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Welcome to ESRD Network 18
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Our Mission

To provide leadership and assistance to renal dialysis and transplant facilities in a manner
that supports continuous improvement in patient care, outcomes, safety and satisfaction.



QI Tools: Forum Medical Advisory Council (MAC) Tools

The Forum of ESRD Networks' Medical Advisory Council (MAC) has developed the below series of QAPI toolkits to assist dialysis facilities in meeting the requirements of the Conditions for Coverage:

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arrowCatheter Reduction Toolkit
arrowDiabetes Care Coordination Toolkit
arrowMedication Reconciliation Toolkit
arrowVaccination Toolkit

2009 Catheter Reduction Toolkit (PDF)

Working Documents: red line
arrowCatheter Reduction Worksheet (excel)
arrowInteractive Tool CVC Reduction Worksheet (excel)
arrowOn Goal Report Catheter Reduction Tool (excel)
arrowPDSA Worksheet (word)
arrowQAPI - Keeping Track of Accountability Form (word)
arrowQAPI Worksheet (word)
arrowReferral Letter - Alternative Access (word)
arrowReferral Letter - PD Catheter (word)
arrowHemodialysis Access Referral - Existing Access (word)
arrowHemodialysis Access Referral - New Access (word)
arrowReferral Letter - Non-maturing Fistulae (word)
arrowReferrral Letter To A Surgeon (word)
arrowRefusal Form (word)

2009 Assurance of Diabetes Care Coordination Toolkit (PDF)

Working Documents: red line
arrowDiabetes Care Coordination Barriers Questionnaire (excel)
arrowDiabetes Patient Passport Example 1 (word)
arrowDiabetes Patient Passport Example 2 (word)
arrowDiabetes Patient Passport Example 3 (word)
arrowPDSA Worksheet (word)
arrowQAPI Action Plan: Designation of DM Care Provider Form (word)
arrowQAPI Action Plan Form (word)
arrowSample Physician Referral Letter - CAPD Patient (word)
arrowSample Physician Referral Letter - CCPD Patient (word)
arrowSample Physician Referral Letter to Endocrinologist (word)
arrowSample Physician Referral Letter to Podiatrist (word)
arrowSample Letter to Peritoneal Dialysis Patients who use Icodextrin (word


2009 Medication Reconciliation Toolkit (PDF)

Working Documents: red line
arrowSample Data Analysis for Medication Reconciliation Worksheet (excel)
arrowSample QAPI Plan (word)


2009 Vaccination Toolkit (PDF)

Working Documents: red line
arrowSample: Vaccination CQI Action Plan (word)
arrowImmunization Data Collection Worksheet - Influenza (excel)

arrowImmunization Data Collection Worksheet - Hepatitis B (excel)
arrowImmunization Data Collection Worksheet - Patient Record (excel)
arrowImmunization Data Collection Worksheet - Pneumovax (excel)
arrowImmunization Data Collection Tool (excel)
arrowImmunization Monthly Intervention Tracking Tool (word)


 

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Copyright © 2012 The Southern California Renal Disease Council / ESRD Network 18