1. ESRD Networks and Collaboration Benefits and Challenges Jenny Kitsen March 16, 2011

2.  Align mutual interest to achieve a common goal  Access to broader diverse skills, knowledge and different perspective  Maximize use of limited professional staff and financial resources  Builds trust and knowledge about culture of other organizations  Stronger acknowledgement in 2011 from CMS to “create innovative partnerships” Recall “Strategic Partnerships for Change” in 2005

3. Definitions:  Networking: Exchanging information for mutual benefit  Coordination:Exchanging information and modifying activities for mutual benefit  Cooperation:Exchanging information, modifying activities, and sharing resources for mutual benefit and to achieve a common purpose Source: Tom Wolff & Associates

4. Definition  Collaboration:Exchanging information, modifying activities, sharing resources, and enhancing the capacity of another for mutual benefit and to achieve a common purpose by sharing risks, resources, responsibilities, and rewards. Source: Arthur T. Himmelman, “On Coalitions and the Transformation of Power Relations: Collaborative Betterment and Collaborative Empowerment,” American Journal of Psychology, Vol. 29, No. 2, 2001, p. 277-284.

5.  Elab (Yr 1998)  ESRD Patient Safety Initiative (Yr 2000)  Dialysis Patient-Provider Conflict Project (Yr 2003)  Fistula First Breakthrough Initiative  Kidney End of Life Coalition  Kidney Community Emergency Response Coalition  Forum Medical Advisory Council Tool Kits

6.  CKD Sub-National Project: 10 QIOs partner with local Networks 1, 2, 7, 8, 12, 13, 14, 15, 16  Safe and Timely Immunizations Coalition (STIC): Networks 6, 11, 15 and several organizations  5 Diamond Patient Safety Project: Networks 1, 5, 4, 6, 8, 9/10, 12  Explore Transplant Program HRSA Funded: Lead is Dr. Waterman, Washington University School of Medicine, St. Louis, MO and Networks 1, 4, 7, 12, 16

7.  Network 8 and Mississippi Nursing Home Association: Reduced fragmented communication and complaints by nursing home staff and dialysis staff regarding dialysis patients.  Network 2 and New York City Office of Emergency Management: Advanced Warning Systems Conference Calls: Prioritized snow removal for ambulatory services and access-a-ride.  Network 4 and Quality Insights of Pennsylvania: Establish a standard transfer form between nursing homes and dialysis clinics.  Network 14 and the Department of Public Health: A standard referral process on serious deficiencies and practices identified by state surveyors. Network advises DPH and closely monitors provider and gives technical assistance.

8.  Proactive approaches to avoid escalation of common issues/problems  Local or regional organizations are close to community to do local pilot projects to test methods and interventions  Common message for educational programs, technical assistance, workshops, deployment of useful QI tools and success stories

9.  Different local projects on the same topic can be confusing (mixed messages) to CMS, national corporate leadership and renal community (i.e. HAI)  Potential to be scattered in work efforts – lack of focus on high important priorities  Lessons learned in local collaborations are only shared locally  Pressured to join coalition and other parties do not see benefit  Be allowed “to learn from mistakes”  No central location of inventory of projects or collaboratives  Consistent method to share experiences and results does not exist  Networks should be encouraged to seek other sources of funding

10.  DO remember to delegate  DON’T try to juggle too many balls  DON’T take it personally  DO maintain an action orientation  DON’T hog the spotlight  DON’T avoid conflict  DON’T forget to celebrate the small victories Reference: W. K. Kellogg Foundation Training Manual, 1994 “Developing Community Capacity” Source: Tom Wolff & Associates

11. A GENUINE LEADER IS NOT A SEARCHER FOR CONSENSUS BUT A MOLDER OF CONSENSUS. - Martin Luther King, Jr.

12.  Network Organizations can serve as an objective, neutral entity to bring organizations together to achieve a common benefit of improving patient services and outcomes. Consider your Network a partner and resource.  Network Organizations can have non-CMS contracts. Each Network has its own unique corporate culture which should consider the pros and cons of diverse funding.  A central location is needed to store and showcase collaborative initiatives  Leverage social media techniques to tell successful collaborative experiences and outcomes.