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Improving the efficiency of the pre-kidney transplant evaluation process –

The Conferences Committee for the 47th ANNA National Symposium, the ANNA Research Committee, and the ANNA Specialty Practice Leaders have accepted the following abstract submitted for the 2016 National Symposium in Louisville, KY.

Abstract: Kidney transplantation evaluation process

Authors: Geraldine Zingraf, MS, MBA, RN, CNN, CCTC;Robin Dreas, CMQ/OE, CQA; Jessica Ellison, BSN, RN; Edward Hollinger, MD, PhD, Rush University Medical Center, Chicago, Illinois; Elizabeth Carlson, PhD, RN, Rush University College of Nursing Chicago, Illinois

This project improved the efficiency and effectiveness of the pre-kidney transplant evaluation process. According to the authors, the former process, which was similar to the national average, was lengthy and involved many steps that added to the number of times a patient returned for testing. The goal was to reduce the number of days needed to place a patient on the kidney transplantation waiting list.

The key stakeholders determined a goal of 90 days for patient placement on the national kidney transplant wait list. To achieve this goal, the workflow was redesigned to address the timing of patient activities, restructuring of the pre kidney transplant team and increasing usage of the transplant tracking software.

Specific interventions included:

  1. Added more clinic appointments to decrease time between referral and the initial evaluation visit.

  2. Redesigned the clinic template to improve efficiency while still allowing evaluation by multiple disciplines.

  3. Leveraged tools available in the electronic medical record.

  4. Trained staff on the use of electronic appointment reminders, questionnaires and checklists.

  5. Achieved financial approval for wait listing prior to the selection meeting.

  6. Changed role of the transplant nephrologist from clinical documentation review to an actual patient visit.

  7. Restructured the staffing of the Pre Kidney transplant team, utilizing Certified Medical Assistants.

  8. Reassigned intake screening from pre-kidney RN coordinators to administrative staff.

Results: Changes such as adding appointments, redesigning of the clinic template, use of the electronic medical record tools and staff training began in February, 2015. These changes resulted in the mean evaluation to wait list time decreasing to 127 days by June, 2015. The remainder of the changes were initiated in July, 2015 resulting in an additional reduction in the mean evaluation to wait list time that is near the goal.

Find this abstract on the ANNA site.

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