Performance Measures for the Evaluation of Patients Referred to the Toronto General Hospital's Kidney Transplant Program

Sultan, Heebah; Famure, Olusegun; Phan, Nicholas; Van, Julie Anh Dung; Kim, Sang Joseph

doi:10.1016/j.hcmf.2013.09.008

Cited by 4 publications

(4 citation statements)

References 25 publications

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“…[62] Likewise, Sultan and colleagues found that the delay in the pre-transplant process is mainly due to the workup being conducted at their local dialysis centres which may not be familiar with the pre-requisite testing resulting in longer waiting time for RT. [63] While addressing these barriers at the hospitals, key-informants suggested that an integrated system for RT service be arranged by coordinating with other supporting services to enhance the pre-transplant evaluation. As the central hub for RT, it would be an appropriate institution to engage experienced surgeons from private practice to train more transplant surgeons in the country.…”

Section: Discussionmentioning

confidence: 99%

A qualitative examination of barriers and solutions to renal transplantation in Malaysia: Key-informants’ perspective

et al. 2019

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Introduction End-stage renal disease (ESRD) is increasing globally, and renal transplantation (RT) is the preferred renal replacement therapy to treat ESRD. Internationally, there are only a few countries with RT rates above 50 per million population (pmp), while most of the countries have RT rates between 30–40 pmp. The low- and middle-income countries (LMIC) makes up the majority for the RT rates below 20 pmp in which Malaysia belongs to despite its increasing ESRD rates. There is a need to explore the barriers to access RT with targeted solutions to improve the RT rates and service in LMIC. Thus, a qualitative study was undertaken in Malaysia to address this issue. Method A qualitative methodological approach was performed between March-May 2018. Semi-structured interviews were used to explore current RT policy and service availability. Key-informants were identified from a detailed stakeholder analysis of RT system in Malaysia. Interviews were digitally audio-recorded, transcribed verbatim, coded with ATLAS.ti software and underwent thematic analysis thoroughly. Results Eight key-informants participated in the study. Barriers and related solutions were classified using the socio-ecological model (SEM). As reported, the barriers and solutions of RT in Malaysia are the results of a complex interplay of personal, cultural, and environmental factors. Key barriers are linked to public’s attitude and perception towards RT and the unaccommodating practices in the healthcare fraternity for RT. Key-informants provided a systematic solution that shed light on how RT could be improved at each SEM level via effective communication, education and inter-agency collaboration. Conclusion The SEM provided a framework to foster a better understanding of current practice, barriers, and solutions to RT in Malaysia. This study is the first to explore the barriers and related solutions to RT comprehensively as a whole. Implications of these findings could prompt a policy change for a better RT service delivery model not just for Malaysia but also for other LMIC. Further stakeholder engagement and evaluation of the systems are required to provide insight into best practices that will help to improve the RT rates and service in Malaysia.

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Section: Discussionmentioning

confidence: 99%

A qualitative examination of barriers and solutions to renal transplantation in Malaysia: Key-informants’ perspective

et al. 2019

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“…18 Unplanned return to the operating room 18,24,25,30,36,39,70 was reported in 7 unique publications, and an additional 3 metrics (blood pressure, graft function, and hemoglobin concentration) [77][78][79][80][81][82][83] were also reported in 7 publications, however, these were consecutive annual reports from the same agency rather than unique citations. The other commonly reported quality metrics included the following: waitlist mortality (n = 6 publications), 19,24,27,31,33,35 patient satisfaction (n = 5 publications), 24,30,35,47,48 the wait time from initial evaluation to final disposition (n = 5 publications), [18][19][20][21][22] in-hospital mortality (n = 4 publications), 45,46,51,52 acute graft rejection (n = 4 publications), 39,42,51,52 and infections (n = 4 publications). 24,25,42,51 Types of Quality Metrics…”

Section: Frequency Of Metric Reportingmentioning

confidence: 99%

Quality Metrics in Solid Organ Transplantation

et al. 2018

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More than 300 quality metrics have been reported in transplantation but many lacked details on development and selection, were poorly defined, or had inconsistent definitions. Measures have focused on safety and effectiveness with very few addressing other quality domains, such as equity and patient-centeredness. Future research will need to focus on transparent and objective metric development with proper testing, evaluation, and implementation in practice. Patients will need to be involved to ensure that transplantation quality metrics measure what is important to them.

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“…The production of high-quality clinical research is another area of achievement for the UHN KTP following the launch of CoReTRIS. [11][12][13][14] A comprehensive data system housing numerous data domains of interest to healthcare staff from various disciplines has made possible the completion of several health quality and research projects. Such successes are instrumental in positioning the KTP as a centre of excellence in transplant care and research for years to come.…”

Section: Program Quality Initiatives and Scientific Researchmentioning

confidence: 99%

Health Information Management for Research and Quality Assurance: The Comprehensive Renal Transplant Research Information System

Famure

Phan

Kim

2014

Healthc Manage Forum

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The Kidney Transplant Program at the Toronto General Hospital uses numerous electronic health record platforms housing patient health information that is often not coded in a systematic manner to facilitate quality assurance and research. To address this, the comprehensive renal transplant research information system was conceived by a multidisciplinary healthcare team. Data analysis from comprehensive renal transplant research information system presented at programmatic retreats, scientific meetings, and peer-reviewed manuscripts contributes to quality improvement and knowledge in kidney transplantation.

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Performance Measures for the Evaluation of Patients Referred to the Toronto General Hospital's Kidney Transplant Program

Cited by 4 publications

References 25 publications

A qualitative examination of barriers and solutions to renal transplantation in Malaysia: Key-informants’ perspective

A qualitative examination of barriers and solutions to renal transplantation in Malaysia: Key-informants’ perspective

Quality Metrics in Solid Organ Transplantation

Health Information Management for Research and Quality Assurance: The Comprehensive Renal Transplant Research Information System

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