F. Community Outreach Activities.
The Renal Network acts as a clearinghouse to provide information concerning ESRD technology and treatment advances to ESRD professionals, patients, and other interested persons and organizations. Information received or generated by the Network was disseminated to the appropriate individuals at the discretion of the Executive Director or other appropriate staff persons. During 1997 information was distributed Network-wide in the following manner:
1. Patient Newsletter, Renal Outreach.
The Renal Network publishes a newsletter for patients in the four-state area three times a year. While ESRD patients are the primary audience, ESRD professionals and members of the renal community receive the newsletter, as well. In total, about 10,000 copies are distributed with each mailing.
Renal Outreach provides a continuing means of communication to all patients within the Network. It contains information on new therapies, medications, nutrition, exercise, and general topics of interest, as well as news of Network and Patient Advisory Committee activities. Patients are encouraged to submit their ideas for articles and to write articles for the newsletter. Each newsletter contains at least one article written by a patient.
2. Network 9 Handbook - Policies and Procedures.
The Network 9 & 10 Handbook was developed to ensure all member facilities are continuously apprised of Network policies and procedures as approved by the Network Coordinating Council. The Handbook is updated periodically as policies are developed or are amended. One copy of the Handbook is supplied to each dialysis facility within the Network area.
3. Professional Newsletter, Progress Notes.
During 1997, The Renal Network continued publication of a newsletter intended for the nephrology professionals in the local renal community. This newsletter, Progress Notes, contains information on business of the Network, legislative news and treatment information. It is distributed to about 3,500 renal professionals and Patient Advisory Committee members.
4. Patient Handbook, Living With Kidney Disease: A Patient Manual.
During 1997, The Renal Network continued to distribute its patient manual to ESRD providers within the Network. The manual provides an overview of many different aspects of kidney failure, such as treatments (including transplantation), diet, exercise and activity, Medicare and insurance. The manual was made available, free of charge, to each dialysis patient and facility in the Network through the social worker.
5. Other Activities.
As events warrant, informational bulletins are sent to the appropriate individuals. These releases of information may be sent to committee members, council members, professional disciplines, patients or other related organizations. If necessary, a general release may be sent to all interested parties.
News of general interest is included in the newsletters of the Network to ensure that the network membership is kept informed of activities on a continuing basis. The Network maintains a mailing list, by category, on computer to facilitate clearinghouse functions. This listing is continuously updated to provide an efficient mailing process.
Additionally, the Network responds to individual requests for information as these are received. The requests come from a variety of individuals, from dialysis patients and family members, renal professionals, students, researchers, and planning organizations and/or dialysis corporations.
6. ESRD Community Relations
The Network uses its database as a constant source of information on the ESRD population for the renal community. During 1997, the Network filled requests Annual Statistical Report data, for ZIP Code and county data, for facility demographic profiles, for SMR data, for core indicator data, and compliance data.
Data requests are received continuously from a variety of interested parties, including:
7. Nephrology Conference
In combining its roles as an information clearinghouse and a professional renal association, The Renal Network sponsors the Nephrology Conference each year. The 1997 Nephrology Conference was held on May 13, 14, and 15 at the Radisson Hotel in Indianapolis, Indiana. The annual, three-day event is designed to allow members of the Network to come together to conduct Network business while providing educational opportunities and allowing for the exchange of ideas among members of the renal community in Illinois, Indiana, Kentucky and Ohio.
The goal of the Conference is to offer a multi-disciplinary scientific seminar, individual meetings of different professional groups, and to provide awards to those individuals and facilities who have excelled in meeting of Network goals during the year. These activities are planned in conjunction with meetings of the Medical Review Board, Executive Committee and the Network Coordinating Council.
The Network recognizes achievement among its members by presenting awards for individuals who have made outstanding contributions to the Network, and also who have gone above and beyond the minimum to meet network reporting requirements, both in data and quality assurance.
The event is organized by the Network Planning Committee to ensure input from the Network members. Additionally, Network-wide professional groups for administrators, social workers and registered dietitians were formed to facilitate planning individual sessions for these disciplines. The Network works in conjunction with the American Nephrology Nurses Association to plan a full-day session for nurses. All programs are designed to provide continuing education credits for participants, which enhances the value of these offerings to Network members.
To further integrate the conference into the renal community, businesses dealing in renal products were invited to exhibit during the event. This served the dual purpose of providing useful information to conference participants while underwriting the event through these sponsors.
