Transplant Change Package
This change package supports dialysis facilities and End Stage Renal Disease (ESRD) Networks to increase the number of patients referred to transplant centers, evaluated for kidney transplantation, and placed on transplant waitlists. Collected from top-performing dialysis facilities, the package includes an intervention menu of actionable change idea options for facility implementation. Please view the Transplant Change Package in its entirety.
The U.S. Department of Health and Human Services launched the Advancing American Kidney Health Initiative in 2019, outlining several bold goals to address kidney disease issues in the United States. The initiative focuses on fewer patients developing kidney failure, fewer Americans receiving dialysis in dialysis clinics, and more kidneys being made available for transplant.

Regarding kidney transplantation, the initiative has set a goal of 80 percent of patients newly diagnosed with ESRD receiving dialysis in the home or receiving a transplant by 2025. Dialysis facilities play a central role in achieving this goal. This change package was developed to support facilities in their efforts to give patients with ESRD the opportunity to get on kidney transplant waitlists, which could lead to successful transplantation.
Getting Started
Change happens at the local level. Dialysis facility Quality Assurance and Performance Improvement (QAPI) meetings are the perfect place to start. Giving interdisciplinary team (IDT) members a copy of this change package for review allows them to identify and prioritize opportunities to increase the number of patients educated, referred, and waitlisted for a kidney transplant. The change ideas presented serve as “tests of change” that drive performance improvement and quality improvement programs.

About QAPI: QAPI merges quality assurance (QA) and performance improvement (PI) into a comprehensive approach to quality management. QA is the process of meeting standards and ensuring care reaches an acceptable level. PI is the proactive, continuous study of processes with the intent to identify opportunities and test new approaches to fix the underlying causes of persistent, systemic problems. Data-driven QAPI programs may be customized to facility needs.

Key steps include:
  • Identifying the problem and defining the goal
  • Deciding on a measurement to monitor improvement
  • Brainstorming solutions based on barriers and root causes
  • Planning an intervention
  • Using Plan, Do, Study, Act (PDSA) to implement the improvement project
This document provides general guidance for incorporating patients into your facility Quality Assurance and Performance Improvement (QAPI) activities. It provides a brief description of QAPI and some of the standardized quality tools and methods, as well as several checklists to help you get started. 
Goal Setting

Help your patients thrive by setting Specific, Measurable, Achievable, Relevant, and Time bound (SMART) goals and checking in on progress at appropriate intervals. Download the worksheet.
PDSA Cycle

This short video can help your staff feel confident on how to complete a Plan, Do, Study, Act (PDSA) cycle when implementing a new quality improvement activity in your clinic. Successful clinics have shared time and again that involving the entire team in an action plan makes a positive difference in the outcome!
Kidney Transplant Drivers Part 1: Creating a Pro-Transplant Culture
Action Steps:
1a: Link the organizational mission to the work
1b: Hire team members who will support a culture of caring
1c: Designate one or two champions to drive transplant efforts
1d: Engage all facility staff in improving transplant referral rates
1e: Engage patients in the transplant referral process

Please use the following tools to assist with meeting the actions steps listed above.
Transplant Champion

The Transplant Champion is a staff member in your facility who can educate patients about how to get on the transplant list, promote the benefits of getting a transplant, share stories of transplant recipients, review available resources with patients. Please use this form to identify your transplant champion and then display in your facility so patients and other staff are aware of who to contact with questions about transplant.
Huddle Helper

One of the strategies for improving the culture of your clinic is to make the most of your daily huddles. The Network has created a Huddle Helper Checklist to assist you with ensuring your huddles are productive and beneficial to all involved.
Transplant Interest Form

Use this form to identify potential transplant candidates in your clinic. Staff can use this form along with the Staff Guidance to Patient Interest Form Tool to make sure proper steps are followed in the referral. Download the Transplant Interest Form for Network 10 or Network 12.
Transplant Bulletin Board Kit

Use this Bulletin Board kit for Transplant to engage both staff and patients around transplant education. Patients and staff can work together to set up and display in your facilities.
10 Benefits of Kidney Transplant

This resource, highlighting ten benefits for patients when considering kidney transplant, was created with input from our Patient Advisory Council.
Sharing Best Practices
We know that you have some current processes and resources in place to help drive the Transplant Referrals for your facility. We would love to have you share this information with the Network and your peers as a way to assist with increasing the number of patients that are referred for or receive kidney transplants. Please use this link to share your best practices.
This newsletter was prepared and distributed by Qsource ESRD Networks, under contract with the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services (contract number HHSM-500-2016-00010C and HHSM-500-2016-00012C). The contents presented do not necessarily reflect CMS policy. 20.Q-ESRD.10.149
ESRD Network 10: 317-257-8265 | Patient Line: 800-456-6919 | Website
ESRD Network 12: 816-880-9990 | Patient Line: 800-444-9965 | Website