1999 Annual Statistical Report
B. Network Structure
1. Staffing
The Renal Network employs 14 full and part-time employees. Those employees include:
Committees:
Network Coordinating Council: The Network Coordinating Council is composed of representatives of dialysis providers from hospitals and other facilities located in the states of Illinois, Indiana, Kentucky, and Ohio. The hospitals and facilities are certified by the Secretary of Health and Human Services to furnish at least one specific end-stage renal disease service. The Network Coordinating Council includes a representative of each of the current Medicare approved end-stage renal disease facilities. Each facility has a single representative, designated by its chief executive officer or medical director, who is approved by the governing board of the facility. The Council is responsible for the election of members to the Board of Trustees and the Medical Review Board. Elections are held by mail-in ballot. The Council meets once annually. During 1999, the Council met on May 20.
During 1999, the following occurred:
Financial statements for year-end 1998 and year-to-date were disclosed.
The 1999 slates for membership on the Board of Trustees and Medical Review Board were presented and approved. Nominations were accepted from the floor and at the annual meeting in May. Members were elected to both committees by mail-in ballot in the fall. Terms of office were to begin on January 1, 2000 and end on December 31, 2002.
1998 data were presented and the 1998 Annual Report was approved.
The Network Coordinating Council was updated on activities with HCFA and the Forum of Renal Networks, and contract issues.
A bylaws change was approved to transfer governing ability from the Network Coordinating Council to the Board of Trustees.
The 1999 Nephrology Conference was held at the Indianapolis Convention Center and Westin Hotel, in Indianapolis, Indiana on May 19, 20, and 21. The Conference held educational programs for administrators, physicians, nurses, social workers, dietitians, and technicians.
Dialysis facilities within Networks 9/10 were informed of and participated in the HCFA Core Indicators Project and the Anemia Study.
Board of Trustees: The Board of Trustees is the chief governing body of ESRD Networks 9/10. The Board of Trustees holds the Network contracts for ESRD Network 9/10 with the Health Care Financing Administration, and is responsible for meeting contract deliverables and oversight of the administration of the Network budget.
The Board of Trustees is composed of 20 members, elected for three year terms of office including:
The Board of Trustees met in person on January 29 – February 1, March 24, June 16 and October 13, 1999.
Members of the Board of Trustees for 1999 were:
During 1999, the Board of Trustees accomplished the following:
Network financial records were reviewed and expenditure reports approved.
The Board of Trustees heard updates from the Medical Review Board, the Patient Advisory Councils, the Nominating Committee, and the Program Committee. These updates included committee activities and action items.
The Board of Trustees was updated on activities with HCFA and the Forum of ESRD Networks, and contract issues.
The Board of Trustees participated in a strategic planning session. Members discussed how to incorporate the core purpose, the core values, and the goals of the Network into current and future projects of The Renal Network, Inc.
Medical Review Board: The Medical Review Board (MRB) is composed of 35 members, elected for three year terms of office including:
The Medical Review Board functions with the concurrence and subject to the review and control of the Board of Trustees. It performs functions prescribed by the regulations issued by the Secretary of Health and Human Services, as well as other duties related to quality improvement, vocational rehabilitation, and patient concerns as requested by the Network Coordinating Council. The MRB met on February 9 and 10, May 18 and 19, September 14 and 15, and November 16 and 17, 1999.
Members of the Medical Review Board for 1999 were:
During 1999, the Medical Review Board:
Continued the distribution of The Physician Activity Report. This report, shows Network nephrologists their patients’ core indicator data as reported via the unique physician identification number (UPIN). These reports were mailed to more than 600 nephrologists at three times during 1999: March, July, and October. Additional data was provided to Illinois nephrologists in September, showing national core indicator data compared to regional core indicator data. This data was targeted to Illinois because of the concern for the low national ranking in Kt/V and URR indicators in the Illinois data.
