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Purpose

The overarching goal of the proposed study is to determine whether the addition of structural interventions at the health system level targeting upstream barriers in the transplant process will improve access to transplant evaluation start.

Conditions

Eligibility

Eligible Ages
Between 18 Years and 80 Years
Eligible Sex
All
Accepts Healthy Volunteers
Yes

Inclusion Criteria

  • Five large transplant centers (Emory Transplant Center and Piedmont Transplant Center in Atlanta, GA; Medical University of SC; Duke University in Durham, NC; and Indiana University in Indianapolis, IN) ~800 referring dialysis center referring to these transplant centers

Exclusion Criteria

  • Individuals referred, initiating evaluation, and waitlisted at non-participating start centers

Study Design

Phase
N/A
Study Type
Interventional
Allocation
N/A
Intervention Model
Single Group Assignment
Primary Purpose
Health Services Research
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Multi-Component Intervention 		Five participating transplant centers will multicomponent intervention in their management of patients referred to their transplant center for a kidney transplantation. The intervention will consist of: (1) required performance feedback reports on closed referrals; and a set of optional components that may be implemented variably by centers, including; (2) contacting patients via their preferred method; (3) phone calls to the dialysis facility during the patient's dialysis session; (4) phone calls to the referring or other provider; (5) use of a multi-module, secure, web-enabled software application called Transplant Referral EXchange (T-REX) or secure email to communicate patient status and no-show information; and (6) communication tracking and audit. Dialysis facilities in GA, NC, SC, and IN will receive resources to support an awareness campaign to support implementation of intervention activities within transplant centers.
  • Other: Performance Feedback Reports on Referral and Evaluation Closures
    Performance feedback reports will reflect each transplant center's performance related to kidney transplant evaluation initiation and referral closure. These reports aim to help centers understand common reasons why patients do not initiate the evaluation process or failed to proceed beyond the evaluation process, and to identify patterns in referral and evaluation closure practices. Reports will be individualized and distributed quarterly to the transplant center champion by the intervention lead.
  • Other: Dialysis Facility Awareness Campaign
    As part of the intervention, dialysis centers will participate in an Awareness Campaign designed to educate staff about transplant center quality improvement efforts and how they may be contacted as part of the project. This campaign may include brief webinars or informative documents distributed via platforms such as IPRO Learn.
  • Other: Patient Contact via Preferred Method
    Transplant centers will contact patients using their preferred method of communication.
  • Other: Phone Call to Dialysis Facility During the Patient's Dialysis Session
    Facilities will enhance their patient communication procedures by making a phone call to the dialysis facility during the patient's dialysis session if the patient has not responded to initial outreach attempts. This additional step increases the likelihood of reaching the patient during a time when they are accessible and can engage in scheduling or follow-up.
  • Other: Phone Call to Provider
    Transplant centers will enhance their outreach procedures by making a phone call to the referring provider (e.g., nephrologist, medical assistant) or another provider involved in the patient's care (e.g., primary care provider) in the event of self-referral if the patient has not responded to initial outreach attempts or "no-shows" an initial evaluation appointment. This additional step ensures that the referring provider is informed of the patient's progress and can assist in re-engagement or decision-making prior to referral closure.
  • Other: Transplant Referral Communication Platforms or Email to Communicate Patient Status and No-Show
    Transplant center staff will utilize transplant referral communication platforms and/or email to communicate updates to dialysis staff regarding patient status (e.g., unable to contact the patient or no-show) before referral closure.
  • Other: Audit and Tracking of Patient Contact Attempts Prior to Referral Closure
    Transplant center staff will continue internally tracking the frequency that a patient is contacted before closure and the date of closure, in alignment with center standard practice. This intervention introduces an audit process to be conducted before closure to ensure that all contact attempts (including one or more attempts to contact the patient directly, one or more phone calls to the alternate preferred contact, or one or more attempted contacts to the dialysis unit to connect with the patient), in alignment with center communication procedures, are appropriately executed.

Recruiting Locations

Piedmont Transplant Institute
Atlanta, Georgia 30309
Contact:
Ana Rossi, MD
(404) 605-4600
ana.rossi@piedmont.org

Emory Transplant Center
Atlanta, Georgia 30322
Contact:
Stephen Pastan, MD
(855) 366-7989
stephen.pastan@emoryhealthcare.org

IU Health Transplant - Indianapolis
Indianapolis, Indiana 46202
Contact:
Jonathan Fridell, MD
(317) 944-4370
jfridell@iu.edu

Duke Transplant Center
Durham, North Carolina 27710
Contact:
Goni Katz-Greenberg, MD
(855) 855-6484
goni.katzgreenberg@duke.edu

MUSC Mid-Carolinas Transplant Center
Lancaster, South Carolina 29720
Contact:
Prince Mohan, MD
(843) 792-5097
mohanp@musc.edu

More Details

Status
Recruiting
Sponsor
Indiana University

Study Contact

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.