An Environmental Scan and Evaluation of Quality Indicators Across Canadian Kidney Transplant Centers
Background: Kidney transplantation is the optimal treatment for an individual requiring kidney replacement therapy, resulting in improved survival and quality of life while costing the health care system less than maintenance dialysis. Achieving and maintaining a kidney transplant requires extensive...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2021-06-01
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| Series: | Canadian Journal of Kidney Health and Disease |
| Online Access: | https://doi.org/10.1177/20543581211027969 |
| _version_ | 1818621420824952832 |
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| author | Tamara Glavinovic Amanda J. Vinson Samuel A. Silver Seychelle Yohanna |
| author_facet | Tamara Glavinovic Amanda J. Vinson Samuel A. Silver Seychelle Yohanna |
| author_sort | Tamara Glavinovic |
| collection | DOAJ |
| description | Background: Kidney transplantation is the optimal treatment for an individual requiring kidney replacement therapy, resulting in improved survival and quality of life while costing the health care system less than maintenance dialysis. Achieving and maintaining a kidney transplant requires extensive coordination of several different health care services. To improve the quality of kidney transplant care, quality metrics or indicators that encompass all aspects of the individual’s journey to transplant should be measured in a standardized fashion. Objective: To identify, categorize, and evaluate strengths and weaknesses of kidney transplant quality indicators currently being used across Canada. Design: An environmental scan of quality indicators being used by kidney organizations and programs. Setting: A 16-member volunteer pan-Canadian panel with expertise in nephrology, transplant, and quality improvement. Sample: Transplant programs, as well as provincial transplant and kidney agencies across Canada. Methods: Indicators were first categorized based on the period of transplant care and then using the Institute of Medicine and Donabedian frameworks. A 4-member subcommittee rated each indicator using a modified version of the Delphi consensus technique based on the American College of Physician/Agency for Healthcare Research and Quality criteria. Consensus ratings were subsequently shared with the entire 16-member panel for additional comments. Results: We identified 46 measures related to transplant care across 7 Canadian provinces (9 referral and evaluation, 9 waitlist activity and outcomes, 6 hospitalization for transplant surgery, 12 posttransplant care, 6 organ utilization, 4 living donor). We rated 24 indicators (52%) as necessary to distinguish high-quality from low-quality care, most of which measured effective (n = 10) or efficient (n = 6) care. Only 7 (15%) of 46 indicators evaluated person-centered or equitable care. Fourteen common indicators were measured by 5 of 7 provinces, 10 of which were deemed “necessary,” measuring safe (n = 2), effective (n = 5), efficient (n = 2), and equitable (n = 1) care. Limitations: The panel lacked patient and allied health representation. Conclusions: There are a large number of kidney transplant quality indicators currently being used in Canada, some of which are common across provinces and focus primarily on measuring effective care. Person-centered and equitable care indicators were lacking, and only half of these indicators were deemed “necessary” for quality improvement. Our results should complement ongoing work to achieve national consensus on the standardization of quality indicators in kidney transplantation. |
| first_indexed | 2024-12-16T18:09:00Z |
| format | Article |
| id | doaj.art-65c449f099bb4b6fbc6e97724c4397c8 |
| institution | Directory Open Access Journal |
| issn | 2054-3581 |
| language | English |
| last_indexed | 2024-12-16T18:09:00Z |
| publishDate | 2021-06-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Canadian Journal of Kidney Health and Disease |
| spelling | doaj.art-65c449f099bb4b6fbc6e97724c4397c82022-12-21T22:21:50ZengSAGE PublishingCanadian Journal of Kidney Health and Disease2054-35812021-06-01810.1177/20543581211027969An Environmental Scan and Evaluation of Quality Indicators Across Canadian Kidney Transplant CentersTamara Glavinovic0Amanda J. Vinson1Samuel A. Silver2Seychelle Yohanna3Department of Medicine, Division of Nephrology, Sunnybrook Health Sciences Centre, University of Toronto, ON, CanadaDepartment of Medicine, Division of Nephrology, Nova Scotia Health Authority, Dalhousie University, Halifax, NS, CanadaDepartment of Medicine, Division of Nephrology, Kingston Health Sciences Centre, Queen’s University, Kingston, ON, CanadaDepartment of Medicine, Division of Nephrology, St. Joseph’s Healthcare Hamilton, McMaster University, Hamilton, ON, CanadaBackground: Kidney transplantation is the optimal treatment for an individual requiring kidney replacement therapy, resulting in improved survival and quality of life while costing the health care system less than maintenance dialysis. Achieving and maintaining a kidney transplant requires extensive coordination of several different health care services. To improve the quality of kidney transplant care, quality metrics or indicators that encompass all aspects of the individual’s journey to transplant should be measured in a standardized fashion. Objective: To identify, categorize, and evaluate strengths and weaknesses of kidney transplant quality indicators currently being used across Canada. Design: An environmental scan of quality indicators being used by kidney organizations and programs. Setting: A 16-member volunteer pan-Canadian panel with expertise in nephrology, transplant, and quality improvement. Sample: Transplant programs, as well as provincial transplant and kidney agencies across Canada. Methods: Indicators were first categorized based on the period of transplant care and then using the Institute of Medicine and Donabedian frameworks. A 4-member subcommittee rated each indicator using a modified version of the Delphi consensus technique based on the American College of Physician/Agency for Healthcare Research and Quality criteria. Consensus ratings were subsequently shared with the entire 16-member panel for additional comments. Results: We identified 46 measures related to transplant care across 7 Canadian provinces (9 referral and evaluation, 9 waitlist activity and outcomes, 6 hospitalization for transplant surgery, 12 posttransplant care, 6 organ utilization, 4 living donor). We rated 24 indicators (52%) as necessary to distinguish high-quality from low-quality care, most of which measured effective (n = 10) or efficient (n = 6) care. Only 7 (15%) of 46 indicators evaluated person-centered or equitable care. Fourteen common indicators were measured by 5 of 7 provinces, 10 of which were deemed “necessary,” measuring safe (n = 2), effective (n = 5), efficient (n = 2), and equitable (n = 1) care. Limitations: The panel lacked patient and allied health representation. Conclusions: There are a large number of kidney transplant quality indicators currently being used in Canada, some of which are common across provinces and focus primarily on measuring effective care. Person-centered and equitable care indicators were lacking, and only half of these indicators were deemed “necessary” for quality improvement. Our results should complement ongoing work to achieve national consensus on the standardization of quality indicators in kidney transplantation.https://doi.org/10.1177/20543581211027969 |
| spellingShingle | Tamara Glavinovic Amanda J. Vinson Samuel A. Silver Seychelle Yohanna An Environmental Scan and Evaluation of Quality Indicators Across Canadian Kidney Transplant Centers Canadian Journal of Kidney Health and Disease |
| title | An Environmental Scan and Evaluation of Quality Indicators Across Canadian Kidney Transplant Centers |
| title_full | An Environmental Scan and Evaluation of Quality Indicators Across Canadian Kidney Transplant Centers |
| title_fullStr | An Environmental Scan and Evaluation of Quality Indicators Across Canadian Kidney Transplant Centers |
| title_full_unstemmed | An Environmental Scan and Evaluation of Quality Indicators Across Canadian Kidney Transplant Centers |
| title_short | An Environmental Scan and Evaluation of Quality Indicators Across Canadian Kidney Transplant Centers |
| title_sort | environmental scan and evaluation of quality indicators across canadian kidney transplant centers |
| url | https://doi.org/10.1177/20543581211027969 |
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