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HRSA Transplant Center Growth and Management Collaborative: Best Practices Evaluation Report - September 2007

     
HRSA Transplant Center Growth and Management Collaborative:
Best Practices Evaluation
Printer-Friendly Report
(717 KB) Adobe Acrobat graphic with link to free Adobe Acrobat Reader download site
Introduction
Study Design and Methodology
Strategy/Driver 1: Institutional Vision and Commitment
Strategy/Driver 2: Dedicated Team
Strategy/Driver 3: Agressive Clinical Style
Strategy/Driver 4: Patient and Family Centered Care
Strategy/Driver 5: Financial Intelligence
Strategy/Driver 6: Aggressive Management of Performance Outcomes
Implementation Considerations
Conclusions
Appendix A - Change Package Document
Appendix B - List of Expert Panelists
Appendix C - Transplant Center and Program
Acknowledgements
 

Appendix C
Transplant Center and Program Data


Mayo Clinic

 
Liver Program (Rochester)
Liver Program (Jacksonville)
Liver Program (Scottsdale)
Kidney Program (Scottsdale)
Number of Transplants
2000
87
136
27
2
2001
68
175
31
12
2002
61
161
32
23
2003
80
164
38
16
2004
68
239
35
42
2005
81
240
51
42
200637
74
202
32
48
3-Year Graft Failure Observed/
0.67*
1.06
0.75
1.05
Expected Ratio        
3-Year Patient Mortality Observed/ Expected Ratio
0.66*
0.84
0.83
0.99
Donor Information
Percent DCD
0.83
6.66
0
1.24
Percent ECD
27.8
37.66
23.04
17.39
Percent SCD
71.37
55.51
76.96
81.37
Percent Import
13.07
78.04
14.78
27.95

 

 

 

Cleveland Clinic

 
Heart
Program
Liver
Program
Lung
Program
Pancreas
Program
Number of Transplants
2000
76
35
45
5
2001
74
30
40
4
2002
60
31
36
9
2003
73
38
47
8
2004
57
90
63
12
2005
71
116
64
16
200637
80
120
52
12
3-Year Graft Failure Observed/Expected Ratio
0.51*
0.86
0.85
N/A
3-Year Patient Mortality Observed/Expected Ratio
0.53*
0.8
0.88
N/A
Donor Information
Percent DCD
0
2
0.62
0
Percent ECD
6.65
32
14.02
1.67
Percent SCD
93.35
66
85.36
98.33
Percent Import
78.71
56.5
70.72
55

 

 

 

The Hospital of the University of Pennsylvania

 
Heart Program
Kidney Program
Liver Program
Lung Program
Number of Transplants
2000
49
76
84
31
2001
48
89
77
33
2002
48
98
106
28
2003
53
100
104
32
2004
44
96
121
39
2005
45
97
120
58
200637
58
116
112
62
3-Year Graft Failure Observed/
0.84
0.44*
0.87
0.9
Expected Ratio
3-Year Patient Mortality Observed/ Expected Ratio
0.76
0.53*
0.86
0.94
Donor Information
Percent DCD
0
10.26
2.69
0
Percent ECD
7.91
24.59
26.65
7.14
Percent SCD
92.09
65.15
70.66
92.86
Percent Import
27.53
19.22
5.84
30.95

 

 

 

Hahnemann University Hospital

 
Kidney Program
Number of Transplants
2000
70
2001
86
2002
93
2003
98
2004
104
2005
101
200637
90
3-Year Graft Failure Observed/Expected Ratio
0.78*
3-Year Patient Mortality Observed/Expected Ratio
1.03
Donor Information
Percent DCD
19.93
Percent ECD
21.61
Percent SCD
58.46
Percent Import
21.11

 

 

 

Children's Hospital of Philadelphia

 
Heart Program
Kidney Program
Liver Program
Number of Transplants
2000
15
7
9
2001
10
8
10
2002
8
7
12
2003
9
11
3
2004
12
15
12
2005
13
6
8
200637
8
18
10
3-Year Graft Failure Observed/Expected Ratio38
2.02*
0.21
0.69
3-Year Patient Mortality Observed/Expected Ratio39
1.72
N/A
0.78
Donor Information
Percent DCD
0
0
5.08
Percent ECD
0
0
0
Percent SCD
100
100
94.92
Percent Import
60.56
9.52
40.68

 

 

 

University of California, San Francisco Medical Center

 
Heart
Program
Kidney
Program
Liver
Program
Number of Transplants
2000
3
164
69
2001
3
135
82
2002
1
162
73
2003
13
178
93
2004
6
191
90
2005
19
146
130
200637
26
146
124
3-Year Graft Failure Observed/Expected Ratio
0.85
0.84
0.68*
3-Year Patient Mortality Observed/Expected Ratio
0.85
0.82
0.60*
Donor Information
Percent DCD
0
1.24
1.67
Percent ECD
1.72
9.25
19.87
Percent SCD
98.28
89.51
78.46
Percent Import
8.62
20.5
27.21

