The Royal Free Hospital ‘hub-and-spoke network model’ delivers effective care and increased access to liver transplantation

Tai, David; Dhar, Ameet; Yusuf, Abdullah; Marshall, Aileen; Patch, David; Tsochatzis, Emmanuel; Alexander, Graeme M.J.; Portal, J; Thalheimer, Ulrich; Thorburn, Douglas; Kallis, Yiannis; Westbrook, Rachel

doi:10.1016/j.puhe.2017.10.012

Cited by 19 publications

(26 citation statements)

References 8 publications

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“…A joint SWLU/King’s transplant multidisciplinary team meeting and clinic for the whole region is held 3–4 times per year. This network differs from others recently reported9 in that it has matured and evolved over a 14-year period as a devolved care model, rather than a hub and spoke, with pre-transplant and post-transplant care devolved fully to a large regional centre providing 24/7 consultant hepatology cover.…”

Section: Introductionmentioning

confidence: 71%

“…While we did not formally assess patient satisfaction in this study, a recent paper reported high levels of patient satisfaction with care provided closer to home using a less devolved hub and spoke model 9. The numbers of patients being transplanted each year continues to rise, and this together with the good survival rates means that the pool of patients needing assessment and long-term post-transplant care is growing rapidly.…”

Section: Discussionmentioning

confidence: 95%

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Risk-adjusted survival in liver transplant patients assessed and managed by a non-transplanting centre: South West Liver Unit experience

Norton

Srivastava

Ramos

et al. 2019

Frontline Gastroenterol

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BackgroundLiver transplant services remain a scarce resource not reflective of geography or burden of liver disease within the UK. To address geographical concerns in the South West (SW), a devolved network model of care for liver transplantation was established in 2004 between the SW Liver Unit (SWLU) at Derriford Hospital, Plymouth and King’s College Hospital, London. The SWLU has evolved to deliver both pre-transplant and post-transplant care for patients across the SW Peninsula. We determined whether risk-adjusted survival in patients assessed and managed at the SWLU compared with existing UK transplant centres.DesignRetrospective analysis of records at National Health Service Blood and Transplant (NHSBT) for patients ≥18 years listed or undergoing first liver only deceased donor transplantation from 1 January 2006 to 31 December 2017. Data collected and used were in accordance with standard NHSBT outcome measures.ResultsWe identified 8492 patients registered for first liver only transplant and 6140 patients who subsequently underwent transplantation. Of these, 215 patients listed and 172 patients transplanted were registered at the SWLU. The 1-year, 5-year and 10-year risk-adjusted post-listing survival for patients registered at the SWLU were 86%, 75% and 67%, respectively, with 1-year and 5-year risk-adjusted post-transplant survival 94.9% and 84.4%, respectively.ConclusionsRisk-adjusted post-listing 1-year, 5-year and 10-year survival outcomes and risk-adjusted 1-year and 5-year post-transplant survival outcomes at the SWLU are good and comparable with the seven UK transplant centres. These outcomes provide assurance that care delivered by our regional programme is equivalent to well-established liver transplant programmes.

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Section: Introductionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 95%

Risk-adjusted survival in liver transplant patients assessed and managed by a non-transplanting centre: South West Liver Unit experience

Norton

Srivastava

Ramos

et al. 2019

Frontline Gastroenterol

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“…Outcomes in non-transplant centres patient care close to home without compromising patient wellbeing. 24,25 Video-conferencing technology has already been successfully used to increase access to care in underserved areas in Canada, most notably in the treatment of hepatitis C infection and is increasingly used in the management of transplant recipients in non-transplant centres. Further, outreach clinics are becoming part of day-to-day clinical service provision.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of liver transplant recipients followed up in non-transplant centres: Care closer to home

et al. 2021

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IntroductionIncreasing rates of liver transplantation and improved outcomes have led to greater numbers of transplant recipients followed up in non-transplant centres. Our aim was to document long-term clinical outcomes of liver transplant recipients managed in this 'hub-and-spoke' healthcare model. MethodsA retrospective analysis of all adult patients who underwent liver transplantation between 1987 and 2016, with post-transplant follow-up in two non-transplant centres in the UK (Nottingham) and Canada (Ottawa), was performed. ResultsThe 1-, 5-, 10-and 20-year patient survival rates were 98%, 95%, 87% and 62%, and 100%, 96%, 88% and 62% in the Nottingham and Ottawa groups, respectively (p=0.87). There were no significant differences between the two centres in 1-, 5-, 10-and 20-year cumulative incidence of death-censored graft-survival (p=0.10), end-stage renal disease (p=0.29) or de novo cancer (p=0.22). Nottingham had a lower incidence of major cardiovascular events (p=0.008). ConclusionAdopting a new model of healthcare provides a means of delivering post-transplant patient care close to home without compromising patient survival and long-term clinical outcomes.

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“…Kelly and Scott (2012) aimed at understanding the benefits valued by the customer in a B2B setting and they concluded that among these benefits one can find service benefits characterized as those designed to improve service delivery. Another study by Tai et al (2018) focused on the health-care sector and discussed quality outcomes in connection with patient satisfaction. In this case, the quality outcome was categorized as a concept corresponding to the service quality discussed in the private literature.…”

Section: Value As a Net Benefitmentioning

confidence: 99%

Assessing inter-organizational performance through customer value: a literature review

Coletta

Vainieri

Noto

et al. 2021

JBIM

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Purpose This study aims to systematically review the literature on the use of customer value for the evaluation of inter-organizational performance, with a wide perspective embracing different contexts and settings. Design/methodology/approach Searching within the Scopus and ISI Web of Science databases, a systematic literature review has been conducted analyzing 41 papers published between 1991 and 2020. Findings Categorization of customer value and inter-organizational performance measures were developed and the main differences among different settings were discussed. Practical implications The results presented in this study may be helpful for practitioners and managers who, in the completion of their activities, have to maintain strong and frequent relationships with other organizations. In fact, practitioners and managers interested in enhancing customer value and measuring inter-organizational performance may find an innovative perspective linking the two dimensions. They could find the categorizations presented in this study as a starting point for developing a performance evaluation framework suitable for evaluating their present business relationships. In fact, the categorizations provide a panorama of how scholars have measured until now inter-organizational performance through customer value, and therefore, they could choose the measures more appropriate for their situation. Originality/value No systematic literature review of the use of customer value for assessing inter-organizational performance has previously been undertaken, especially considering different settings.

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The Royal Free Hospital ‘hub-and-spoke network model’ delivers effective care and increased access to liver transplantation

Abstract: Hub-and-spoke LT networks are effective in offering equivalent clinical outcomes, high patient satisfaction and alleviate clinical pressure on the hub centre. They have to potential to help eliminate the geographical disparity in mortality rates from chronic liver disease.

Cited by 19 publications

References 8 publications

Risk-adjusted survival in liver transplant patients assessed and managed by a non-transplanting centre: South West Liver Unit experience

Risk-adjusted survival in liver transplant patients assessed and managed by a non-transplanting centre: South West Liver Unit experience

Long-term outcomes of liver transplant recipients followed up in non-transplant centres: Care closer to home

Assessing inter-organizational performance through customer value: a literature review

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