Institutional members access full text with Ovid®

Share this article on:

Quality assessment and performance improvement in transplantation: hype or hope?

Reich, David J.

Current Opinion in Organ Transplantation: April 2013 - Volume 18 - Issue 2 - p 216–221
doi: 10.1097/MOT.0b013e32835f3fcf
REGULATORY, FINANCIAL AND ETHICAL CONSIDERATIONS IN TRANSPLANTATION: Edited by Anton I. Skaro

Purpose of review: Healthcare reform and the national quality strategy is increasingly impacting transplant practice, as exemplified by quality assessment and performance improvement (QAPI) regulations for pretransplant and posttransplant care. Transplant providers consider not just patient comorbidities, donor quality, and business constraints, but also regulatory mandates when deciding how to care for transplant candidates and recipients. This review describes transplant quality oversight agencies and regulations, and explores recent literature on the pros and cons of transplant QAPI.

Recent findings: Transplant's heavily regulated system of care and remuneration involves extensive QAPI process and outcome requirements, and assessment of lifelong, risk-adjusted data from the national, audited, publicly reported, electronic registry. Transplant is a model-integrated delivery system, with payment bundling and accountability for equitable access to high quality, efficient, cost-sensitive, and multidisciplinary care. However, transplant QAPI requires expensive resources and, to bolster wise risk-taking, novel treatments, and access to care, more nuanced risk adjustment, public reporting, and attention to geographic competitive variability. However, transplant QAPI requires expensive resources. In order to bolster wise risk-taking, novel treatments, and access to care, QAPI also requires more nuance in the areas of risk adjustment, public reporting, and attention to geographic competitive variability.

Summary: With its focus on innovation and on clinical outcomes, transplantation is poised to continue providing outstanding clinical care and to pioneering systems that advance patient safety, satisfaction, and resource utilization, leading in the field of QAPI and healthcare reform.

Division of Multiorgan Transplantation and Hepatobiliary Surgery, Department of Surgery, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, Pennsylvania, USA

Correspondence to David J. Reich, MD, FACS, Professor and Chief, Division of Multiorgan, Transplantation and Hepatobiliary Surgery, Drexel University College of Medicine, Hahnemann, University Hospital, 216 North Broad Street, 5th Floor, Feinstein Building, MS 1001, Philadelphia, PA 19102, USA. Tel: +1 215 762 7143; fax: +1 215 762 3846; e-mail: david.reich@drexelmed.edu

© 2013 Lippincott Williams & Wilkins, Inc.