The 2007 CMS Final Rule included expectations that transplant centers implement data-driven quality assessment and performance improvement (QAPI) programs. Currently, insufficient data exists to guide transplant centers' on development of quality program infrastructure.

Methods: In late 2017 respondents anonymously completed an internet-based survey querying centers' quality full time equivalents (FTEs), 2016 transplant volumes and QAPI meeting practices. Non-parametric correlation coefficients examined relationships between staffing, volumes and number of QAPI meetings.

Results: 54 centers responded (Figure 1) (48% university-affiliated, 15% single organ centers, UNOS regions 2-11).

Figure 1

Figure 2

91% had dedicated quality programs (86% initiated since 2007). 96% had quality staff (0.2 to 11 FTEs) and 57% felt staffing was inadequate. Reporting structures were to the transplant department (71%), hospital (8%) or mixed/other (21%). Quality meetings were program-specific (37%), comprehensive (17%) or a combination (46%). Adult transplant volumes (Figure 2) correlated with quality FTEs and number of QAPI meetings (rho≥0.60, p<0.001); pediatric volumes correlated with QAPI meetings (rho=0.67, p=0.001) but not significantly with FTEs (rho=0.36, p=0.087). Table 1 shows number of centers with quality FTEs per job role. Quality FTEs were not related to QAPI meeting volumes.

Table 1

Conclusion: There is wide variation in quality practices and transplant volumes generally related to staffing and QAPI meeting volumes.

CITATION INFORMATION: Cook M., Feurer I., Smith L., Rega S., Zavala E. Evaluating Transplant Quality Staffing Models via a National Survey Am J Transplant. 2017;17 (suppl 3).

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