 

 

Stanford University
Heart
Program
Kidney
Program
Number of Transplants
2000
37
5
2001
52
16
2002
47
41
2003
50
42
2004
61
47
2005
54
47
200637
58
44
3-Year Graft Failure Observed/Expected Ratio
0.94
0.26*
3-Year Patient Mortality Observed/Expected Ratio
0.95
0.32*
Donor Information
Percent DCD
0
0.45
Percent ECD
1.82
10.45
Percent SCD
98.18
89.09
Percent Import
16.67
22.27

 

 

 

California Pacific Medical Center

 
Kidney Program
Number of Transplants
2000
68
2001
97
2002
101
2003
102
2004
99
2005
102
200637
112
3-Year Graft Failure Observed/Expected Ratio
0.79*
3-Year Patient Mortality Observed/Expected Ratio
0.70*
Donor Information
Percent DCD
1.28
Percent ECD
12.64
Percent SCD
86.08
Percent Import
27.52

 

 

Clarian Health-Methodist/IU/Riley

 
Kidney Program
Liver Program
Lung Program
Pancreas
Program
Number of Transplants
2000
41
52
32
N/A
2001
92
72
27
N/A
2002
161
133
31
3
2003
170
160
45
10
2004
163
150
41
24
2005
196
157
51
18
200637
102
134
38
22
3-Year Graft Failure Observed/Expected Ratio
0.77*
1.12
0.69
N/A
3-Year Patient Mortality Observed/Expected Ratio
0.54*
1.11
0.68
N/A
Donor Information
Percent DCD
1.72
3.41
0.41
3.03
Percent ECD
7.44
17.32
5.69
0
Percent SCD
90.85
79.27
93.9
96.97
Percent Import
22.31
31.73
30.89
42.42

 

 

 

University of Washington Medical Center

 
Liver Program
Lung Program
Number of Transplants
2000
83
27
2001
70
31
2002
76
36
2003
103
37
2004
123
42
2005
114
42
200637
120
60
3-Year Graft Failure Observed/Expected Ratio
0.74*
0.63*
3-Year Patient Mortality Observed/Expected Ratio
0.75
0.69*
Donor Information
Percent DCD
6.52
0
Percent ECD
14.94
6.12
Percent SCD
78.54
93.88
Percent Import
12.88
40.82

 

 

 

New York-Presbyterian Hospital/Columbia University Medical Center

 
Heart Program
Kidney Program
Lung Program
Number of Transplants
2000
93
28
18
2001
103
17
19
2002
82
17
22
2003
85
22
26
2004
93
40
35
2005
116
101
43
200637
104
124
54
3-Year Graft Failure Observed/
Expected Ratio
0.79
0.82
0.99
3-Year Patient Mortality Observed/
Expected Ratio
0.77
0.83
1.03
Donor Information
Percent DCD
0
4.53
0
Percent ECD
3.85
23
6.84
Percent SCD
96.15
72.47
93.16
Percent Import
62.98
58.19
65.79

 

 

 

New York-Presbyterian Hospital/Weill Cornell Medical Center

 
Kidney Program
Number of Transplants
2000
35
2001
24
2002
29
2003
31
2004
28
2005
98
200637
172
3-Year Graft Failure Observed/Expected Ratio
0.75
3-Year Patient Mortality Observed/Expected Ratio
0.71
Donor Information
Percent DCD
3.63
Percent ECD
29
Percent SCD
67.37
Percent Import
53.78

 

 

Duke University Medical Center

 
Heart Program
Lung Program
Number of Transplants
2000
52
52
2001
68
61
2002
60
50
2003
51
55
2004
47
58
2005
35
67
200637
46
54
3-Year Graft Failure Observed/Expected Ratio
0.67*
0.73*
3-Year Patient Mortality Observed/Expected Ratio
0.68*
0.70*
Donor Information
Percent DCD
0
0
Percent ECD
6.55
13.51
Percent SCD
93.45
86.49
Percent Import
52.08
77.84

 

Note: All data provided by HRSA DoT

* Statistically significant (p<0.05)

37  Number of transplants performed from January 1, 2006 - June 30, 2006 was doubled to estimate totals for 2006.

38  CHOP observed/expected ratios are for pediatric transplants only. The number of transplants performed from 2000 to 2006 includes all patients; however, 3-year graft failure and patient mortality only include pediatric patients.

39  Ibid

 
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