Fistula First

In 2003, the ESRD National Vascular Access Improvement Initiative (NVAII) began through a partnership of the Centers for Medicare & Medicaid Services (CMS), the Institute for Healthcare Improvement (IHI), ESRD Networks, and others.

The initial 3-year project (2003 - 2006) aimed to increase arterial venous fistula (AVF) use. K-DOQI guidelines state that AVF should be the access for at least 50% of incident and 40% of prevalent hemodialysis patients. 

Since that time, CMS has named the Fistula First project as a Break-through Initiative to give additional national focus to this important project.

Network 11 is using a multi-faceted approach to improve AVF incidence and prevalence rates. This approach involves collaboration and partnership with providers, vascular access surgeons, nephrologists, and patients. State survey agencies, quality improvement organizations, payors, and others, have also partnered in this project.

See facilities that have achieved AVF prevalence rate improvement goals for 2010!

Tools and Resources

For Dialysis Facilities
Pre-ESRD Strategies
For Patients
For Nephrologists and Surgeons