This document discusses the management of a hemodialysis unit. It emphasizes the importance of an interdisciplinary team approach involving physicians, nurses, social workers, dietitians, and patients. It also stresses the need for continuous quality improvement through a Quality Assessment and Performance Improvement (QAPI) team that collects data from various sources to identify problems, analyze causes, develop solutions, implement changes, and reassess outcomes. The goal is to provide high quality care that meets standards and addresses key issues like infection control, dialysis adequacy, anemia management, and patient satisfaction.

1. MANAGEMENT OF HEMODIALYSIS UNIT
DR. AHMED AKL, MD,
ISN EDUCATION AMBASSADOR,
Consultant of Nephrology & Transplantation,
Urology & Nephrology center,
Mansoura, Egypt

2. Infection
Control
Dialysate
Delivery
Water
Quality
Patient
Satisfaction
Anemia
Transplant & Modality
Education
Quality of
life
Nutrition
Vascular
Access
Mineral Bone
Disease
Dialysis
Adequacy
Patient

3. 1- Appropriate staffing of dialysis unite.
2- Continuous quality improvement in
dialysis units.
3- Prevention of access related infection.
4- Prevention of transmission of non-access
related infection in dialysis patients.

5. INTERDISCIPLINARY TEAM
Physician
Social
WorkerDietitian
RN

6. INTERDISCIPLINARY CORE TEAM
Physician
Social
Worker
Dietitian
RN
Patient

7. Medical
Director
Social
Worker
Dietitian
RN
Admin
CEO
Anemia
RN
Access
Adequacy
RN
Infection
RN
Biomed.
Tech
QAPI TEAM

8. STANDARDS
COLLECT DATA
IDENTIFY PROBLEMS
RE-ASSESS
ANALYZE PROBLEMS
AND GENERATE
SOLUTIONS
CHOOSE AND
IMPLEMENT SOLUTION
COLLECT DATA
IDENTIFY PROBLEMS
ANALYZE PROBLEMS
AND GENERATE
SOLUTIONS
CHOOSE AND
IMPLEMENT SOLUTION
RE-ASSESS

9. DATA SOURCES
• Electrical safety testing reports.
• Reuse master file.
• Patient satisfaction surveys.
• State and federal survey reports.
• Medical device alerts.
• Manufacturers recalls.
• Performance appraisals.
• Utilization review reports.
• Medical record.
• Dialysis record/Log sheets.
• Patient care plans.
• Hospitalization record.
• Laboratory and other diagnostic records.
• Incident reports.
• Equipment maintenance reports.
• Water Quality monitoring reports.
• Culture reports: Water, reused dialyzers,
Dialysate, Environmental.
• Hepatitis surveillance reports.
Patient
Equipment
Environment

10. RESPONSE TO UNDERPERFORMANCE

11.  INTERDISCIPLINARY CORE TEAM:

12.  Medical Director Oversight Of Facility Staff:

13.  QAPI IDENTIFIES KTV PROBLEMS:

14.  Quality Metrics in ESRD:

15.  Continuous Quality Improvement In Dialysis Units:

16.  CHECK SHEET:

17.  In Conclusion:
Medical
Director
Social
Worker
Dietitian
RN
Admin
CEO
Anemia
RN
Access
Adequacy
RN
Infection
RN
Biomed.
Tech
QAPI TEAM

18. THANK YOU