Patient Experience and Access to Care

Qsource ESRD Network 12 continues to actively seek ways to understand and if possible, reduce the incidence of involuntary patient discharges — particularly for the reason of non-adherence to treatment. Included here are resources to assist in identifying and dealing with difficult patient situations

• Forum of ESRD Networks Grievance Toolkit
• Network 12 IVD Memo
• Involuntary Discharge/Transfer Checklist
• When Patients Don’t Come to Dialysis
• Five Whys Root Cause Analysis – Missed and Shortened Treatments
• Minutes Matter – The Risks of Shortened or Missed Treatments

Understanding the Conditions for Coverage related to Involuntary Discharge

This on demand webinar provides an overview of the ESRD CfC’s regarding IVDs, the sanctioned reasons for an IVD/IVT, the steps required for an IVD by facilities, actions to take to prevent IVDs and the Network role and review process.

• View the Recording
• Download the Slides
• Complete the Evaluation

Decreasing Dialysis Patient-Provider Conflict (DPC)

• Decreasing Dialysis Patient-Provider Conflict (DPC) Overview

The Decreasing Dialysis Patient/Provider Conflict (DPC) toolkit is a wonderful tool to help staff manage conflict effectively, improve communication, and increase patient and staff satisfaction. Conflict is never easy and the unique characteristics of the dialysis setting can make it even more challenging. The DPC was developed by a national group of dialysis professionals and is recognized as a resource for decreasing involuntary discharges in the ESRD Conditions for Coverage. The DPC toolkit includes several tools to assist with both staff training and quality improvement. The training aims to decrease patient-provider conflict by building conflict resolution skills, improving communication and increasing understanding of how interactions with patients, their families and other staff may trigger or escalate conflict in the dialysis setting.

To learn more about or to re-visit this resource check out the DPC Overview provided. The manual can be downloaded by visiting the NCC website or if you’d like a hard-copy (with the interactive CD) complete the Network Resource Request form.

Resources on De-escalation Strategies and Violence Prevention

In recent years, the Network has seen an increase in the number of involuntary discharges due to an immediate severe threat. Although these events cannot always be prevented, we recognize that it is helpful for staff to feel confident in their skills of de-escalation and communication when dealing with a difficult situation. We encourage your team to review the following video series as part of your facility in-service trainings and use them to guide a discussion on how the skills reviewed can improve patient-centered care.

Verbal De-Escalation of the Agitated Patient. University of Colorado School of Medicine. Simpson SA, Rylander M, Medlin H, Albert L. May 2017.

Chapter 1: Identification and assessment of agitation

Chapter 2: Basic Elements of Verbal De-Escalation

Chapter 3: More practice with verbal de-escalation

Chapter 4: Advanced skills in de-escalation

Chapter 5: Personal safety and escape skills