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Patient and Family Engagement (PFE)

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Centers for Medicare & Medicaid Services (CMS) recognizes that patients, families, and caregivers are essential partners in the effort to improve the quality and safety of healthcare provided to all patients. It is only by including them as active members of their own healthcare team that quality can be improved and care become more patient-centered; by fully engaging patients, families, and caregivers in the design, delivery and evaluation of care, it is made safer, treatment plan adherence is increased, and hospital readmissions are reduced.

The resources found on this page can help both patients and dialysis facility staff, as part of the healthcare team, fully engage in the process for quality improvement.

For Providers

The following resources can be used to engage patients in the facility’s QAPI program, Life Planning and to find support outside of the facility.

The ESRD Network’s Peer to Peer Support Program was developed to match trained Peer Mentors with Peer Mentees that are new dialysis, considering a treatment change or who are just interested in talking with another dialysis or transplant patient to ask questions or discuss their experience. This section includes all of the information and forms the dialysis facility, Peer Mentor or Peer Mentee needs to get started.

What is Peer Mentoring?

A peer mentor empowers fellow patients to move forward and cope with their lives after being diagnosed with ESRD. Peer mentoring:

  • Helps patients understand the benefit of controlling their health and being involved in their care, which can result in patients living longer and healthier lives.
  • Closes the gap in communication with dialysis staff in an effort to ensure that staff understand patients’ concerns, issues, and priorities.
  • Provides support and increases the confidence that many new patients need.

What are the benefits of Peer Mentoring?

  • Patients may have family and friends to assist with their new diagnosis. However, it helps to have someone who has been through the same experience and has a good understanding of all that dialysis involves.
  • For those who do not have friends or family to assist them, Peer Mentors can be essential in providing strong support.

What is the role of a Peer Mentor?

Peer mentors can have several roles, including:

  • Providing information.
  • Listening to concerns.
  • Sharing experiences.
  • Promoting positive behavior.
  • Offering encouragement.
  • Relieving anxiety.

Who should be a Peer Mentor?

  • Peer Mentors can come from all backgrounds. Mentors should be individuals with positive outlooks on managing kidney disease.
  • Individuals who are succeeding at achieving their treatment goals can provide insight to help others successfully manage kidney disease.

I want to start a peer mentoring program at my facility. Where do I begin?

  • The ESRD Network is available to support you with starting a Peer Mentoring program at your facility.
  • The HSAG ESRD Network Peer Champion can provide you with the resources to identify Peer Mentors and Peer Mentees and then can take it from there to make the Peer connections. 
  • The HSAG ESRD Networks also have a closed Facebook Dialysis Peer Support Group that some patients may be interest in participating in.
  • Contact the HSAG ESRD Network Peer Champion via:

Additional Peer Mentoring Resources

Listed below are support groups and peer mentoring programs for dialysis patients.​ Some national, nonprofit organizations also have websites devoted to educating and empowering those with kidney disease.​​

The Department of Health and Human Services National Quality Strategy’s new focus on better care for the individual through beneficiary- and family-centered care involves working with patients rather than doing to or for patients. Such partnerships are mutually beneficial to the patients and the facility. Involving patients in your facility’s QAPI and/or Governing Body meetings can be an effective means of engagement and partnership. Below are some tools to help you get started.

Helpful Documents:

Network 7

Network 13

Network 15

Network 17

Continuing Education Courses:

  • QI: Culture of Change
    The purpose of this course is to provide a basic understanding of continuous quality improvement (CQI), while also addressing the stages of change. 1 Continuing Education (CE) Credit
  • Understanding Rapid Cycle Improvement
    This course aims to improve your knowledge of quality improvement by explaining each step of the improvement model and directing you to pro-actively improve care processes. 3 CE Credits 

PFE Webinars:

Other Resources:

The POC meeting is an ESRD Patient's opportunity to communicate directly with his or her healthcare team about decisions that affect their dialysis care. It is the patient's opportunity to learn more about ESRD and how his or her choices can affect various aspects of treatment. The information provided here will help you to engage more patients in their POC meetings.

PFE Webinars

  • POSTER/FLYER: PAC Kidney Month (Poster/Flyer)
  • POSTER: Respect in the Facility (English/Spanish)
  • Good Relationships With Your Clinic (English/Spanish)
    This resource is intended for both patients and staff. You spend a lot of time together, so good relationships with your dialysis staff are important to you and to them. All people want to feel safe, respected, and trusted when working together. One way to do this is by setting "healthy boundaries." This resource discusses what boundaries are, what they do, why they are important, and what to do if a boundary ever gets violated. 
  • Patient and Family Engagement
    Agency for Healthcare Research and Quality (AHRQ) ESRD Toolkit
  • Person-and Family-Centered Care
    This web page from the Institute for Healthcare Improvement (IHI) is dedicated to putting the patient and family at the heart of every healthcare decision and empowering them to be genuine partners in their care.
  • Partnership for Patients
    The website for the Health and Human Services (HHS) public-private partnership that works to improve the quality, safety and affordability of healthcare for all Americans.
  • The Forum of ESRD Networks
    This not-for-profit supports and advocates for the ESRD Networks in their efforts to monitor the quality of chronic kidney disease, dialysis and kidney transplant care.
  • Taking Charge of Your Healthcare: Your Path to Being an Empowered Patient 
    From Consumers Advancing Patient Safety (CAPS), this is a comprehensive toolkit that can be used by providers during hospital discharge to help patients leave the hospital with confidence.
  • Tips to Improve Patient Engagement at the Facility Level
    Tips that can assist your staff to establish the genuine engagement with patients that is essential in the provision of high-quality healthcare and to achieve improved healthcare outcomes.
  • Conflict Resolution Tip Sheet
    This document provides tips to foster a positive and productive conflict resolution meeting.

