Quality Measurement of a Contemporary Kidney Transplant Program

Abstract

In the era of increasing oversight of transplantation, which includes a prescriptive framework for quality monitoring, transplant centers have been provided some necessary blueprints for developing a basic Quality Assurance/Assessment and Performance Improvement (QAPI) program. Missing from the regulatory framework for the QA portion of QAPI is the inclusion of structure and value as quality indicators in addition to process and outcomes. A meaningful and effective method of both measuring and monitoring quality in a kidney transplant program involves incorporating structure and value as additional quality measures. This achieves monitoring of minimum program requirements as well as program efficiency, and it meets the goals of multiple stakeholders such as payers, providers/programs, regulators, and patients. In order to make the QAPI program successful and to establish ownership with the transplant team, goal setting and benchmark establishment should be a collaborative process.

In effective QAPI programs, the PI portion is equally critical. Meaningful PI not only meets minimum regulatory requirements of established methodologies for monitoring but also incorporates PI monitoring secondary to adverse event occurrences and the recognition of negative trends. All QA measures and PI methodology, along with pertinent policies and documentation, should be incorporated into the program’s annual Quality Plan.