Please take a moment to provide some feedback regarding the lack of patients entering a home modality. Also include efforts to implement processes to get patients trained on a home modality.

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* 1. Select your facility from the drop down below.

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* 2. What is your email address?

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* 3. What do you believe is the main reason patients in your facility are not beginning home modality?

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* 4. What quantitative measure  are you using to determine if your interventions are resulting in a positive outcome? (Quantitative Measures involve the collection of specific numbers, which is the opposite of qualitative data, that are observations)

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* 5. What successes have your home modality education/interventions provided?

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* 6. What challenges have you experienced?

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* 7. Does your corporate entity utilize an algorithm for internal tracking of home modality training starts?

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* 8. If yes to Question #7, does your facility fully utilize this algorithm? Explain below:

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* 9. If no to Question #7, will/has your facility developed an algorithm? Explain below:

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* 10. Please describe your plan to have at least one patient trained on a home modality by the end of this project?

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* 11. Would you be interested in partnering with a home champion facility?

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* 12. How much time did it take to complete this survey?

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