Transplant Outreach Part 5: How do I manage growth and ensure long term success?

You have successfully set up your outreach program and established a strong local presence (please check out my 4 previous posts on this topic). What now? In order to achieve sustainability, you will have pressures to improve efficiency, reduce costs and demonstrate value. It is important to have in place a methodology by which you track your activity from both a quantitative perspective as well as to be sure that the quality delivered matches the quality of your main program.

These factors are all intertwined and actually began early on in your efforts. By putting in place efficient operating protocols and systems, you have established the framework for growth. Efficient intake of referrals leads to shorter turnaround times for work-ups and hence the ability to further market and bring in new referrals. Your referral network will grow as they see the quality of the services provided. One recommendation is to create a dashboard for key elements of the program and then carefully monitor those elements to identify early on any potential issues that could negatively impact your efforts.  

Some process oriented quantitative measures that can be utilized are number of referrals, time from referral to listing in case of transplant, or to the treatment phase of care for non-transplant cases, either for a surgical procedure or a medication therapy. The clinical quality of the program can be tracked by the usual quality metrics for the care in question, paying careful attention to how performance in your outreach program compares to the care provided at the main institution. While the procedures will likely all be done at the main institution, it is critical to ensure that the pre- and post-procedure care is provided seamlessly at your offsite locations.

Demonstrating financial viability will be critical to maintain the support needed for your program from the main institution. This can be done by tracking not only the direct increase in procedure numbers but also by tracking the ancillary and off-shoot activity that results from your outreach efforts. For example, if you evaluate a potential kidney recipient and he requires bariatric surgery prior to the procedure, it is imperative that this value be claimed for your outreach program since the activity is a result of your initial efforts.  

It is through careful monitoring and data management of your program's efforts that you will be able to demonstrate quality care to your referring physician network. This will highlight your capabilities and encourage even more referrals.

About the Author: Dr. John Daller, MD, PhD, FACS

As a former Director of several transplant programs, Dr. Daller has expertise in all aspects of transplant program management, as well as hospital program development including clinical, regulatory, business and administrative leadership via his company Strategic Illuminations. He consults in the area of medical legal review, due diligence and scientific evaluations, as well as utilization review via Daller Consulting. He is also Chief Medical Officer of Concordia Valsource, LLC which provides consultative services to developing biopharmaceutical companies and to Venture Capital groups investing in the health and life sciences. Previously, Dr. Daller was Vice President for Medical Programs in the Transplant Business Unit of Genzyme Corporation.