Improving Time to Kidney Transplant Listing: A Single Center Quality Improvement Initiative.

Area of Science:

• Nephrology
• Transplant Surgery
• Healthcare Quality Improvement

Background:

• Kidney transplant listing processes are often lengthy and fragmented, leading to delayed access to transplantation.
• Initiatives are needed to streamline the evaluation and listing pathway for kidney transplant candidates.

Purpose of the Study:

• To reduce the time from kidney transplant evaluation to listing by 25% within 12 months using a quality improvement (QI) initiative.
• To improve access to kidney transplantation for Indigenous patients.

Main Methods:

• A mixed-method QI study was conducted at a tertiary care academic transplant center.
• Interventions included improved documentation, expedited investigations, dedicated support for Indigenous patients, and an informatics tool.
• Outcomes were compared pre- and post-intervention using chart review and semi-structured interviews.

Main Results:

• Median time to listing decreased by 17% (from 437 to 362 days).
• The proportion of Indigenous patients listed increased from 11% to 23%.
• Key delays in cardiology, colonoscopy, and mammogram investigations were identified and partially addressed.

Conclusions:

• A multifaceted, data-driven QI intervention successfully reduced kidney transplant listing times.
• The initiative improved access for Indigenous patients, highlighting the importance of addressing health inequities.
• QI initiatives are crucial for optimizing transplant processes and enhancing patient care.