Table 1.

Proposed quality measures for a patient-centered ESRD Quality Incentive Program

Quality Domain	Proposed Measure
Patient experience and engagement	Measurement of patient quality of life (17,49)
Patient experience and engagement	Assessment of psychologic and social effects of kidney failure on patients and their families and means to reduce it (8,16,21,50); patient satisfaction with life; satisfaction with care
Clinical care	Global symptom assessments quarterly using validated tools measuring pain, depression, anxiety, itching, patient satisfaction with care, and psychosocial stressors (19,21,36,51,52)
Clinical care	Advance care planning at initiation of dialysis and yearly thereafter or when the patient’s condition changes (36)
Clinical care	Documentation of preferred surrogate decision maker in the event of incapacity (14,36)
Clinical care	Universal screening for patients for whom palliative care would be appropriate with the surprise question (34,39,40)
Clinical care	Process for shared decision making for all patients, including those with a poor prognosis (35,36)
Clinical care	Referral to hospice when appropriate (36,39)
Care coordination	Assessment of “high risk domains [for rehospitalization]” on first dialysis visit after hospitalization (46)
Care coordination	Medication reconciliation as a continual process, including on first dialysis visit after hospitalization, to improve care and reduce likelihood of readmission (46)
Care coordination	Completion of the physician orders for life-sustaining treatment (53) form for patients with a poor prognosis