Kidney Quality Improvement Partnership KQu IP University Hospitals

Kidney Quality Improvement Partnership (KQu. IP) University Hospitals Plymouth NHS Trust Update on Project Work Leanne Savage, Transplant Liaison Nurse Linda Boorer, Transplant Nurse Consultant Dr Imran Saif, Consultant Nephrologist and Director of Transplantation Phil Isaac Transplant Nurse Practitioner

Driver Diagram Change Ideas Kidney Quality Improvement Partnership | West Midlands Regional Day 11/6/2020 2

Update on Progress • Increasing the number of available theatre slots • Allocated theatre now unavailable • Have a plan in place for 24 lists dedicated to living donation per year through each of our surgeons own lists • IS to arrange meeting with medical director moving forward with a view to ensuring adequate theatre space and staffing • Prediction – 19 live donor nephrectomies by March 2020 (16 LDTx) • Reasons behind lower numbers than last year – delay in nuclear medicine availability by 3 months, 4 lists cancelled due to theatre staffing/availability • Contact cards for patients • Currently give out a contact card on paper with the numbers for the transplant team, including living donor coordinators and waiting list nurses • Going to look into sending out an electronic contact so that patients have the numbers stored in their phones Kidney Quality Improvement Partnership | West Midlands Regional Day 11/6/2020 3

Update on Progress • Website • Under construction at present • All information has been updated with landing pages for each topic e. g. TWL, LD with links to NHSBT and leaflets that we have reviewed • Link to a video of a transplant operation • Thinking about a TAC seminar video to encourage consistent information giving • Staff awareness initiatives • Planned education for ward staff on all aspects of transplantation • Review living donor options and TWL status for dialysis patients • Have revisited transplant decisions of all HD and PD patients under 7 consultants – have another 4 to go • Standardised cardiology assessment • Completed by IS Kidney Quality Improvement Partnership | West Midlands Regional Day 11/6/2020 4

Update on Progress • 3 visit LKD assessment pathway • 11 donors have gone through the 1 day assessment from 1 st July – 31 st October • 2 have donated already with a third ready to donate and another being ready next week. Kidney Quality Improvement Partnership | West Midlands Regional Day 11/6/2020 5

Update on Progress • Standardised recipient referral form to TAC • Not started – awaiting results from what has been done in Bristol prior to looking at this • Documented transplant decision for patients with an e. GFR of <20 m. L/min Q 3 and Q 4 below Kidney Quality Improvement Partnership | West Midlands Regional Day 11/6/2020 6

Update on Progress • Bariatric surgery pathway for potential recipients with high BMI • No update on whether this is any further forward – LS to email the bariatric surgeon for an update • Each unit to review organ acceptance criteria • Consistently reviewing both accepted and declined offers on a monthly basis within the steering group • Units to invite patient representatives to KQu. IP • Patients have been invited and we have a regular attendee • Patient representatives are also invited to the trust transplant committee meeting for input • Dashboard • Suspended list reducing - Plymouth patients suspended equates to 19. 6% (25% previous quarter) national suspended rate is 35% Kidney Quality Improvement Partnership | West Midlands Regional Day 11/6/2020 7

Kidney Quality Improvement Partnership (KQu. IP) University Hospitals Plymouth NHS Trust Update on Project Work Leanne Savage, Transplant Liaison Nurse Linda Boorer, Transplant Nurse Consultant Dr Imran Saif, Consultant Nephrologist and Director of Transplantation Phil Isaac Transplant Nurse Practitioner

Driver Diagram Change Ideas 11/6/2020 Kidney Quality Improvement Partnership | West Midlands Regional Day 9

Update on Progress • Increasing the number of available theatre slots • Allocated theatre now unavailable • Have a plan in place for 24 lists dedicated to living donation per year through each of our surgeons own lists • IS to arrange meeting with medical director moving forward with a view to ensuring adequate theatre space and staffing • Prediction – 19 live donor nephrectomies by March 2020 (16 LDTx) • Reasons behind lower numbers than last year – delay in nuclear medicine availability by 3 months, 4 lists cancelled due to theatre staffing/availability • Contact cards for patients • Currently give out a contact card on paper with the numbers for the transplant team, including living donor coordinators and waiting list nurses • Going to look into sending out an electronic contact so that patients have the numbers stored in their phones 11/6/2020 Kidney Quality Improvement Partnership | West Midlands Regional Day 10

Update on Progress • Website • Under construction at present • All information has been updated with landing pages for each topic e. g. TWL, LD with links to NHSBT and leaflets that we have reviewed • Link to a video of a transplant operation • Thinking about a TAC seminar video to encourage consistent information giving • Staff awareness initiatives • Planned education for ward staff on all aspects of transplantation • Review living donor options and TWL status for dialysis patients • Have revisited transplant decisions of all HD and PD patients under 7 consultants – have another 4 to go • Standardised cardiology assessment • Completed by IS 11/6/2020 Kidney Quality Improvement Partnership | West Midlands Regional Day 11

Update on Progress • 3 visit LKD assessment pathway • 11 donors have gone through the 1 day assessment from 1 st July – 31 st October • 2 have donated already with a third ready to donate and another being ready next week. 11/6/2020 Kidney Quality Improvement Partnership | West Midlands Regional Day 12

Update on Progress • Standardised recipient referral form to TAC • Not started – awaiting results from what has been done in Bristol prior to looking at this • Documented transplant decision for patients with an e. GFR of <20 m. L/min Q 3 and Q 4 below 11/6/2020 Kidney Quality Improvement Partnership | West Midlands Regional Day 13

Update on Progress • Bariatric surgery pathway for potential recipients with high BMI • No update on whether this is any further forward – LS to email the bariatric surgeon for an update • Each unit to review organ acceptance criteria • Consistently reviewing both accepted and declined offers on a monthly basis within the steering group • Units to invite patient representatives to KQu. IP • Patients have been invited and we have a regular attendee • Patient representatives are also invited to the trust transplant committee meeting for input • Dashboard • Suspended list reducing - Plymouth patients suspended equates to 19. 6% (25% previous quarter) national suspended rate is 35% 11/6/2020 Kidney Quality Improvement Partnership | West Midlands Regional Day 14