February QIA Activity Report

Please provide updates and feedback by February 28, 2019.  

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* 1. Which QIA(s) are you reporting for?

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* 2. Please select your facility from the drop down list below; facility name, CMS Certification Number (CCN - 33-XXXX), and city/town have been included.

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* 3. Your name and contact information

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* 4. Does your facility have

  Yes No
Home Therapies Training (PD or HHD) at your facility?
A relationship with a home training facility? (shared resources/speakers)
A relationship with a transplant facility? (shared resources/speakers)

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* 5. Has your facility performed an RCA for the QIA(s)

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* 6. RCA Method (e.g., Current Reality Tree, Failure Mode and Effects Analysis, Fault Tree Analysis, Fishbone Diagram, Five Whys Analysis, Pareto Analysis, )

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* 7. Please list your top three barriers (For each QIA Applicable)

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* 8. Has your facility assessed the process for educating patients about their treatment options?

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* 9. Do you discuss patient treatment options education (# of home therapy/transplant referrals) at QAPI meetings?

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* 10. Do you have staff in-services/education on Treatment Options?

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* 11. Comments or Questions about these QIAs?

Thank you for completing the January QIA MSR for your facility.
 
We appreciate your time and effort.
 
 
Please click on "DONE" to submit your responses to the Network
  
Quality Improvement Team
 
IPRO ESRD Network of New York
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