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Two OPTN collaborative improvement projects show strength of sharing peer-to-peer effective practices

Published on: Monday, June 5, 2023

The Organ Procurement and Transplantation Network (OPTN) convenes and supports the member community through a wide range of collaborative improvement initiatives. Every OPTN collaborative aligns with a particular area of interest in the organ donation and transplant community, and brings peers together to learn from one another.  

Two national collaboratives currently underway demonstrate how the OPTN, as the central hub of the community, is able to drive member improvement and support the strategic goal of sharing effective practices in order to increase transplant. The participants in the OPTN DCD Lung Transplant Collaborative and the OPTN Offer Acceptance Collaborative are more than halfway through their projects, and the OPTN is providing a status update on both collaboratives for the community. More comprehensive data and reporting will be shared after the projects have concluded later this year.

DCD Lung Transplant Collaborative: December 2022 – July 2023

  • Why this project is important
    • Data indicates that DCD lungs can be transplanted with favorable outcomes, but the volume of DCD lung transplants performed in the United States varies among programs, even while organ procurement organizations (OPOs) continue to recover DCD donors at increasing rates.
    • The eight-month collaborative seeks to address this variation in practice by fostering improvement efforts; a primary aim is to increase the number of DCD lung transplants by 30 percent over the previous eight-month period.
    • The OPTN strategic plan specifically encourages inter-organ and inter-program collaboration and the development of effective practices to increase the number of DCD donor organs recovered and transplanted.

  • What participants have been working on
    • In the first half of the project (December 2022 – March 2023), participating programs focused on optimizing their internal program processes and patient care practices. This could involve aspects of internal communications, organ offer review processes, candidate listing practices, and care coordination.
    • The second half of the project (April 2023 through July 2023) will see participants focus on strengthening their collaboration with OPOs. Depending on each individual lung program’s project goals, this collaboration with OPOs might relate to communicating donor assessment and ongoing clinical evaluation, recovery and logistical needs, and pre- and post-recovery huddles.
    • Throughout the course of the project, all participants have taken part in a robust series of webinars and collaborative calls facilitated by OPTN performance improvement specialists. The OPTN Lung Transplantation Committee will be updated on the project’s status and progress in June.

  • Data to date
    • Monitoring is ongoing, but early data indicates that programs may be benefiting from the focused project.
    • A total of 55 DCD lungs were transplanted by participants during the first half of the project, which is 49 percent of the overall project goal.
    • More data will be shared after the project concludes.

  • Collaborative to conclude with an in-person Learning Congress
    • The OPTN is planning to host an in-person event in September 2023. In order to share learnings as broadly as possible, the OPTN will invite all lung transplant programs to attend, regardless of their participation in the collaborative. Additional details will be shared as they are finalized.
    • The OPTN has had success in bringing together the community at previous Learning Congresses.

Offer Acceptance Collaborative: January 2023 – July 2023

  • Who is participating 
    • 83 adult and pediatric transplant programs are participating, representing all OPTN regions. The cohort includes kidney, heart, liver and lung program types. Participating programs vary in size and offer acceptance rates, making this a rich opportunity to share effective practices.
    • Find the full list of participating transplant programs and learn more about the design and launch of this project, including the hybrid kickoff event that took place Jan. 31- Feb 1, 2023.
  • Why this project is important
    • The processes involved in accepting organ offers are integral to the transplant system and to saving lives, but organ offer acceptance rates vary across the nation. A recent report from the National Academies of Sciences, Engineering and Medicine (NASEM) notes this variation in acceptance practices and sees offer acceptance as a key area for improvement. NASEM has also noted the success of OPTN collaboratives in the donation and transplant communityand recommends a continued emphasis on sharing of effective practices.
    • The transplant community will see the implementation of a new performance monitoring metric in July 2023. The OPTN Board of Directors approved bylaw changes in 2021 that will allow for a more holistic evaluation of transplant programs, including offer acceptance rate ratio, a pre-transplant metric. Read more about enhanced transplant program performance monitoring.
  • What participants have been working on
    • Nearly a dozen collaborative calls have taken place with different organ groups and with the pediatric programs. Participating programs also have access to regular coaching calls and a private website and data dashboards.
    • Participating programs are conducting thorough data reviews and are working to clearly define donor acceptance criteria on both the programmatic and candidate levels.
    • Webinars have provided participants an opportunity to learn more about important tools such as OPTN Offer Filters, as well other key topics relevant to the project aim.
  • Check out the playlist: Get offer acceptance content on demand
    • Search for the OPTN Offer Acceptance Collaborative Playlist in the OPTN Learning Management System (known as UNOS Connect)
    • Recorded presentations from the hybrid kickoff event provide access to a range of thought leadership on system performance.
    • These modules have information about transplant program performance monitoring, the offer acceptance rate ratio, and OPTN tools to drive improvement, as well as effective practices related to offer acceptance.
    • The playlist also allows users to view recordings of the project webinars to date.

Future OPTN collaborative improvement projects

The OPTN designs projects such as these so that members are able to share effective practices with their peers, who can then implement them to spread progress and improve the system.

The OPTN is currently planning more collaborative projects to improve the system and increase transplant, and is exploring additional topics related to transplantation of DCD organs.