Change Concept 11: Outcomes Feedback to Guide Practice

Facilities can start by measuring performance on a monthly basis by access type – catheter, AV graft, and AV fistula – since access type is the major determinant of outcomes and directly affects dialysis delivery and adequacy.  It is also important to focus specifically on native AV fistula outcomes and performance, including tracking the monthly AV fistula placement and failure rate in incident as well as prevalent patients.

• Networks work with dialysis providers to give specific feedback to all decision-makers on incident and prevalent rates of AVF, AVG, and catheter use.
• Review data monthly or quarterly in facility staff meetings. Present and evaluate data trended over time for incident and prevalent rates of AVF, AVG, and catheter use.

Changes for Improvement

Provide Specific Outcomes Feedback to All Decision Makers

Provide specific outcomes feedback to all decision makers, including incident and prevalent rates of AV fistula, AV graft, and catheter use. The ESRD Networks are currently working with dialysis providers to collect and provide this information regularly to each facility.

Review Data Monthly or Quarterly in Facility Staff Meetings

Discuss and evaluate data trended over time for incident and prevalent rates of AV fistula, AV graft, and catheter use. Track and disseminate all vascular access-related outcomes.