Beyond striving to achieve industry-leading outcomes for our patients, DaVita® and our physician partners are continuously innovating new programs to raise the standard for kidney care, reduce healthcare costs and improve access to care for all patients—not just our own.
It is not enough to focus our quality improvement initiatives on individual clinical outcomes. If we truly want to shape the future of kidney care, we must look at our patients wholly and tailor treatments to their unique health conditions. This holistic approach, which includes vital services beyond dialysis, achieves three key results:
With intensive collaboration, constant communication and unyielding focus, we and our physician partners are “moving the needle” on clinical care. To us, growth is not just continuously improving at what we already do, but branching out in innovative ways that benefit nephrologists and their patients.
A few of the many clinical initiatives that help DaVita physicians achieve excellent outcomes are:
IMPACT™: DaVita's IMPACT care management program improves outcomes and reduces mortality rates by focusing on the first 90 days of dialysis, when patients are at highest risk for serious and potentially fatal complications.
CathAway™: DaVita's CathAway program helps transition patients from central venous catheters (CVCs) to arteriovenous fistulas, reducing the risk of hospitalization from infections and blood clots.
Vaccinations: DaVita's pneumoccocal pneumonia and influenza vaccination initiatives lead the industry and help foster a safe environment for patients and the clinical team. In 2012, DaVita vaccinated 91 percent of patients for each.
SHAPE (Stable Hemoglobin Anemia Program Effort protocol): SHAPE is a large-scale effort to manage anemia through computerized algorithms. The goal is to provide a protocol that, with greater than 90 percent adherence to protocol orders, achieves a high percentage of patients with Hb in the 10-12 g/dL target range, while maintaining excellence in below-target outcomes and minimizing above-target results. These targets are in the CMS Clinical Performance Measures (CPMs) for anemia management in dialysis patients, and are consistent with both the CMS pay-for-performance Quality Improvement Program (QIP) measures for dialysis facilities and the FDA prescribing information for Epoetin alfa.
DigiQIFMM: CMS requires dialysis facilities to hold quality improvement (QI) meetings as part of their conditions for coverage, but does not specify how they should be conducted. DaVita created a tracking form called QIFMM (Quality Improvement and Facility Management Meetings), and when this form went digital in 2010, it greatly accelerated the decision-making process for facility administrators launching improvement plans.
Zen Tool: Zen is a unique physician mineral and bone disorder (MBD) management tool that facilitates simultaneous review of key biochemical markers and provides guidance for adjusting related medications, including phosphate binders, vitamin D sterols, calcimimetics and diet counseling. A computer-generated report graphs individual patient trends, response to therapy and movement toward a combined goal.
MBD Scorecard: DaVita developed a combined MBD scoring system that evaluates, tracks and communicates the effectiveness of MBD management processes monthly at the facility level. Each facility is awarded a score determined by preassigned weights for each clinical indicator and based on a percentage of patients achieving key MBD targets.
In addition to improving the quality of care for all patients, these initiatives are helping to lower the cost of healthcare in the United States. Although ESRD patients comprise 1.3 percent of Medicare patients, they make up 7.5 percent of total Medicare costs, in large part because of hospitalization costs associated with their comorbid care. By reducing hospitalizations through our holistic approach to kidney care, DaVita is generating significant savings to the American healthcare system.
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