Quality Priorities

November 15, 2005

MINUTES 
Kidney Care Quality Inititative Steering Committee
November 15, 2005 
Conference Call

Attendees: 
David Warnock, National Kidney Foundation (NKF)
Alan Kliger, Renal Physicians Association (RPA)
Mike Lazarus, Fresenius Medical Care North America (FMC)
Gail Wick, American Nephrology Nurses Association (ANNA)
Tom DeVose, American Society of Nephrology (ASN)
Kent Thiry, DaVita
Linda Keegan, Kidney Care Partners (KCP)
Kathy Lester, Patton Boggs and Kidney Care Partners

Summary
As the first meeting of the Kidney Care Quality Initiatives (KCQI) Steering Committee, members focused on the selection of Work Group members and facilitator/leaders. In addition, there was a discussion about including a representative of the American Society of Pediatric Nephrology as a member of the Steering Committee. The KCP Board is considering the request; an answer is expected before the end of the week. The members also discussed the important role patients will play in the Work Groups.

Discussion of Draft Guiding Principles 
Working from a list of nominees generated during initial KCQI discussions and the KCP Board meeting, the Steering Committee selected members through a process in which each Steering Committee member nominated one person to serve on each Work Group. Steering Committee members discussed these individuals to determine if there were any concerns with those selected and to assess whether anyone who should be included had not been. Once the members were selected, the Steering Committee discussed which Work Group members should be considered for the facilitator/leader position.

1. Clinical Measures Work Group 
The Steering Committee members nominated the following individuals as members of the Clinical Measures Work Group:

  • Bill Haley, Facilitator/Leader*
  • John Burkart
  • Tom Golpher
  • Donna Mapes
  • Charlie McAllister*
  • Jerry Yee*

An asterisk (*) indicates that the Steering Committee believes the individuals will be available to serve. Because the Steering Committee was uncertain about three of the individual, the group selected three alternative members. The Steering Committee agreed that if one of the selected individuals cannot serve, no alternate will be contacted. If two selected individuals cannot serve, the first alternate will be contacted. The other alternates will be contacted, as needed, in the order they appear. The alternates are:

  • Al Collins
  • George Aronoff
  • Don Wesson

The issue of appropriate representation for pediatric nephrologists was discussed. Given the open question about whether ASPN will be invited to participate on the Steering Committee, the group agreed that it was more appropriate to have a separate Work Group on pediatric issues to highlight their importance.

The group also discussed the role of patients on this Work Group and agreed that Steering Committee members could have a little more time to identify patients with medical or other relevant expertise. If such patients are identified, the Steering Committee members will have the opportunity to talk with them and discuss their inclusion on the next call. If a patient is selected, he/she will be added to the Work Group, but no other member will be removed to maintain the current Work Group size.
After a discussion about the need for the leader to be a strong facilitator and consensus builder, the Steering Committee selected Bill Haley as the facilitator/leader.

2. Quality of Life/Patient Perspectives Work Group 
The Steering Committee members stressed the importance of having patients dominate this Work Group and agreed to have the Work Group include 3 patients. The Steering Committee members nominated the following individuals as members of the Quality of Life/Patient Perspectives Work Group:

  • Bill McClellan, Facilitator/Leader*
  • Dick Goldman*
  • Lori Hartwell* (patient)
  • Sally Burrows Hudson*
  • Mycha Naftalin* (patient)

An asterisk (*) indicates that the Steering Committee believes the individual will be available to serve. The Steering Committee also selected, on a contingent basis, Bill Peckham, who is a patient affiliated with the Northwest Kidney Centers. More information about Mr. Peckham will be gathered so that the Steering Committee can learn more about him before finalizing this selection.

The group selected three alternate members. If one of the patients cannot serve, Celeste Lee, who is also a patient, will be asked to serve (after the Steering Committee has the opportunity to learn more about her and is comfortable with her expertise). If a non-patient individual is not able to serve, Linda Szczech will be invited.
The Steering Committee selected Bill McClellan as the facilitator/leader.

3. Pay for Performance Work Group 
The goal of this Work Group is to provide the structure required to implement a pay for performance program, including suggested legislative and regulatory approaches. The Steering Committee members nominated the following individuals as members of the Pay for Performance Work Group:

  • Alan Nissenson, Facilitator/Leader*
  • Brian Pereira*
  • Ray Hakim*
  • Jonathan Himmelfarb*
  • Don Wesson*
  • LeAnne Zumwalt*

An asterisk (*) indicates that the Steering Committee believes the individual will be available to serve, but members were less certain about Dr. Pereira and Dr. Wesson. The group selected Bob Rubin and Jay Wish as alternate members.

The Steering Committee selected Alan Nissenson as the facilitator/leader.

4. Pediatric Work Group 
The task of this Work Group is to focus on how a quality program should address the unique aspects of the pediatric setting. The Steering Committee members unanimously agreed that they do not have the expertise to determine which of the nominees should be asked to serve on the Work Group. The Steering Committee agreed to ask two members of ASPN – Sharon Andreoli and Sandy Watkins – for assistance in establishing this Work Group. The Steering Committee also agreed that the Work Group should include a nurse and a patient-parent. It was decided that because Cindy Richards, a nurse, had been nominated, she should be considered during the selection process. Ms. Lester and Dr. Kliger will talk with the ASPN about establishing this Work Group.

Next Call 
The next call for the Steering Committee will occur before the end of the week. Ms. Lester will email the date and time to the Steering Committee members. It will focus on finalizing the Guiding Principles and approving the deliverables, timeline, and date/place of the mid-December in-person meeting.