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Proposed Changes to the OPTN Transplant Program Outcomes Review System. OPTN/UNOS Membership and Professional Standards Committee. What problem will the proposal solve?.
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Proposed Changes to the OPTN Transplant Program Outcomes Review System OPTN/UNOS Membership and Professional Standards Committee
What problem will the proposal solve? • OPTN method for reviewing transplant program outcomes is thought to have contributed to members’ increasingly conservative behavior • Transplant programs are becoming more selective • Organs accepted to transplant • Patients listed for transplant
What are the proposed solutions? • Tier 1: Expanded Program Performance Review • >60% probability that hazard ratio > 1.75 • 100% MPSC engagement • Tier 2: Routine Program Review • >60% probability that hazard ratio > 1.25 & the program is not included in Tier 1 • 50% MPSC engagement • Tier 3: Routine Program Review • Hazard ratio > 1.0 & the program is not included in Tier 1 or Tier 2 • 10% MPSC engagement • Tier 4: Performing As Expected or Better • Hazard ratio ≤ 1.0 • 0% MPSC engagement
What are the proposed solutions? HR ≤ 1 As Expected or Better Tier 0% Probability of MPSC Review
What are the proposed solutions? • MPSC and Member Actions • Expanded Program Performance Review Tier 1 – members will be expected to complete an “expanded survey” • Routine Program Review Tiers 2 & 3 – members that are randomly selected will be expected to complete an “initial survey” • Programs demonstrating ongoing and appropriate quality improvement efforts will be released from further MPSC review
How will members implement this proposal? • No major changes to members’ role in this process • Transplant programs are expected to be responsive to the MPSC if engaged in an outcomes performance review
How will the OPTN implement this proposal? • Board consideration – December 2016 • Programming – No • Implementation- If approved, the MPSC will use this method to identify programs for outcomes review in the June 2017 MPSC Outcomes Reports • Will require SRTR to revise its process for running the MPSC Outcomes Reports used to identify programs for outcomes review • Could be implemented together or separately from Transplant Program Performance Measure proposal • Also sponsored by MPSC this public comment cycle • Developed independently from this proposal
Questions? Jeffrey Orlowski, MS, CPTC Committee Chair Jorlowski@lifeshareok.org Chad Waller Committee Liaison chad.waller@unos.org
Current MPSC Review Space OPTN Bylaws Appendix D.11.A (Transplant Program Performance)