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Habbous S, Barnieh L, Litchfield K, McKenzie S, Reich M, Lam NN, Mucsi I, Bugeja A, Yohanna S, Mainra R, Chong K, Fantus D, Prasad GVR, Dipchand C, Gill J, Getchell L, Garg AX. A RAND-Modified Delphi on Key Indicators to Measure the Efficiency of Living Kidney Donor Candidate Evaluations. Clin J Am Soc Nephrol 2020; 15:1464-1473. [PMID: 32972951 PMCID: PMC7536753 DOI: 10.2215/cjn.03780320] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/16/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Many patients, providers, and potential living donors perceive the living kidney donor evaluation process to be lengthy and difficult to navigate. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We sought consensus on key terms and process and outcome indicators that can be used to measure how efficiently a transplant center evaluates persons interested in becoming a living kidney donor. Using a RAND-modified Delphi method, 77 participants (kidney transplant recipients or recipient candidates, living kidney donors or donor candidates, health care providers, and health care administrators) completed an online survey to define the terms and indicators. The definitions were then further refined during an in-person meeting with ten stakeholders. RESULTS We identified 16 process indicators (e.g., average time to evaluate a donor candidate), eight outcome indicators (e.g., annual number of preemptive living kidney donor transplants), and two measures that can be considered both process and outcome indicators (e.g., average number of times a candidate visited the transplant center for the evaluation). Transplant centers wishing to implement this set of indicators will require 22 unique data elements, all of which are either readily available or easily collected prospectively. CONCLUSIONS We identified a set of indicators through a consensus-based approach that may be used to monitor and improve the performance of a transplant center in how efficiently it evaluates persons interested in becoming a living kidney donor.
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Affiliation(s)
- Steven Habbous
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Quality, Measurement, and Evaluation, Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Lianne Barnieh
- Department of Nephrology, London Health Sciences Centre, London, Ontario, Canada
| | - Kenneth Litchfield
- Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease, Canada
| | - Susan McKenzie
- Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease, Canada
| | - Marian Reich
- Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease, Canada
| | - Ngan N. Lam
- Division of Nephrology, University of Calgary, Calgary, Alberta, Canada
| | - Istvan Mucsi
- Kidney Transplant Program, University Health Network, Toronto, Ontario, Canada
| | - Ann Bugeja
- Division of Nephrology, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Seychelle Yohanna
- Division of Nephrology, McMaster University, Hamilton, Ontario, Canada
| | - Rahul Mainra
- Saskatchewan Transplant Program, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada
| | - Kate Chong
- Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease, Canada
| | - Daniel Fantus
- Department of Medicine, Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - G V Ramesh Prasad
- Kidney Transplant Program, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Christine Dipchand
- Division of Nephrology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jagbir Gill
- Division of Nephrology, St. Paul’s Hospital, Vancouver, British Columbia, Canada
| | - Leah Getchell
- Canadians Seeking Solutions and Innovations to Overcome Chronic Kidney Disease, Canada
| | - Amit X. Garg
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Department of Nephrology, London Health Sciences Centre, London, Ontario, Canada
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