Who's taking care of whom?

by Gary Peterson    

NephrOnline has an article about four major kidney patient groups asking Congress to help correct the ESRD transition adjuster rate. 

"The American Kidney Fund, Dialysis Patient Citizens, National Kidney Foundation and Renal Support Network last week sent joint letters requesting Congress intervention to fix the transition adjuster to House and Senate leadership as well as select committee leadership."

This strategy seems to be the same one used by large providers for the last two decades to win increases in the composite rate.  In the past, individual patients were encouraged to sign form letters expressing concern about the falling quality of care.  Today, patient organizations -- which rely heavily on corporate contributions -- are playing that role. 

And has the quality of dialysis care has declined?  

None of these "patient" organizations provided any commentary on the ProPublica/Atlantic articles that appeared earlier this month on the quality of dialysis patient care.

The only person that I have heard publicly address the content of the articles and insist that they "should cause a sense of outrage" is....  Dr. Barry Straube.

 

Comments

[Roberta Mikles RN]

Our group, Advocates4QualitySafePatientCare www.qualitysafepatientcare.com is comprised of those patients who have experienced retaliation/intimidation for speaking out to ensure they received safe care. These individuals, speak through myself, as their spokesperson, as they continue to face fear, either covert or overt. We appreciated Dr. Straube's comment and we have been outspoken regarding delivery of care in many units for six years now. I, myself, as a family member and advocate, have attempted at various levels to try and get someone to listen.. often, met with deaf ear.

Dr Straube's comment "should cause a sense of outrage', in all due respect, should have been stated years ago and should have been the beginning of every conversation with every person related to dialysis, including at each open-door forum.

Although there are many problems within the survey process and often providers identify various reasons for cited deficiencies, e.g. paper error, staff nervous during survey process, new Conditions etc., the fact remains that there are preventable errors (identified during survey) that result in potential or actual harm. Further, everyone involved in the dialysis arena has been well-aware of such. So, why has there been no change in the level of oversight and enforcement? --->>> Who Is Taking Care of Whom?

We continue to hear from patients that nothing has changed since the new Conditions or mandated dialysis technician certification. Someone needs to take a very close look at the surveys. Patients have even told me that they, when asked by Surveyors, will not speak up for fear that their facility staff will find out. We need a complete 'overhaul' of this system.

Roberta Mikles, RN BA
Advocates4QualitySafePatientCare
www.qualitysafepatientcare.com
San Diego, CA

[Dori Schatell]

I saw that article, too, Gary, and wondered why it was the "ESRD transition adjuster rate" (frankly, I'm not even certain exactly what that IS) that these groups chose to collaborate on. But, I didn't wonder too hard...

What I'd LIKE to see dialyzor groups come together on is advocacy to get CMS to follow through on policy changes to increase access to more frequent HD in light of the FHN study results. Getting rid of the requirement for medical justification for a 4th treatment would make it far easier to offer short daily HD, and truly would save lives.

[River Curtis-Stanley]

I'd love to see dialyzors empowered to speak up anonymously about conditions affecting their lives, their centers, their quality of life, and their emotional state without being quizzed by their centers on why they feel the way they do. Surveys are all well and good if the patient wants to answer them, but what about those who would rather give the information without giving out their names, dialysis times, locations, etc.? Especially when it comes to psychological issues?