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Improving Transplant Program Outcomes Review System Proposal

This proposal aims to address the issue of conservative behavior in transplant program outcomes review, providing solutions through tiered performance reviews and member engagement to ensure higher quality transplantation outcomes.

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Improving Transplant Program Outcomes Review System Proposal

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  1. Proposed Changes to the OPTN Transplant Program Outcomes Review System OPTN/UNOS Membership and Professional Standards Committee

  2. 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

  3. 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

  4. What are the proposed solutions?

  5. What are the proposed solutions? HR ≤ 1 As Expected or Better Tier 0% Probability of MPSC Review

  6. What are the proposed solutions?

  7. 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

  8. 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

  9. 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

  10. Questions? Jeffrey Orlowski, MS, CPTC Committee Chair Jorlowski@lifeshareok.org Chad Waller Committee Liaison chad.waller@unos.org

  11. Additional Information

  12. Current MPSC Review Space OPTN Bylaws Appendix D.11.A (Transplant Program Performance)

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