Quality initiatives in pediatric transplantation

Abstract

Purpose of reviewPediatric transplantation faces unique challenges in implementing dynamic quality improvement measures because of proportionally smaller volumes compared to adults, logistics of being integrated successfully within larger or complex hospital systems, lack of adult-affiliated transplant centers, varying focus in prioritization of relevant outcome metrics, and potential lack of sufficient resources. Recent findingsTo address these challenges, multiinstitutional collaborations have developed which have proven increasingly effective in driving awareness and quality improvement measures to supplement regulatory efforts in the pediatric population. Relevant work from the Pediatric Heart Transplant Society and Studies in Pediatric Liver Transplantation will be highlighted. The introduction of learning networks such as the Improving Renal Outcomes Collaborative and the Starzl Network for Excellence in Pediatric Transplantation have further focused on continuous learning initiatives in renal and liver transplantation using collaboration and patient informed measures. SummaryOptimal transplant performance improvement is fully integrated into health delivery at all points of the patient pathway. Progress in performance improvement will require ongoing integration of big data solutions, improved patient engagement and technology solutions.

A learning health network for pediatric liver transplantation: Inaugural meeting report from the Starzl Network for Excellence in Pediatric Transplantation

“…has focused on combining registry data with QI, education, research, and patient advocacy. 3 In order to accelerate progress in improvement beyond the traditional registry approach, SNEPT (www.starz ltran splan tnetw ork.com) was established in 2018 with the mission to unite big data, technology, patient advocacy, and transplant thought leaders to deliver the best care and develop new, scalable solutions to pediatric transplantation's most challenging problems. Recently, SNEPT convened its inaugural meeting.…”

“…Collaborative LHN have sought to address this challenge, using QI methods to translate evidence into practice more efficiently by deploying support teams across centers to test and implement strategies quickly and reliably . The success of these efforts is reflected in the dramatic expansion of networks and collaborators, growing to encompass 558 teams across 286 pediatric care organizations as of this writing.…”

“…Particularly in children, the transplant journey encompasses decades of pre‐ and post‐transplant opportunity with multiple areas of potential impact. The Society of Pediatric Liver Transplantation with parentheses (SPLIT) has focused on combining registry data with QI, education, research, and patient advocacy . In order to accelerate progress in improvement beyond the traditional registry approach, SNEPT (http://www.starzltransplantnetwork.com) was established in 2018 with the mission to unite big data, technology, patient advocacy, and transplant thought leaders to deliver the best care and develop new, scalable solutions to pediatric transplantation's most challenging problems.…”

“…Collaborative LHN have sought to address this challenge, using QI methods to translate evidence into practice more efficiently by deploying support teams across centers to test and implement strategies quickly and reliably. [1][2][3] The success of these efforts is reflected in the dramatic expansion of networks and collaborators, growing to encompass 558 teams across 286 pediatric care organizations as of this writing. Systematic implementation of QI science and increasing engagement of and partnership with patients and families have been directly translated into improved outcomes, included but not limited to disease remission and improved physical functioning, decreased serious safety events, and a reduction in mortality.…”

Multicenter data to improve health for pediatric renal transplant recipients in North America: Complementary approaches of NAPRTCS and IROC

“…In this review, we examine the history, current efforts, and future plans of two pre‐eminent networks in North America that together represent complementary components of a learning healthcare system for these patients. NAPRTCS focuses primarily on research, benchmarking, and large‐scale multicenter data to identify best practices and gaps in care, 6 whereas the IROC has the primary objective to accelerate the spread and implementation of research findings into clinical practice, while also pursuing research to understand gaps in care and health outcomes 11,12 …”