BRLA
Joined: 08 Nov 2003
Posts: 22
Posted: Thu Jan 15, 2004 2:32 pm Post subject: DIALYSIS PATIENT-PROVIDER CONFLICT (DPPC)
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With respect and credit to RenalWeb Board (i.e., understanding that all BB's are public information and with thought that info is shared for benefit of all dialysis patients and their advocates), the following is copied for your info and feedback:<
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>Peterson<
>Administrator posted 01-15-2004 08:10 AM <
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>January 15, 2004 - A report on dialysis patient-provider conflict (DPPC), sponsored by the ESRD Networks (web site) and prepared by Interactive Management Consultants, Ltd. (web site) aims to "ensure that patients and providers in the dialysis units are able to resolve the issues of conflict and improve the quality of care of all patients in the units."<
>Designing A Collaborative Action Plan With the ESRD Stakeholders<
>Report of the Dialysis Patient-Provider Conflict (DPPC) - A Consensus Project with the Participation of the Community of Stakeholders - 141 page document (pdf format)<
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>Majority convergence was achieved on four important actions as the highest priority. These are:<
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>Adopt the setting of national curriculum/standard of education for dialysis technicians;<
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>Increase reimbursement in keeping with inflation for dialysis so that financially stretched corporations can implement educational and other initiatives for DPPC;<
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>Adopt comprehensive regulations for the procedures and standards for limiting and terminating patient services at a facility; and<
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>Leverage dialysis units to ?make? social workers do what they are supposed to ? not be clerical workers.<
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>[This message has been edited by Gary Peterson (edited 01-15-2004).]<
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>We, at DEO, are always satisfied whenever there is any indication of forward movement to address concerns we have made public for years. Those noted above are steps in the right direction, but CMS, the Networks, and dialysis industry must understand and accept that we, advocates at DEO, are not about "paper", i.e., writing the best standards, guidelines, regulations, etc., WITHOUT IMPLEMENTATION OR OVERSIGHT THAT SUCH, IN FACT, WILL BE CARRIED OUT. We believe that our government and our medical professionals have the capability and knowledge to assure that dialysis patients in this country receive the best there is, and it will be that about which we will continue our struggle. The following are my personal positions; your feedback is welcomed and appreciated.<
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>DIALYSIS TECHNICIANS - It is imperative that technicians are adequately trained and demonstrate competency not only in "book knowledge" but that they possess experential skills, from supervision of licensed/registered medical staff, before they are delegated sole or independent responsibility for care of dialysis patients;<
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>REIMBURSEMENT - It is imperative that facilities are reimbursed adequately, based on inflation, for their services, including those which may not have been to this date due to inadequate reimbursement, staffing, etc. At the same time, though, it is equally imperative that "government oversight" insures that dialysis corporations are not benefitting financially at expense of quality patient care;<
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>TERMINATION OF PATIENTS - It is imperative and long overdue that serious investigation and changes be made as they pertain to "involuntary termination" (DUMPING) of dialysis patients. Specifically, there are dire needs to (1) investigate use of "non-compliance" as primary reason for discharging patients (2) determine reason(s) for major discharge of "special populations", and (3) develop staff education/training programs which may impact this issue. This, discharging of patients, is a matter which is intolerable and cannot be supported by patients, their caretakers, and the public at large. It is to be recognized and appreciated that the physician/facility-patient relationship is a two-fold one and that there cannot be, will not be, quality care without mutual respect on part of both. <
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>SOCIAL WORKERS - It is imperative that "social workers" begin to function based on their education and expertise, that they are relieved from primary "clerical/financial" tasks, and that they begin to interact with patients to address those issues, stresses, uncertainties, etc., peculiar to a dialysis patient.<
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>Generally, it is time that the dialysis corporations/facilities fess up to that they have told us, patients and public, they are about.<
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>It seems that some progress is being made. Let's not quiver in our stance. There is still so much to be done and WE WILL DO IT!
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observation
Joined: 23 Jan 2003
Posts: 5
Posted: Fri Jan 16, 2004 9:24 am Post subject: DPPC
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Thank you BRLA for clarifying the issues and noting that written standards are nothing without enforcement of same.<
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>In reading ESRD's points, the only one that struck me as clear was the one regarding SWs. The others could easily be stretched, especially the one about reimbursements. It seems to say it's not possible to educate at the present time without MORE reimbursement. Education should be a given -not a reimbursement issue.<
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>Whose job will it be to enforce ESRD's DPPC? Yes, eyes will be on this pronouncement of care.<
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Yea right
Joined: 17 Jan 2004
Posts: 1
Posted: Sat Jan 17, 2004 6:15 am Post subject: Since when has the govt cared?
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Yea right! You might have to call in another 6 years of investigations and expect the slaughter to continue.
