A Look into a New Approach to Transplant Program Evaluation—the COIIN Project
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Purpose of Review
Current kidney transplant program performance assessment metrics are reviewed, including their use by regulatory entities, and a new approach to program assessment, the Collaborative Innovation and Improvement Network (COIIN), is described.
Current kidney transplant program performance assessment is based on 1-year patient and graft survival data. Program specific reports used by the OPTN, CMS, and third-party payers have resulted in risk-averse clinical decision making by transplant programs limiting the transplantation of less than ideal kidneys and access to transplantation for increased risk recipient candidates. In response, HRSA has funded the COIIN project as an alternative performance monitoring approach based on a data-rich, real-time, collaborative, monitoring framework. The goal is to reduce risk-avoidance decision making allowing the transplantation of a broader range of kidneys into appropriate recipients.
The COIIN project is a 3-year effort being piloted in a diverse group of transplant programs as an alternative to current performance metrics. If successful, this may replace the current performance monitoring system.
KeywordsCOIIN Risk aversion Performance metrics Program specific reports Kidney transplantation MPSC CMS Collaborative innovation and improvement network HRSA OPTN
Compliance with Ethical Standards
Conflict of Interest
Henrisa Tosoc-Haskell reports that she is a director of Member Quality at United Network of Organ Sharing/Organ Procurement Transplant Network, a contractor under the direction of HRSA. David Klassen and Maureen McBride declare no conflict of interests.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • of importance •• of major importance
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