Assessing transplant education practices in dialysis centers: Comparing educator reported and medicare data

Amy D. Waterman*, John D. Peipert, Christina J. Goalby, Katrina M. Dinkel, Huiling Xiao, Krista L. Lentine

*Corresponding author for this work

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background and objectives The Centers for Medicare & Medicaid Services (CMS) requires that dialysis centers informnewpatients of their transplant options and document compliance using theCMS-2728Medical Evidence Form (Form-2728). This study compared reports of transplant education for new dialysis patients reported to CMS with descriptions from transplant educators (predominantly dialysis nurses and social workers) of their centers’ quantity of and specific educational practices. The goal was to determine what specific transplant education occurred and whether provision of transplant education was associated with center-level variation in transplant wait-listing rates. Design, setting, participants, & measurements Form-2728 data were drawn for 1558 incident dialysis patients at 170 centers in theHeartland Kidney Network (Iowa, Kansas,Missouri, and Nebraska) in 2009–2011; educators at these centers completed a survey describing their transplant educational practices. Educators’ own survey responses were compared with Form-2728 reports for patients at each corresponding center. The association of quantity of transplant education practices used with wait-listing rates across dialysis centerswas examined using multivariable negative binomial regression. Results According to Form-2728, 77% of patients (n=1203) were informed of their transplant options within 45 days. Educators, who reported low levels of transplant knowledge themselves (six of 12 questions answered correctly), most commonly reported giving oral recommendations to begin transplant evaluation (988 informed patients educated, 81%of centers) and referrals to external transplant education programs (959 informed patients educated, 81% of centers). Only 18% reported having detailed discussions about transplant with their patients. Compared with others, centers that used more than three educational activities (incident rate ratio, 1.36; 95% confidence interval, 1.07 to 1.73) had higher transplant wait-listing rates. ConclusionsWhile most educators inform new patients that transplant is an option, dialysis centers with higher wait-listing rates use multiple transplant education strategies.

Original languageEnglish (US)
Pages (from-to)1617-1625
Number of pages9
JournalClinical Journal of the American Society of Nephrology
Volume10
Issue number9
DOIs
StatePublished - Sep 4 2015

Fingerprint

Medicare
Dialysis
Transplants
Education
Medicaid
Compliance

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

Cite this

Waterman, Amy D. ; Peipert, John D. ; Goalby, Christina J. ; Dinkel, Katrina M. ; Xiao, Huiling ; Lentine, Krista L. / Assessing transplant education practices in dialysis centers : Comparing educator reported and medicare data. In: Clinical Journal of the American Society of Nephrology. 2015 ; Vol. 10, No. 9. pp. 1617-1625.
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abstract = "Background and objectives The Centers for Medicare & Medicaid Services (CMS) requires that dialysis centers informnewpatients of their transplant options and document compliance using theCMS-2728Medical Evidence Form (Form-2728). This study compared reports of transplant education for new dialysis patients reported to CMS with descriptions from transplant educators (predominantly dialysis nurses and social workers) of their centers’ quantity of and specific educational practices. The goal was to determine what specific transplant education occurred and whether provision of transplant education was associated with center-level variation in transplant wait-listing rates. Design, setting, participants, & measurements Form-2728 data were drawn for 1558 incident dialysis patients at 170 centers in theHeartland Kidney Network (Iowa, Kansas,Missouri, and Nebraska) in 2009–2011; educators at these centers completed a survey describing their transplant educational practices. Educators’ own survey responses were compared with Form-2728 reports for patients at each corresponding center. The association of quantity of transplant education practices used with wait-listing rates across dialysis centerswas examined using multivariable negative binomial regression. Results According to Form-2728, 77{\%} of patients (n=1203) were informed of their transplant options within 45 days. Educators, who reported low levels of transplant knowledge themselves (six of 12 questions answered correctly), most commonly reported giving oral recommendations to begin transplant evaluation (988 informed patients educated, 81{\%}of centers) and referrals to external transplant education programs (959 informed patients educated, 81{\%} of centers). Only 18{\%} reported having detailed discussions about transplant with their patients. Compared with others, centers that used more than three educational activities (incident rate ratio, 1.36; 95{\%} confidence interval, 1.07 to 1.73) had higher transplant wait-listing rates. ConclusionsWhile most educators inform new patients that transplant is an option, dialysis centers with higher wait-listing rates use multiple transplant education strategies.",
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Assessing transplant education practices in dialysis centers : Comparing educator reported and medicare data. / Waterman, Amy D.; Peipert, John D.; Goalby, Christina J.; Dinkel, Katrina M.; Xiao, Huiling; Lentine, Krista L.

In: Clinical Journal of the American Society of Nephrology, Vol. 10, No. 9, 04.09.2015, p. 1617-1625.

Research output: Contribution to journalArticle

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AB - Background and objectives The Centers for Medicare & Medicaid Services (CMS) requires that dialysis centers informnewpatients of their transplant options and document compliance using theCMS-2728Medical Evidence Form (Form-2728). This study compared reports of transplant education for new dialysis patients reported to CMS with descriptions from transplant educators (predominantly dialysis nurses and social workers) of their centers’ quantity of and specific educational practices. The goal was to determine what specific transplant education occurred and whether provision of transplant education was associated with center-level variation in transplant wait-listing rates. Design, setting, participants, & measurements Form-2728 data were drawn for 1558 incident dialysis patients at 170 centers in theHeartland Kidney Network (Iowa, Kansas,Missouri, and Nebraska) in 2009–2011; educators at these centers completed a survey describing their transplant educational practices. Educators’ own survey responses were compared with Form-2728 reports for patients at each corresponding center. The association of quantity of transplant education practices used with wait-listing rates across dialysis centerswas examined using multivariable negative binomial regression. Results According to Form-2728, 77% of patients (n=1203) were informed of their transplant options within 45 days. Educators, who reported low levels of transplant knowledge themselves (six of 12 questions answered correctly), most commonly reported giving oral recommendations to begin transplant evaluation (988 informed patients educated, 81%of centers) and referrals to external transplant education programs (959 informed patients educated, 81% of centers). Only 18% reported having detailed discussions about transplant with their patients. Compared with others, centers that used more than three educational activities (incident rate ratio, 1.36; 95% confidence interval, 1.07 to 1.73) had higher transplant wait-listing rates. ConclusionsWhile most educators inform new patients that transplant is an option, dialysis centers with higher wait-listing rates use multiple transplant education strategies.

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