Transplant is a treatment option that offers the opportunity for better clinical outcomes. This quality improvement activity focuses on increasing the number of patients on the United Network for Organ Sharing (UNOS) Waitlist.
Criteria: Include at least 30% of facilities in Network service area
Baseline: 5 year average trend of patients on UNOS waitlist (10/2013-9/2018)
QIA Activity Period: January 2019 - September 2019
Patients on the waitlist PRIOR to January 1, 2019 will not be counted in the rate, only NEW patients to the UNOS waitlist from Jan- Sept 2019 will count towards goal
Final Re-Measure: September 2019 UNOS waitlist data
Goals: Facilities selected for this project will demonstrate a 2% increase on the natural trend of patients on the transplant waitlist
The Network staff will use the 6 Step process described by Sullivan, et al (2012) to monitor the patient progression through this process of getting on a transplant waitlist. These steps track the patients through their navigation from initial interest in transplant to final placement on the waitlist.
The 6 Steps are as follows:
- Interest in transplantation
- Referral call to transplant center
- First visit to transplant center
- Transplant center work up
- Successful transplant candidate
- On waiting or evaluate living donor
New York State Transplant Coalition webpage
• Launch/identify interventions to improve Facility Transplant Referral Process
• Utilize Network-Developed Resource Toolkit
• Develop dedicated Treatment Options “Education Station” Tips PDF; Poster PDF
• Submit Monthly Status Reports to Network on Last Business Day of the month.
• Participate in Network Site Visits
• Participate in Bi- Monthly ESRD NCC Transplant QIA LAN
QIA Resource online order form
Transplant QIA 2018 Activity Checklist PDF
American Society of Transplantation Patient Resources webpage
Ascent To Transplant webpage
Ascent to Transplant Webinar: Kidney Allocation System and Impacts to Patient Care
Donate Life webpage
Transplant Living: Learning Center webpage
What is a referral? The CMS definition of a Transplant Referral: “any first-time referral for a patient (i.e., the patient has not already been referred or been placed on a transplant waitlist), and for which either a dialysis facility or transplant center provides an indication that the patient has been referred. Patients who have had transplant failures are considered as restarting the referral process anew, and would be eligible for “first-time” referrals.”
ESRD NCC Transplant QIA LAN Calls
|DATE||TITLE||PRESENTER(S)||OBJECTIVES||INTERVENTION SUPPORT||RECORDING LINK|
|August 21, 2018||The Kidney Transplant Workup||Amy Schurke, RN, BSN, CCTC||Explain how patient is referred|
Define initial phone contact with patient
Define Transplant Work up and all that is involved
Discuss importance of care partner support
Discuss expectations of the recipient throughout the workup once listed
Discuss Barriers/Hurdles patients may have prior to starting the transplant process
|June 19, 2018||Transplant from the Clinic’s Perspective||Kay Kerby, LCSW||• Learn importance of regularly monitoring patients and their transplant status.|
• Identify barriers to transplant.
• Understand the importance of utilization and coordination with the Interdisciplinary Team (IDT) and community resources to facilitate a successful transplant process.
|Step 1: Suitability for referral to|
Step 2: Interest in transplantation
Step 3: Referral call to transplant center
|April 17, 2018||Patients Helping Patients Navigate the Seven Steps to Wait Listing||Anne Huml, MD Kate Greenway, BS|
Sara Cox, MSW, LISW
Jennifer Truster, BSN
|• Discuss how the mechanisms of transplant (7 steps toward transplant wait listing) were identified and the common barriers encountered at each step.|
• Describe the role of a patient navigator and how this model can be utilized to create peer-to-peer patient engagement activities to assist patients in working through the process for transplant wait listing.
• List interventions to overcome barriers with a peer-to-peer approach or hemodialysis unit assistance.
|February 20, 2018||Creating a Successful Transplant Outreach Program||Christina Psathas, MA||Describe the transplant center’s approach to increase patient and staff engagement in the kidney transplant process|
• Identify the key responsibilities of a transplant surgeon designee
• Discuss the evolution of the transplant surgeon designee program created and developed by Saint Barnabas Medical Center
|Step 3: Referral call to transplant center|
Step 4: First visit to transplant center
Step 6: Successful transplant candidate