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University of Iowa Organ Transplant Center Case Study

Collaborative Improvement: increasing patient consent for high KDPI kidneys

The University of Iowa Organ Transplant Center kidney program participated in the OPTN Collaborative Innovation and Improvement Network (COIIN). The experience was an opportunity to improve their internal processes and guidelines related to educating patients about moderate-to-high KDPI kidneys in order to transplant more of these organs. When a candidate for transplant consents to accept a moderate-to-high KDPI organ, they may potentially experience transplant sooner.

“COIIN participation—the ability to have structured meetings with other centers and share resources and ideas—helped us by ensuring we had a common platform to discuss the issue of KDPI use,” says Trisha Godard-Shepherd, RN, CCTC, MBA, Transplant Quality and Operational Improvement Engineer at University of Iowa Organ Transplant Center.

To increase utilization of moderate-to-high KDPI kidneys during the collaborative, the University of Iowa team set out to identify and educate potential candidates for these organs. They came up with standardized guidelines for use of high KDPI kidneys by examining published data, local transplant volumes and local wait times.

The criteria they developed related to and included patient age, patient age plus additional risk factors, and blood type. The center’s selection committee would then consider each individual patient, meaning that all team members were hearing the same information and were familiar with KDPI guidelines and usage.

Because these organs require patient consent, the team also knew they wanted to improve the way they educated patients. Their coordinators developed a workflow checklist item for high KDPI consent. If a patient is eligible for a high-KDPI organ according to the new criteria, a task is added to a coordinator checklist. The coordinator can then provide additional education for the patient in order to obtain consent prior to listing.

As a result of these changes, the center increased its percentage of patients listed for High KDPI kidneys from 9.2 percent to 16.03 percent over the 9-month collaborative improvement period.