Quality metrics in solid organ transplantation: protocol for a systematic scoping review

Abstract

BackgroundTransplantation is often the best, if not the only treatment for end-stage organ failure; however, the quality metrics for determining whether a transplant program is delivering safe, high quality care remains unknown. The purpose of this study is to identify and describe quality indicators or metrics in patients who have received a solid organ transplant.Methods/designWe will conduct a systematic scoping review to evaluate and describe quality indicators or metrics in patients who have received a solid organ transplant. We will search MEDLINE, Embase, and the Cochrane Central Register for Controlled Trials. Two reviewers will conduct all screening and data extraction independently. The articles will be categorized according to the six domains of quality, and the metrics will be appraised using criteria for a good quality measure.DiscussionThe results of this review will guide the development, selection, and validation of appropriate quality metrics necessary to drive quality improvement in transplantation.Systematic review registrationPROSPERO CRD42016035353.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-016-0279-4) contains supplementary material, which is available to authorized users.

A RAND-Modified Delphi on Key Indicators to Measure the Efficiency of Living Kidney Donor Candidate Evaluations

“…One strength of this study is the way individuals with lived experience were incorporated into the research team from the outset. Patients have rarely been featured in the development of quality indicators in transplantation (24).…”

How patients choose kidney transplant centers: A qualitative study of patient experiences

“…First, researchers and clinicians have proposed new quality measures that could inform where a patient goes to seek transplantation . One objective of the project was to involve patients to “ensure that transplantation quality metrics measure what is important to them” . Second, gaps currently exist in providing information to candidates, particularly those with higher risks of being turned down.…”

“…Our current qualitative study sought to better understand the experiences and perceptions of adult patients as they previously learned about kidney transplant center options, including the barriers to using available information about centers and how information was prioritized when making decisions. Recent debates highlight a need to inform patients about patient‐centered program quality measures . A better understanding of patient experiences can inform the development of new quality measures and information resources and can provide important patient perspectives to those counseling patients about transplantation and what center options could be considered.…”

Measuring quality in living donation and kidney transplantation: moving beyond survival metrics

“…2 A systematic review of quality indicators in transplantation has shown a considerable gap between the ideal measurement of quality, as defined by the Institute of Medicine, and what is currently being measured in kidney transplantation. 3 Although over 300 transplantation quality indicators have been reported in the literature, most have focused on safety and effectiveness, with very few addressing other domains of quality such as equity and patient centeredness. In addition, virtually no patient involvement has been seen in the development or selection of kidney transplantation quality indicators.…”

“…The stakeholder groups, which would be similar in other jurisdictions around the globe, included patient partners and patient organizations; nephrologists and surgeons involved in living kidney donation and kidney transplantation; government agencies involved in health care delivery and data collection; health quality and safety organizations; and representatives from organ donation organizations, professional societies, and health care charities (details of meeting process and participants can be found in the Supplementary Appendix). A comprehensive set of potential quality indicators was compiled from the findings of our systematic review, 3 qualitative interviews, 4 and an environmental scan. Participants were preassigned into groups of diverse stakeholders to capture a range of opinions.…”