Implemented the first Quality Improvement Project (QIP) of the new HCFA-Network contract. The QIP looks at physician practices in prescription and adequacy measurements in the area of peritoneal dialysis. A study protocol and data collection instruments were sent to all peritoneal dialysis programs within Networks 9/10.
Implemented the second QIP in the area of vascular access. The central venous catheter rate in Networks 9/10 has been one of the highest in the nation according to the Centers for Disease Control & Prevention data, 1995-97. The MRB identified this process of care as an opportunity for improvement. The goal of the QIP is to lower the Networks 9/10 catheter rate.
Began the process of establishing a repository of Network data, called The Renal Network Data System (TRNDS). The purpose of the repository would be to encourage members of the Network, as well as the renal community at large, to use the data for their research purposes.
Oversaw the dissemination of a Facility Profile, which displays descriptive data from each facility, with comparisons of regional, state, Network and national statistics for those same areas, include demographic and diagnosis data. Included also are SMR and gross mortality. These profiles are distributed annually to each facility to help them in their continuous quality improvement efforts.
Oversaw the activities of the Pediatric Renal Group, a subcommittee of the Medical Review Board. The goal of the group is to act as a resource to the Network on the care and treatment of pediatric dialysis and transplant patients.
Received continuous updates on the activities of the Health Care Financing Administration and the new Scope of Work, the United States Renal Data System (USRDS), The Forum of ESRD Networks, and the Quality Assurance Committee of The Forum.
Reviewed data profiles, including rates for mortality, home therapy, and transplantation.
Reviewed grievances filed with the Network.
Oversaw the implementation of the HCFA clinical performance measures project.
Oversaw and participated in the development and implementation of the Core Interventions Project.
Patient Advisory Councils: The Patient Advisory Councils (PAC) operate as four distinct councils in the states of Illinois, Indiana, Kentucky and Ohio. Membership is composed of an appointed representative and an alternate from dialysis and transplant facilities who choose to participate on the Council. At the end of 1999 there were more than 200 PAC Reps throughout the Network. During 1999:
PAC material was revised to include levels of PAC activities and involvement.
Information about the PAC was sent to each facility to verify the status of its PAC Rep or to recruit a PAC Representative and Alternate.
The second edition of the PAC newsletter, PAC ActionGram, was sent to PAC Reps. The focus was on nutrition and contained resources and a mini-poster to be posted in the facilities.
Social workers and PAC Reps were sent the results of the PAC Activity Report. PAC Reps primarily meet new patients, hand out Network resources, and post educational information on the bulletin board.
Patient Leadership Committee: The Patient Leadership Committee's (PLC) purpose is to identify and address ESRD patient needs and concerns through the development of educational projects and activities. It focuses on the overall needs of renal patients in the Network. Its membership includes the state PAC Chairpersons and Vice-Chairpersons, patients from the four- state area who represent the four modalities of treatment, and staff members from each state.
The PLC had four subcommittees during 1999:
The Pediatric Subcommittee focused on the educational needs of pediatric renal patients and their families. The committee developed the game cards for the renal component of the game, ESRD Special Edition of Adventure Park and started working on game cards for a game to be produced by Chronic Care Challenges. It also worked with Indiana University/Purdue University media students to develop a CD-ROM educational game.
The Family Subcommittee focused on the needs of family members and worked on articles to be published in the patient newsletter, Renal Outreach.
The Renal Outreach Subcommittee reviewed the format of the Renal Outreach and designed sections for special features and question and answer columns. They made recommendations for the newsletter’s format and created a sample edition.
The Patient Issues Subcommittee focused on patient and PAC needs. They completed the revisions for the Network’s Patient Rights and Responsibilities to make it easier to understand, reviewed and made suggestions on the draft of levels of PAC activities and discussed ways to keep PAC Reps abreast of new material.
The PLC met on March 12, June 10, September 10, and November 4, 1999.
The following were members of the Patient Leadership Committee during 1999: