ABSTRACT
The Organ Procurement and Transplantation Network implemented the Collaborative Improvement and Innovation Network (COIIN) to improve the use of donors with kidney donor profile index >50%. COIIN recruited 2 separate cohorts of kidney transplant programs. Cohort A included 19 programs of 44 applicants (January 1, 2017, to September 30, 2017), and cohort B included 39 programs of 47 applicants (October 1, 2017, to June 30, 2018). We investigated the effect of COIIN on kidney yield (number of kidneys transplanted from donors from whom any organ was recovered), offer acceptance, deceased donor transplant rates, and waitlist mortality rates for January 1, 2016, to March 31, 2019. COIIN did not notably affect kidney yield or waitlist mortality rates. Cohort A, but not cohort B, had significantly higher deceased donor transplant and offer acceptance rates during its intervention period than programs not in COIIN (adjusted transplant rate ratio: cohort A, 1.08 1.171.27 , cohort B, 0.94 1.011.08 ; adjusted offer acceptance ratio: cohort A, 1.08 1.181.29 , cohort B, 0.93 1.001.08 ). Thus, COIIN improved the use of kidneys at programs in cohort A but not at those in cohort B. Further research is necessary to understand the different effects for cohorts A and B, and further monitoring of posttransplant outcomes is required.
Subject(s)
Kidney Transplantation , Tissue and Organ Procurement , Donor Selection , Humans , Registries , Tissue Donors , Waiting ListsABSTRACT
Learning Health Networks (LHN) improve the well-being of populations by aligning clinical care specialists, technology experts, patients and patient advocates, and other thought leaders for continuous improvement and seamless care delivery. A novel LHN focused on pediatric transplantation, the Starzl Network for Excellence in Pediatric Transplantation (SNEPT), convened its inaugural meeting in September 2018. Clinical care team representatives, patients, and patient families/advocates partnered to take part in educational sessions, pain point exercises, and project identification workshops. Participants discussed the global impact of transplant from both a population and individual perspective, identifying challenges and opportunities where the Starzl Network could work to improve outcomes at scale across a variety of transplant-related conditions.
Subject(s)
Learning Health System , Liver Transplantation/standards , Child , Delivery of Health Care , Family , Humans , Pain Management , Pain Measurement , Pediatrics/methods , Quality Improvement , Quality Indicators, Health Care , Treatment OutcomeABSTRACT
PURPOSE OF REVIEW: The purpose is to describe an approach for improvement using an organized collaborative improvement framework where participants learn, apply, and share improvement ideas supported through a 3-year Organ Procurement Transplant Network (OPTN) project called Collaborative Improvement and Innovation Network (COIIN). The COIIN project, proposed as an alternative approach to monitoring transplant performance, supported collaboration, and improvement in 58 transplant hospitals and partner organ procurement organizations. The aim was to increase transplantation with a focus on increasing the utilization of moderate-to-high (50-100%) Kidney Donor Profile Index (KDPI) kidneys. RECENT FINDINGS: Preliminary findings show increases in transplant rate and utilization of moderate-to-high KDPI kidneys was achieved in many participating organizations. Preliminary COIIN project results suggest that an improvement approach that supports collaborative improvement can be effective in driving improvement. SUMMARY: The COIIN project involved the development of a change package of key interventions for three key areas: waitlist management, organ-offer acceptance, and care coordination. Additionally, a balanced scorecard approach using outcome, process, and relationship measures, was used and effective in driving improvement. The preliminary COIIN outcome and process results suggest that collaborative improvement does drive improvement and was well received in the transplant community. VIDEO ABSTRACT: In the video, two of the authors describe the content of the review and present the main topics discussed in the article (http://links.lww.com/MOT/A22).
