*Purpose: To increase living donation through process improvement.

*Methods: Quality improvement project, with intention to substantially improve the living donor (LD) transplant (Tx) rate. Participants: All interested LD candidates from April 2019 to November 2019. Non-directed donors, donors &gt 60 years old and recipients with more than three donors underwent legacy multi-day evaluation and served as controls. Intervention: Living donors who passed initial screening underwent 1-Day LD evaluation. Figure 1 illustrates the timeline of events. Tests included a 24 hr Urine collection started the day prior, and AM fasting lab draw. The lab and imaging results were reviewed by a transplant nephrologist. If acceptable, patients proceeded to computed tomography (CT) abdomen pelvis followed by multi-disciplinary team assessment. Regardless of the group, all donors starting the study were given a survey. The results of one-day evaluation were reviewed, if deemed acceptable and cross match compatible, a surgery date was scheduled. Outcome: Change in rate of living donation transplantation following intervention.

*Results: 109 potential donors were evaluated, 80% of donors were evaluated in the one-day evaluation versus 20%. 33% in one-day evaluation and 23% in multi-day evaluation were excluded due to either medical or surgical issues. Compared to multi-day evaluation, one day-evaluation path had a significantly lower median days from referral to evaluation (111.5 vs 52.5 days, p<0.001). With the roll out of new process, we saw a 90 % increase in living donation rate (Figure 2). Regardless of the group, 46 (90%) patients preferred one day evaluation, Figure 3.

*Conclusions: With implementation of one-day living donor evaluation, we observed a significant and sustained increase in living donation. Additionally, donor preference suggests that regardless of their initial evaluation status, donors prefer one-day evaluation across all domains. Donors in one-day evaluation also noted significant improvement in scores for scheduling, communication, and overall experience. The one-day evaluation delivered superior patient experience and maximized value conferred by living donation.

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