Engaging Physicians in Continuous Quality Improvement

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      The current ESRD environment poses significant challenges for the medical director and the admitting nephrologist of a dialysis facility. The expectations and requirements of their role have broadened and are under much greater scrutiny today than ever before. A positive response to this challenge lies in the appropriate incorporation of continuous quality improvement (CQI) methods into the provision of dialysis care. By embracing CQI the physician will find these new requirements considerably less taxing and indeed hopefully positive in their impact on the quality of care delivered to his patients. Essential components of the CQI methodology include the use of a multidisciplinary team; participative management; a consistent process, well understood by all team members; a content expert (team leader); and a trained facilitator. A familiarity with CQI tools and techniques and a willingness to play whatever is the most appropriate role in the CQI team—leader, facilitator, or contributing member—will be positive not only to those under the nephrologist's care, but also to his own professional growth and satisfaction as well.
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      1. Code of Federal Regulations: 42 CFR Part 405(u). Conditions of Participation for Providers of ESRD Services

        • Owen W
        The Dialysis Facility Medical Director: Scope of Work and Documentation of Services. American Society of Nephrology, Toronto, Canada2000
        • Yessian M
        Government Oversight: The OIG's Focus on ESRD in the Coming Years. American Society of Nephrology, Toronto, Canada2000
        • Deming WE
        Out of the Crisis. Massachusetts Institute of Technology, Center for Advanced Engineering Studies, Cambridge, MA1989
        • Walton M
        The Deming Management Method. Putnam Publishing Group, New York, NY1986
        • Vlchek D
        • Day L
        A quality improvement model for renal care.
        Nephrol News & Issues. 1991; (suppl 1)
        • Berwick D
        Curing Healthcare. Jossey-Bass, San Francisco, CA1990
        • Vlchek D
        The Santayana review: Learning from our mistakes in clinical practice.
        Semin Dial. 1993; 6: 223-226
        • Gross S
        • Burton B
        • Vlchek D
        A CQI approach to improved vascular access outcomes.
        Nephrol News & Issues. 1995; 9: 72-74
        • Pfeffer J
        • Sutton R
        The Knowing-Doing Gap. Harvard Business School Press, Boston, MA1999
        • Kouzes J
        • Posner B
        Credibility. Jossey-Bass, San Francisco, CA1993
        • Maddux RB
        Teambuilding. Crisp Publications, Menlo Park, CA1992
        • Scholtes PR
        The Leader's Handbook. McGraw Hill, New York, NY1999
        • Scholtes PR
        The Team Handbook. McGraw Hill, New York, NY1988
      2. Brassard M The Team Memory Jogger. Goal/QPC, Methuen, MA1991
        • Vlchek D
        • Burrows-Hudson S
        • Kammerer J
        A Reference Manual on Continuous Quality Improvement in Dialysis. Forsythe, Marcelli & Johnson, Newport Beach, CA1993