to end of life, when medically appropriate in order to ensure the patient achieves the maximum level of rehabilitation and independence possible.
  • Improve collaboration with providers to ensure achievement of the goals.
  • Improve the collection, reliability, timeliness, and use of data to measure processes of care, outcomes, and to support the ESRD Network program.

The Institute of Medicine's definition of quality is used to define quality care, which is: "The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." CMS has defined rehabilitation for the purpose of this contract as restoring an individual to the maximum level of independence and quality of life that an individual can achieve.

The Network shall achieve these goals through the development and implementation of the work requirements outlined in this SOW.

The ESRD Network Program Health Care Quality Improvement Program (HCQIP) Mission

The Network, in conducting the activities listed in this SOW assists CMS in achieving the strategic goals and the mission of the HCQIP. The ESRD Network Program HCQIP supports achievement of the strategic goals by assuring patient centered, effective, safe, efficient, equitable, and timely care delivery to individuals with ESRD, specifically:

  • Patient Centered: Care delivery and processes of care are focused on patient needs, concerns, values, and expressed priorities. Care givers are empathetic and care is provided in a compassionate, responsive manner.
  • Safe: Patients receive safe care in ESRD facilities. Systems of care are designed to allow staff to anticipate and prevent, or minimize adverse events, learn from system failures, and seek system improvements. Care givers trained to recognize and anticipate errors and recover from them.
  • Effective: Care givers use scientific knowledge, evidence-based guidelines, and best demonstrated practices to offer individuals with ESRD the best available care. Care givers use this medical advice and consider the individual preferences of patients to derive effective care plans.
  • Efficient: National and local resources are used efficiently to deliver high quality care. Only those administrative and production costs that ensure high quality care are included in program operation.
  • Equitable: Care provided to an individual with ESRD does not vary in quality because of personal characteristics or socio-economic status.
  • Timely: Dialysis facilities have processes in place to measure and minimize unnecessary delay in provision of services; healthcare interventions occur neither too soon nor too late.

Implementation of the HCQIP will result in achievement of the strategic goals as demonstrated in such areas as:

  • Measurable Outcomes Achievable by patients and caregivers using valid evidence based measures of performance, developed through broad consensus, and that have strong correlation to patient outcomes (e.g., quality of care, quality of life, hospitalization, mortality, perception of care and experience of care);
  • Cultural Change: Renal coalitions at the national and local level work together for the benefit of the patient employing "spread" technique to share and promote success. Individuals are informed, prepared, and involved in making choices as they move through the continuum of care from early ESRD to end of life. Patients and providers have a respectful relationship where a patient's informed choice is honored. An individual that progresses from CKD to ESRD receives appropriate care, with patient education and informed choice guiding appropriate renal replacement therapy (RRT). Preparation for RRT includes timely vascular or peritoneal access, referral to transplant centers for evaluation, and discussion of all possible modalities including those that are self-care and self-directed, when appropriate.
  • Process Redesign: Rapid cycle improvement is employed by the Networks. Data elements collected are defined and data reports generated to assure high quality care. Redundant or unnecessary data elements are identified and eliminated. Information technology is used in partnership with providers to increase efficiency, accuracy, and timeliness of data collection and reporting. ESRD Networks work with the care givers, facilities, and other representatives of the renal community in an inclusive and collaborative manner to assure provision of quality care.

Results of the HCQIP program are publicly reported (e.g., dialysis facility compare) to beneficiaries and open communications occur with providers in order to: promote informed health choices; protect individuals from poor care; and strengthen the health care delivery system.