Table 2.

Predictors of facility-level SMRs stratified by domain

Factorn Units with SMR < 1.0Mean in Units with SMR < 1.0n Units with SMR ≥ 1.0Mean in Units with SMR ≥ 1.0Effect Size (95% confidence interval)Spearman r ValuePa
Patient characteristics
    frequency that patients stay for the entirety of their prescribed dialysis session without leaving prematurely594.82294.360.6 (0.2 to 1.0)−0.310.018
    patient cooperation with staff and other patients in dialysis facility595.29294.860.6 (0.2 to 1.0)−0.240.011
    willingness of patients to learn from staff and physicians about self-care594.76294.190.6 (0.2 to 1.0)−0.380.003
    patient compliance with dietary advice593.74293.130.6 (0.2 to 1.0)−0.350.004
    patient discipline in following medical advice594.21293.60.6 (0.2 to 1.0)−0.250.004
    patient motivation for self-care593.36293.020.4 (0.1 to 0.9)−0.250.052
    patient discipline in self-care594.33293.90.4 (0.1 to 0.9)−0.260.051
    patient independence for self-care593.94293.50.4 (0.1 to 0.8)−0.190.043
    overall level of patient accountability for their actions related to their ESRD593.22292.880.4 (0.1 to 0.9)−0.180.053
Physician characteristics
    ability of physicians to interact with their patients with care and respect514.99254.480.4 (0.1 to 0.9)−0.180.041
    willingness of physicians to spend time with staff without feeling “bugged”565.38275.010.4 (0.1 to 0.8)−0.130.049
Dietician characteristics
    ability of dieticians effectively address cultural issues in developing plan555.49285.640.4 (0.1 to 0.9)−0.320.04
    knowledge of dieticians regarding resources available to patients565.79285.090.4 (0.1 to 0.9)−0.290.055
    ability of dieticians to withhold judgment when patients do not follow advice565.71284.780.4 (0.1 to 0.9)−0.200.041
Facility characteristics, policies, and practices
    frequency that management calls in per diem nursing staff when faced with unexpected staffing shortage593.01282.450.4 (0.1 to 0.9)−0.160.009
    frequency that nursing staff conduct medication reconciliation595.55284.90.8 (0.4 to 1.2)−0.250.0002
    rapidity that multidisciplinary care conferences are convened after hospital discharge of a patient returning to the dialysis facility504.19253.310.6 (0.2 to 1.1)−0.320.0064
    frequency that routine multidisciplinary conferences are convened613.92293.430.4 (0.1 to 0.9)−0.100.12
    perceived quality of continuing medical education programs593.37292.940.4 (0.1 to 1.0)−0.130.05
  • Facilities were divided into top- versus bottom-performing facilities using 12-month facility-level SMRs. The table presents dialysis practices that distinguished between groups using benchmarks for statistical significance (P ≤ 0.05) and effect size (≥0.4 SD). Values are obtained from staff in dialysis facilities who self-rated their own facilities using six-point Likert scales.

  • a P value refers to Spearman correlation coefficient.