ESRD Network 18 - QI Tools & Forms

QI Tools & Forms

2008 Quality Improvement Manual (pdf)
QI Manual: Section I Only - Introduction to QAPI (pdf)
QI Manual: Section II Only - Quality Assessment & Performance Improvement (pdf)
QI Manual Section III Only - MRB Statements & Resources (pdf)

Forum Medical Advisory Council (MAC) Toolkits
The Forum MAC has developed a series of QAPI toolkits to assist dialysis facilities in meeting the requirements of the Conditions of Coverage which are as follows:
Catheter Reduction Toolkit, Assurance of Diabetes Care Coordination Toolkit, Medication Reconciliation Toolkit and Vaccination Toolkit.

QAPI Hemodialysis Package (excel)

Immunization

The Vaccination Toolkit

Safe & Timely Immunizations Coalition - A Comprehensive Resource Guide of Educational Materials on Hepatitis B, Influenza, and Pneumococcal Immunizations (PDF 285 page document)

Give These People Influenza Vaccine! (PDF)

Guidelines for Vaccinating Kidney Dialysis Patients and Patients with CKD (PDF)

Hepatitis B Vaccination Tracking Form (PDF) (Word)

How Can I Protect Myself and My Family From An Influenza Pandemic? (Word)

Influenza Vaccine Information Statement (VIS) 2007-08 English / Spanish (PDF)

Influenza Vaccine Tracking Form (PDF) (Word)

It's Federal Law...Vaccine Information Statements (VISs) (PDF)

Quick Reference Information: Medicare Immunization Billing
Procedure Codes & Descriptors, FAQs, etc.

Transplant Referral Documents

MRB Statement
Transplant Center: Long Term Plan, Annual Review, Matrix, Control Form, Directory, and Log Form

Quality Assessment and Performance Improvement (QAPI)

Albumin Run Chart (PDF)

Anemia Run Chart (PDF)

QAPI Plan and Guidelines for Using the PDSA Process (Word)

Dialysis Adequacy Run Chart (PDF)

Fishbone (Cause & Effect) Diagram and Instructions (PDF) (Word)

"Improving on the Fishbone" Article (PDF)
Effective Cause-and-Effect Analysis: Cause Mapping - By Mark Galley

Medical Records Model

Non-Standard Bath Use in Adult Chronic Hemodialysis

2007 CPM Outcome Comparison Tool - PD (PDF)

Vascular Access Tracking Form (PDF) (Word)

Vinegar Use in Hemodialysis

Network 18's Clinical Performance Goals

2009-2010 Clinical Performance Goals (Word)

2008-2009 Clinical Performance Goals (Word)

2007-2008 Detail Plan for Clinical Indicators (PDF)

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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 & Forms

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 & Forms

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.