opo performance improvement: increasing kidney utilization kevin o’connor unos region 6 forum...
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OPO Performance Improvement:Increasing Kidney Utilization
Kevin O’ConnorUNOS Region 6 Forum
Seattle, WAOctober 3, 2013
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•National kidney discard rate near 20%•LCNW rate lower than US, but increasing•Opportunity for performance improvement•Led by LCNW Surgical Recovery Coordinators
Assist with recovery processPlace kidneys
Kidney Utilization From LCNW Donors
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NYT Article, September 2012
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NYT Article, September 2012
Over 8000 Kidneys Discarded in Three Years, 2010 - 2012
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2009 2010 2011 20120.0%
5.0%
10.0%
15.0%
20.0%
25.0%
19.2%18.3% 17.9% 18.7%
6.8%
12.9%
19.8%
14.0%
Kidneys Discarded / Kidneys Recovered
US LCNW
Source: OPTN DSA Dashboard
US and LCNW Discard Rates
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Stepwise Process
1. Identify Opportunity for Improvement (data)
2. Engage Staff Directly Involved in Process
3. Establish Clear Directive and Goal
4. Allow Staff to Develop Solutions
5. Test and Monitor New Approaches (data)
6. Do More of What Works
7. Stop Doing Things That Don’t Work
8. Acknowledge and Celebrate Progress
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Reducing Kidney Discards at LCNW
1. Analyze Data to Identify “At Risk” Kidneys
2. Include Transplant Program Staff in Process
3. Get a Head Start On At Risk Kidneys
4. Streamline Local Offer Process
5. Improve Work Flow with UNOS Organ Center
6. Have Knowledge of “Go To” Kidney Programs
7. Early Decision to Avoid Kidney Wastage
8. Expedite Placement of Exported Kidneys
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AJT 2010:10, 1613 -1620
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Regression Model for Predicting Discard
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Exported LCNW Kidneys in 2011
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Source: OPTN DSA Dashboard
US and LCNW Discard Rates
2009 2010 2011 2012 20130.0%
5.0%
10.0%
15.0%
20.0%
25.0%
19.2%18.3% 17.9% 18.7% 18.0%
6.8%
12.9%
19.8%
14.0%
3.8%
Kidneys Discarded / Kidneys Recovered
US LCNW
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Source: OPTN DSA Dashboard
US Discard Rates
2009 2010 2011 2012 20130.0%
5.0%
10.0%
15.0%
20.0%
25.0%
19.2%18.3% 17.9% 18.7% 18.0%
Kidneys Discarded / Kidneys Recovered
US
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Source: OPTN DSA Dashboard
LCNW Discard Rates
2009 2010 2011 2012 20130.0%
5.0%
10.0%
15.0%
20.0%
25.0%
6.8%
12.9%
19.8%
14.0%
3.8%
Kidneys Discarded / Kidneys Recovered
LCNW
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Summary
• LCNW Identified Opportunity for Improvement
• Followed a Systematic Approach
• Reinforced Practices That Worked
• Continue to Monitor This Closely
• LCNW Kidney Utilization is Second Best in US