Tracking data in your transplant care software is a key component of QAPI programs, not only for CMS, but now also with UNOS debating the requirement of QAPI programs. One of the most challenging aspects of transplant program management is ensuring that your Quality Assessment and Process Improvement programs are measuring meaningful and actionable items that lead to program improvement.
There are many factors that contribute to these projects but the one thing they all have in common is that they are all data driven. Center outcomes are clearly impacted by data that is collected relative to patients as this data tells us how the patient is doing and is also used to calculate expected outcomes. One challenge that we see when helping centers assess their operational efficiency is lab turn around.
While at first thought, this may be taken to mean the time it takes to get a lab back from an outside lab, what is really important is the time it takes to produce an actionable event. Having an outside lab or physician's office send you a lab within 24 hours is not useful if the actionable information is trapped in a voicemail or in a pile of faxed papers that needs to be sorted and distributed to the appropriate person's mailbox. These types of delays are often compounded by a scenario where after finally being routed to the proper workflow, lab results must be manually entered into your transplant care software before the responsible person is notified.
The elevated CMV PCR or toxic range tacrolimus level that is not acted upon for a few days due to being lost in a pile of papers or the unrecognized unexpected HCV positive result can all lead to potential issues for a program in terms of QAPI and ultimately compliance with the CMS Conditions of Participation.
By having well ingrained workflow process solutions such as automated data management, these situations can be avoided and improved outcomes and safety can result. QAPI projects can focus on improving workflow processes and efficiencies that will lead to better reported outcomes. With the increased emphasis on QAPI programs, by not only by CMS but potentially by UNOS as well, programs that are prepared to embrace these processes will ultimately be more successful.
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.