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Supporting equitable access to kidney transplant in remote Western Australia using continuous quality improvement
Felicity Stewart1, Nicholas Corsair1, James Stacey1
1Kimberley Renal Services, Broome, Western Australia, Australia.
Summary
Improving kidney transplant access for Aboriginal people requires addressing temporary contraindications like smoking and adherence. Continuous quality improvement (CQI) in suitability assessments is key for successful waitlisting.
Area of Science:
- Nephrology
- Public Health
- Health Services Research
Background:
- Significant disparities in kidney transplantation access exist for Australian Aboriginal and Torres Strait Islander populations with End-Stage Kidney Disease.
- The kidney transplant journey involves a critical initial suitability assessment before waitlist activities.
- Addressing these access barriers is crucial within Aboriginal Community Controlled renal services.
Purpose of the Study:
- Implement a continuous quality improvement (CQI) approach for transplant suitability assessments.
- Assess all patients within the service for transplant suitability.
- Identify key temporary contraindications to focus health service improvements.
- Explore patient experiences with the suitability assessment process.
- Inform pre- and post-transplant care models for Kimberley Renal Services.
Main Methods:
- Mixed methods design incorporating file review.
- Descriptive analysis of transplant suitability assessment results.
- Semi-structured interviews with thematic analysis to explore patient experiences.
Main Results:
- 30% of assessments showed no contraindications; 64% had temporary contraindications; 6% had permanent contraindications.
- Most common temporary contraindications included smoking (49%), treatment adherence (36%), and high body mass index (24%).
- Patients desired more information on the transplant process and support for modifiable risk factors.
Conclusions:
- A CQI approach successfully increased suitability assessments for Aboriginal people in Kimberley.
- Identified temporary contraindications provide a focus for improving waitlisting success.
- Involving Aboriginal staff and patients in education and support is vital for prospective kidney transplant recipients.
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