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Quality Metrics in Dialysis: It Takes a Village
Abhinav Bhalla1, Sri Lekha Tummalapalli2, Jeffrey Silberzweig3
1Division of Nephrology & Hypertension, Department of Medicine, Weill Cornell Medicine, New York, NY.
Advances in Kidney Disease and Health
|December 12, 2025
Summary
Dialysis care relies on an interdisciplinary team. Evolving quality metrics and trends like home dialysis require enhanced team collaboration for high-quality patient outcomes.
Area of Science:
- Nephrology
- Healthcare Management
- Public Health
Background:
- Dialysis therapy requires a multidisciplinary team, including nurses, physicians, social workers, and dietitians, as mandated by federal regulations.
- The End-Stage Renal Disease (ESRD) Quality Incentive Program, established in 2012, incentivizes high-quality dialysis care through performance metrics.
- Evolving quality metrics necessitate increased collaboration among the dialysis interdisciplinary team.
Purpose of the Study:
- To discuss the interdisciplinary nature of dialysis facility staffing.
- To highlight the role of each team member in achieving high performance on dialysis quality metrics.
- To address staffing challenges and propose solutions, considering recent trends like home dialysis and social determinants of health.
Main Methods:
- Review of federal regulations for dialysis facility staffing.
- Analysis of the ESRD Quality Incentive Program's evolution and its impact on interdisciplinary teams.
- Discussion of current trends in dialysis care, including home dialysis and social determinants of health.
- Examination of staffing challenges exacerbated by the COVID-19 pandemic.
Main Results:
- The interdisciplinary team is crucial for meeting evolving quality metrics in dialysis care.
- Staffing challenges, particularly during the COVID-19 pandemic, impact the delivery of high-quality dialysis.
- Increased focus on home dialysis and social determinants of health demands a more central role for the interdisciplinary team.
Conclusions:
- Effective interdisciplinary collaboration is essential for optimizing dialysis patient care and quality outcomes.
- Addressing workforce shortages and adapting to new care models are critical for the future of dialysis.
- The interdisciplinary team's role will expand to encompass home dialysis support and addressing social determinants of health to ensure comprehensive patient well-being.
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