Use of quality index tracking to drive improvement in clinical outcomes.

BACKGROUND: DAVITA QUALITY INDEX (DQI) is a scoring index that allows DaVita facilities to evaluate various aspects of patient clinical outcomes. This index was developed by DaVita Inc., the managing company of the Richmond Kidney Center. RKC is a 23-station hemodialysis clinic that provides end-stage renal disease care to 140 patients in Staten Island, New York. In December 2002, RKC ranked 358 out of 502 clinics based on the DQI. In January 2003, a new medical director was appointed to oversee the care of these patients. Recognizing the relatively poor standing of our facility's DQI score, we developed a core team that monitored clinical performance and sought to improve results. The team consisted of the medical director, administrator, nurse manager, social worker, and dietitian. By January 2005, RKC had significantly improved its DQI and ranked fourth out of 658 clinics. This article will summarize how this unit successfully improved their clinical outcomes utilizing the DQI index developed by DaVita.