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5-Diamond Patient Safety Program

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Missed Treatments

Everything you need to complete this module is right here! Click on the links below to access the necessary tools and resources available for completion of this module.


To decrease the number of missed treatments due to non-adherence. Non-adherence would be those situations in which the patient had a choice to attend or not attend. Situations such as hospitalization or vacationing at another unit would not penalize the patient.

Required Activities

  • Complete an in-service training module on missed treatments/patient non-compliance. (with speaker notes)
  • Track individual patient missed days, by reason treatment was missed, using the Missed Treatment Log.
  • Provide feedback reports to patients indicating the number of days missed and percent of actual treatments received vs. prescribed.
  • Educate patients about the difference between normal kidney function (168 hours/week), dialysis (approx. 12 hours/week), and their actual treatment received.

Optional Activities

  • Create a game (see sample SURVIVOR Game) where patients can compete for recognition, nominal prizes/awards, or privileges by not missing treatment.
  • Develop an activity that addresses shortened treatments.
  • Educate staff about barriers to adherence and how to communicate more effectively with patients to encourage change.

Additional Tools and Resources

Patient Letters:

Patient Resources:

Staff Resource Articles:


  • 100% of staff in-serviced on missed treatments.
  • Decrease the total number of missed treatments by >10%.
  • Sustain the improvement of decreased total number of missed treatments by >10% for at least 3 months.

After you have completed this module, and have documented the required measures, please submit the following documents via mail or fax.

5-Diamond Patient Safety Program
1360 Energy Park Drive, Suite 200
Saint Paul, MN 55108
651-644-9853 Fax

  1. Completed Project Reporting Form.
  2. In-service attendance log. (Please note that the facility in-service must be completed as a group.)
  3. Completed Missed Treatment Log showing total number of missed treatments before in-service training.
  4. Completed Missed Treatment Log showing total number of missed treatments after in-service training, for at lease three months - see above measures.

For more assistance contact us at or at 651-644-9877.