Kidney Transplant Length of Stay: A Data Driven Quality Improvement Project

Abstract

Kidney transplant has been deemed a cost-effective treatment for end-stage renal disease. Medicare is the primary payor for the kidney transplant diagnosis-related group and payment is based on a 5.5-day length of stay. Exceeding this designated length of stay leads to financial loss for organizations. The purpose of this quality improvement project is to provide a gap analysis between actual care provided and expected care during the discharge process of a kidney transplant recipient. The clinical nurse leader graduate student anticipated that identified gaps in expected care would drive evidence-based interventions that may reduce length of stay in this patient population. Since case management has a profound effect on the discharge process, the organizational case management policy Assessment and Discharge Planning for the Transplant Recipient was utilized as the foundational document for the gap analysis. Results of the gap analysis found that communication techniques may be a barrier to earlier discharge at this institution. An analysis of the data collected revealed that formal interprofessional discharge rounds are not being conducted and that communication to the outpatient transplant social worker is 30.7%. A literature review provided evidence that utilizing TeamSTEPPS to improve interprofessional communication during the discharge process could reduce kidney transplant hospitalization by 1-day. If the stakeholders at this academic hospital successfully improved communication during the discharge process via TeamSTEPPS, this change could potentially save the organization $60,000 annually.M.S.N., Clinical Nurse Leader -- Drexel University, 201