The Medical Review Board developed a "Policy and Procedure to Evaluate Formal Complaints" to address grievances filed with the Network. This policy is in compliance with the HCFA national policy for evaluating and resolving patient grievances. In addition, a special subcommittee of the Medical Review Board is designated to deal with filed grievances.
The Network 9 grievance policy was written and approved by the Medical Review Board, approved by the Executive Committee and approved and adopted by the Network Coordinating Council. A copy of the policy was then distributed to all facilities within the Network area. An article explaining the grievance policy was also published in Renal Outreach, the patient newsletter of Network 9 & 10.
Network staff members routinely handle many requests for assistance directly from patients and their families, as well as facility staff members. These requests mainly involve supplying information from various sources available to the Network, such as location of dialysis centers, help with transient dialysis, location of isolation stations, specific federal regulations, etc. In some instances, the Network may act as a go-between, making an initial contact for an individual who is seeking assistance.
In total, the Medical Review Board heard 10 grievances during the course of 1997.
The area of renal rehabilitation was addressed in a number of ways by the PAC, the PLC, and Patient Services; the following actions were accomplished during 1997:
III. NETWORK ADMINISTRATION
At the beginning of 1997 all dialysis and transplant facilities within the Network were participating as required by HCFA and The Renal Network. At year-end 1997, all dialysis facilities within the Network 9 & 10 area were participating as required by HCFA and The Renal Network.
B. Need for Additional/Alternative Services
Each year through the patient tracking system, The Renal Network conducts a review of facility operations. From this report the following information is available:
"Services Rendered," describes each facility by area of location within the Network and the modes of therapy offered.
"Current Operations," shows the number of stations currently operating at each dialysis facility within the Network.
"Patient Capacity by Facility," calculates the total number of patients that could dialyze at each facility based on the number of shifts and stations available at that facility.
"Utilization," identifies the actual utilization of each dialysis facility at year end 1997.
"Pediatric ESRD Facilities," shows the number of stations currently operating at each pediatric dialysis facility within the Network.
During 1997 no requests were made to the Health Care Financing Administration for sanctions of area facilities.
IV. DATA MANAGEMENT
The Renal Network has designed a patient medical information system to enable the continual assessment of the ESRD patient population. A computer system has been designed to integrate data, generate internal reports, and contribute to the national database.
The data processing system is based on the generation of HCFA mandated forms and a Network tracking report by ESRD facilities. These forms provide the necessary information and updates that assure the accuracy of the data system.
HCFA Medical Information System (MIS) Forms that are processed through the Network office include:
As these forms are received in the Network office, they are input on the patient data base, a HCFA logging program, and a compliance program, and forwarded to HCFA.
The Network 9 & 10 Data Department routinely completes the following activities:
A compliance program was implemented in January 1992. The program tracks compliance for forms submission and completion by each facility. The program generates a report showing each facility, which forms were received, and whether or not they were compliant. It also generates a master report showing compliance rates for all facilities within the Network. Compliance rates are reviewed monthly by Network staff. Quarterly, compliance reports are generated and sent to the facilities. The Medical Review Board reviews compliance rates for those facilities who fall below the HCFA goals at their quarterly meetings.
Compliance rates for calendar year 1997 are as follows:
| Timeliness: | Illinois | 83.6% |
| Indiana | 91.6% | |
| Kentucky | 92.6% | |
| Ohio | 86.2% | |
| Network 9/10 | 86.9% | |
| Accuracy: | Illinois | 96.4% |
| Indiana | 96.7% | |
| Kentucky | 96.7% | |
| Ohio | 96.1% | |
| Network 9/10 | 96.4% |
A tracking form is used to update the patient information on a bimonthly basis. Each ESRD facility receives a copy of its tracking report bimonthly. All are expected to make appropriate corrections, additions, and/or deletions and return the report to the Network office. This information is then entered into the database.
During 1992, a program was developed to electronically transmit data from ESRD facilities to the Network office. The program mirrors the "paper" tracking system. The program was pilot tested in the spring and summer of 1993 and made available to all Network 9 facilities in the fall of 1993. During 1994, the program was implemented in facilities throughout the Network and became the most utilized of the two systems.
The data system has unlimited capability to collect information on ESRD patients. Currently, approximately 30,000 active and inactive patient listings are in the system. Information collected on each patient includes:
After the data is computerized, it is then available for statistical manipulation. Various statistics and data profiles are generated through the Network data system as described earlier in this report. The data tables contained in this report were generated through the Network data system as well.