Key performance indicators KPIs for deceased donor kidney

Key performance indicators (KPIs) for deceased donor kidney retrieval Chris Callaghan On behalf of Working Group 3, NORS Review Implementation Board Renal Transplant Services Meeting, March 2016

Background

WG 3 – KPIs for NORS • Role: to develop new KPIs for NORS teams – 1) Operational (data requirements, availability, mobilisation time, response to clinical incidents), some have £ consequences – 2) Quality (organ-specific), in development, applied from 2017, not £ consequences, for comparison • Discussions with key stakeholders (AGs, NRG) • Presentation to the NORS Implementation Board

Organ-specific KPIs for NORS • Four domains – 1) Organ damage – 2) Quality of communication – 3) Graft outcome – 4) Timeliness of retrieval • Background, WG 3 recommendation

Organ-specific KPIs for NORS • Organ damage – Currently coded as ‘moderate’ (requiring surgical repair) or ‘severe’ (unusable) – Funnel plots, by NORS team – WG 3 recommendation: continue with the above, await further electronic coding (J Asher)

Organ-specific KPIs for NORS • Quality of communication – By phone, from retrieval to implanting teams – WG 3 recommendation: only if concern about usability (damage, perfusion, parenchyma, anatomy, vessels), coding to be developed

Organ-specific KPIs for NORS • Graft outcome – Relevant to retrievals, evidence-based, riskadjusted, adequate statistical power – WG 3 recommendation: not directly relevant to kidney transplantation; decision for transplantation rests with implanting team

Organ-specific KPIs for NORS • Timeliness of retrieval – No clear evidence of impact on graft outcome, but overall quality indicator – WG 3 recommendations: % thresholds • KTS to start of perfusion (DCD) • Start of perfusion to nephrectomy (DBD / DCD, multi-organ / kidney-only, first / second) • Nephrectomy to kidney in box (multi-organ / kidney-only)

Thank you