Peer Mentoring Templates
Brand these templates with your logo and use them to inform patients about peer mentoring and to elicit feedback and interest.

For Patients, Families, and Caregivers

The following resources can be used by patients, families and caregivers to find support outside of the dialysis facility.

The ESRD Network’s Peer to Peer Support Program was developed to match trained Peer Mentors with Peer Mentees that are new dialysis, considering a treatment change or who are just interested in talking with another dialysis or transplant patient to ask questions or discuss their experience.  This section includes all of the information and forms a dialysis or transplant patient needs to become a Peer Mentor or Peer Mentee.  

Peer-to-Peer Background and Overview

What is Peer Mentoring?

A peer mentor empowers fellow patients to move forward and cope with their lives after being diagnosed with ESRD. Peer mentoring:

  • Helps patients understand the benefit of controlling their health and being involved in their care, which can result in patients living longer and healthier lives.
  • Closes the gap in communication with dialysis staff in an effort to ensure that staff understand patients’ concerns, issues, and priorities.
  • Provides support and increases the confidence that many new patients need.

What are the benefits of Peer Mentoring?

  • Patients may have family and friends to assist with their new diagnosis. However, it helps to have someone who has been through the same experience and has a good understanding of all that dialysis involves.
  • For those who do not have friends or family to assist them, Peer Mentors can be essential in providing strong support.

What is the role of a Peer Mentor?

Peer mentors can have several roles, including:

  • Providing information.
  • Listening to concerns.
  • Sharing experiences.
  • Promoting positive behavior.
  • Offering encouragement.
  • Relieving anxiety.

Who should be a Peer Mentor?

  • Peer Mentors can come from all backgrounds. Mentors should be individuals with positive outlooks on managing kidney disease.
  • Individuals who are succeeding at achieving their treatment goals can provide insight to help others successfully manage kidney disease.

Peer Mentor Requirements

  • Over 18 years old​.
  • Received dialysis treatment for at least one year​.
  • Completed the Peer Mentoring training modules.​
  • Completed the Network application and signed agreement form​.

Peer Mentees Requirements

  • New to dialysis or interested in home dialysis/transplant​.
  • Completed the Network application and signed agreement form.​

I want to start a peer mentoring program at my facility. Where do I begin?

  • The ESRD Network is available to support you with starting a Peer Mentoring program at your facility.
  • Dialysis or transplant patients can participate by:
    • Becoming a Peer Mentor.
    • Being matched with a Peer Mentor for support.
    • Joining the HSAG ESRD Network closed Facebook Peer Support Group.
  • Talk with your Social Worker or a facility staff member about your interest in Peer Mentorship and starting a program for your facility. 
  • Contact the HSAG ESRD Network Peer Champion to get more information via:

HSAG ESRD Network Peer to Peer Support Program Resources

  1. 2023 Peer-to-Peer Agreement Form
  2. HSAG ESRD Network Peer-to-Peer Program Flyer
  3. HSAG ESRD Network Facebook Dialysis Peer Support Group Flyer
  4. HSAG ESRD Network Patient Volunteer Interest Form
  5. ESRD Network National Coordinating Center (NCC) Peer Mentoring Resources

How to begin as a Peer Mentor

  1. Watch this Peer-to-Peer Program video to understand how the Peer-to-Peer program works, instructions for the 2023 Peer-to-Peer agreement form, NCC trainings, and HSAG Peer Support Facebook Group.
  2. Have the Facility Social Worker fax your completed Peer to Peer Agreement form to the Network.
  3. Register via computer or smart phone on the ESRD National Coordinating Center’s Kidney Learning Hub: www.kidneylearninghub.com (the register link is in the top right corner)
    • After you complete the short registration page, you will receive a confirmation email.
    • To complete the registration, you will need to click on the link in the email.
    • You can use the Kidney Learning Hub User’s Guide if you need assistance:  Kidney Learning Hub User Guide.pdf
    • If you have any issues with the NCC website, you can watch this brief video tour.
  4. Complete Learning Modules 1, 2 and 3 on the NCC’s Kidney Learning Hub patient courses. Each module has a short test associated with it.
  5. Following completion of the modules, the ESRD Network will reach out with a completion certificate and to discuss next steps.

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