August 23, 2007
MINUTES
Kidney Care Quality Alliance Steering Committee
August 23, 2007
Conference Call
Attendees
| ANNA | Gail Wick |
| ASPN | Barbara Fivush |
| DaVita | LeAnne Zumwalt |
| FMC | Ray Hakim |
| NKF | Dolph Chianchiano |
| National Partnership for Women and Families | Devon McGraw |
| NRAA | Maureen Michael |
| Administrative Arm Patton Boggs | Piper Nieters Su, Julie Black |
| KCP | Linda Keegan |
Summary
The Steering Committee discussed the NQF draft report on ESRD performance measures.
Approval of Minutes
Members approved the July 20, 2007, meeting minutes.
Report on NQF Draft Report
Staff reported that the NQF ESRD Steering Committee recommended both permanent and time-limited measures for endorsement. The NQF did not recommend any anemia management measures in light of the FDA black box warning. Staff noted that NQF, in its report, solicited comments on the three options for reporting outcomes and process as well as the definition of flu season.
Steering Committee members noted that revised KDOQI anemia management measures will be published in the September edition of the American Journal of Kidney Disease. The revised guidelines state:
- In the opinion of the Work Group, selection of the Hb target and selection of the Hb level at which ESA therapy is initiated in the individual patient should include consideration of potential benefits (including improvement in quality of life and avoidance of transfusion) and potential harms (including the risk of life threatening adverse events). (Clinical Practice RECOMMENDATION)
- In the opinion of the Work Group, in dialysis and nondialysis patients with CKD receiving ESA therapy, the selected Hb target should generally be in the range of 11.0 to 12.0 g/dL. (Clinical Practice RECOMMENDATION)
- In dialysis and nondialysis patients with CKD receiving ESA therapy, the Hb target should not be greater than 13.0 g/dL. (Clinical Practice GUIDELINE – MODERATELY STRONG EVIDENCE).
Steering Committee members agreed that KCP should comment on this aspect of the NQF report.
The committee members discussed their support for a hemoglobin range such as 11-13 g/dL. Members noted that the NQF ESRD Steering Committee vote was split on an appropriate range. The KCQA Steering Committee encouraged KCP to comment on the reporting of combined outcome and process measures, noting that KCQA focused on outcomes measures. Most members agreed that regardless of the aggregation level, the outcome should be reported separately.
Staff noted that the KCP work group to develop comments on the NQF draft report will meet on August 28, 2007. Questions arose as to whether NQF ESRD Steering Committee members, who are also members of KCP, could participate in the call. Staff will reach out to the NQF ESRD project director for an answer.
Report on AMA Consortium Collaboration
The Steering Committee co-chairs reported that they do not have any new information regarding the potential collaboration with the AMA Consortium.
Next Steps
The next meeting is tentatively scheduled for October 10, 2007. Staff will send an email to confirm the date and time.
