Memphis Area Fistula First Coalition
All people with CKD will receive early diagnosis, education and treatment to delay or avoid the need for dialysis. Those choosing hemodialysis will be offered an evaluation for placement of AV fistula.
The Memphis Area Fistula First Coalition will strive to form effective partnerships, share prevention goals, and will enhance community efforts to delay or prevent the onset of end stage renal disease. For those who do progress to end stage, MAFFC will promote; patient education and empowerment to avoid inferior access types; process changes in care transitions to maximize the opportunity for fistula creation in individuals requiring hemodialysis; referral networks based on evidence-based outcomes; participation by nephrologists and surgeons in Fistula First goals and; active identification and reduction of barriers where feasible.
Achieve a fistula prevalence rate of 60% and a fistula incidence rate of 40% by the end of 2012.
- To work with area hospitals to modify systems to detect CKD and promote AV fistula planning and placement as stated in FFBI Change Concept #12.
- To provide ongoing educational opportunities related to vascular access management to the Memphis area renal professionals.
Activities and Accomplishments:
- “Central Venous Occlusion (CVO) Repair & The Hemodialysis Reliable Outflow (HeRO) Device: ‘New Options for Intervention & Access”, workshop for nurses and PCTs, February 21, 2012, Memphis, TN.
- “Central Venous Occlusion (CVO) Repair & The Hemodialysis Reliable Outflow (HeRO) Device: ‘New Options for Intervention & Access”, dinner for physicians, February 22, 2012, Memphis, TN.
- We Can - Cannulation Workshop, May, 2, 2012, Cleveland, MS
- We Can – Cannulation Workshop, May 3, 2012, Memphis, TN.
- "Assessment, Mangement and Cannulation of the Dialysis Vascular Access" workshop, July 25, 2012 - live in Knoxville, video conferenced to Nashville and Memphis
- "Assessment, Management and Cannulation of the Dialysis Vascular Access" workshop, July 26, 2012 - live in Knoxville, video conferenced to Johnson City, Nashville, and Memphis
- "PAD in the CKD Patient" workshop, September 2, 2012, QSource Building, Memphis, TN.
- Dialysis facility staff attended Care Transition meeting in Jackson, TN on August 2nd and August 28th.
- Dialysis facility staff invitied to Care Transition Coalitions in Martin, Columbia, Nashville, and Chattanooga area.
- To provide educational opportunities to patients and caregivers to promote self-cannulation and other self-management principles.
- To develop and facilitate an initiative with Memphis area facilities to increase the percentage of self-care patients in these units.
Activities and Accomplishments:
- World Kidney Day, March 8, 2012, Baptist Hospital, Memphis TN, Coalition members exhibited.
- Session on "You are Part of Your Healthcare Team" at Tennessee Patient Meeting addressed being involved in your healthcare and vascular access management.
- Coaliton members continue to work on virtual toolkit on patient self-management
The Memphis Area Fistula First Coalition formed in October 2005 as the result of a CMS-ESRD Network contract requirement for coalition building. The ESRD Networks were allowed to choose the focus of the coalition, based on the scope of work as described by contract. Network 8, Inc., the ESRD Network of Alabama, Mississippi and Tennessee, selected the Fistula First project as the coalition focus and based the coalition in Memphis, due to the low prevalence of AVF use and high number of patients receiving care in the Memphis area.
Healthcare professionals and organizations were invited to participate in the coalition, and current organizations represented include area hospitals, dialysis facilities, AAKP, Amedisys Home Health, QSource, Memphis Blues Chapter of the American Nephrology Nurses’ Association, and the National Kidney Foundation of West Tennessee.
Coalition members identified the following strategies that could lead to improved vascular access outcomes in the Memphis area:
- Education/Public Awareness for providers/professionals
- Education/Public Awareness for patient and community
- Policy Changes – improve reimbursement rates for fistulas, change transportation rules – to be addressed nationally through the Fistula First Breakthrough Initiative
- Establishing vascular access coordinator positions in Memphis
- Development/Implementation of surgeon training
- Establish vascular access center(s)/recruitment of surgeons
For more information on how to become a coalition participant, contact Brenda Dyson at the Network 8 office.