Improve Transplant Coordination  
Quality Improvement Activity (QIA)
For questions or technical assistance, please contact:
Sarah Keehner,
RN, BSN, CNN
Quality Improvement Director
(203) 285-1214

Heather Camilleri, CCHT
Quality Improvement Coordinator
(203) 285-1224
QIA Facilities:
List of facilities included in the Improving Transplant Coordination QIA
QIA Kick Off Webinar:

Improve Transplant Coordination QIA Kick Off Webinar conducted on February 12, 2018:

Recording

Slides

ACTION REQUIRED:
DISCUSS:  Talk with dialysis team members and patients to develop a facility plan  to increasing utilization of home dialysis.

COMPLETE: Download,
review and complete the Plan portion of the
PDSA Tool and submit via email to:  
Friday, March 9, 2018.
One assessment per facility.
Resources:

The list of Transplant Centers in the New England area.

 

Turning a negative into a Positive flyer to help educate patient on the common misconception of receiving a transplant.  

* English

* Spanish

Disparity Education:

The following

link provides of brief

over view of the dispirited amongst race found in the ESRD population:

Kidney Health Disparities

Feedback Requested:

Please take a moment to give us your feedback regarding the resource provided below to ensure they meet the needs of your facility. 

Transplant Resource Assessment
 

Dear Provider,

Thank you to all the facilities that have completed the 5-Why's RCA tool. If you have not completed and submitted the RCA tool assessment at this time, please do so as soon as possible.

Based on the RCAs that have been submitted, four common barriers were identified:
  1. Communication breakdowns 
  2. Fear of the transplant process/workup
  3. Ineligibility
  4. Patient choice
Feedback from the completed RCAs, determined the lack of communication between patients, dialysis facilities, and transplant centers to determine the next steps in the process. Patients fear the lengthy workup time and process through the transplant journey. There can be difficulty in planning and attending all the scheduled appointments and requirements. The RCAs also identified decreased understanding of patient eligible criteria at transplant centers. The last recognized barrier is patient choice. Transplant as a treatment option is usually a discussion between the patient, their families, and the healthcare team; interest in transplant is ultimately a patient's choice.
 
Below are three suggestions of how to overcome these barriers:
  1. Implement a tracking tool to monitor communication from the transplant centers, dialysis facilities, and patients.
  2. Provide education to all patients and staff members on the United Network for Organ Sharing (UNOS) Kidney allocation guidelines
  3. Partner with your local transplant center to provide  patient education during a lobby day event
  4. Discuss transplant with patients during their care plans
This month the Network is asking facilities to develop a PDSA cycle to help overcome facility specific barriers.  Begin with discussing and developing a plan (the P of the PDSA cycle).

Also, during this project the Centers of Medicare & Medicaid Services (CMS) will be tracking and monitoring facilities patient population on the transplant waitlist to identity any disparities that may be present amongst patients on a transplant waitlist. CMS will focus on the following five disparate populations:
  1. Age (65 and older vs. 18-64)
  2. Ethnicity (Hispanic vs. Non-Hispanic)
  3. Facility Location (Rural vs. Urban)
  4. Gender (Female vs. Male)
  5. Race (Population other than White, including African American, Asian, Native American, Pacific Islander, etc. vs. White)
A priority of the Network staff is to serve as a resource to both dialysis patients and professionals throughout project activities.  Open communication about existing processes, barriers, and successes is encouraged.  Network staff is providing supplemental resources to assist with educating staff and patients, not adding additional burden. However, in order to assess barriers, and identify how the Network can effectively meet needs of the community, please complete the ACTION REQUIRED activities located on the left side bar of the newsletter by March 9, 2018. 
Project Goals
Participating facilities shall demonstrate a 10% point increase in patients who are on a transplant waitlist by October 2018.
Project Activities
* Perform a Root Cause Analysis of barriers
* Complete PDSA cycle and submit to Network
* Appoint a Transplant Patient Ambassador
* Promote peer-to-peer mentoring
We Want to Hear from YOU!
Please contact the Quality Improvement Department if you have questions, comments, or specific barriers that you would like to address.  Let us know if you have identified any best practices that you would like to share with the community.