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      Mobile Application for Communication Increases the Efficiency of Organ Procurement and Transplantation

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          Abstract

          Background:

          Donor organ recovery is a complex process involving organ procurement organizations and multiple surgical teams from various transplant centers. Nearly 30% of discarded organs are wasted due to reasons related to improper coordination and communication.

          Problem Statement:

          Lack of real-time communication results in many hours of preventable delay between procurement and transplant teams resulting in the high volume of organ waste, clinical frustration, and critical delays.

          Methods:

          A Plan-Do-Study-Act performance improvement methodology was utilized to design and implement a dedicated mobile communication application (app). Critical time points in the organ offer, procurement, and transplant processes were analyzed from the Report of Organ Offers, and relation coordination metrics were measured.

          Processes Addressed:

          Members of procurement and transplant teams in Iowa were interviewed and a dedicated smartphone application was implemented to replace phone calls, e-mails, faxes, and text messages during upcoming kidney offers from July 31, 2017 to July 31, 2018.

          Outcomes:

          Teams reported a substantial increase in clinical productivity and case progress awareness, including a noteworthy reduction in phone calls. The relational coordination data indicated substantially higher relationship and communication quality with the app. The Report of Organ Offer data revealed a 35% increase in organs transplanted and a 50% reduction in time from initial organ offer to transplant with the use of the mobile application.

          Implications for Practice:

          The use of a dedicated communication application reduces clinical frustration and delays during the coordination of organ offer, procurement, and transplant. Technologies that improve communication have the potential to improve organ utilization.

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          Most cited references9

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          Relational coordination among nurses and other providers: impact on the quality of patient care.

          The present study examined nurse reports of relational coordination between nurses and other providers and the impact of relational coordination on patient care quality. While communication between providers has been traditionally considered important to improve quality, relational coordination extends this view, emphasising the value of high-quality relationships exemplified by shared goals, shared knowledge and mutual respect; and high-quality communication that is timely, frequent, accurate and problem-solving. Direct care registered nurses (RNs) (n=747) completed surveys to assess relational coordination across five provider functions and six types of patient care units. Nurses also reported perceptions about patient care quality. In all analyses, relational coordination between nurses and other providers was significantly related to overall quality, in the expected directions. As relational coordination increased, nurses reported decreases in adverse events such as hospital-acquired infections and medication errors. Enhancing relational coordination between nurses and other providers is central to improving the quality of patient care. IMPLICATIONS FOR NURSE MANAGERS AND NEW KNOWLEDGE: The emerging theory of relational coordination provides a useful new research-based framework for managers to use to improve provider relationships, communication and the quality of care. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.
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            Disparities in Acceptance of Deceased Donor Kidneys Between the United States and France and Estimated Effects of Increased US Acceptance

            Key Points Question Would a more aggressive approach to organ acceptance provide a benefit to wait-listed kidney transplant candidates? Findings This cohort study analyzes the use of 156 089 deceased donor kidneys in the United States and 29 984 in France and finds that the US discard rate of these kidneys is nearly twice that of France. It uses computer simulation to model a lower US discard rate similar to that of France, and estimates a US increase of 132 445 allograft life-years. Meaning Greater acceptance of kidneys from older and comorbid deceased donors in the United States could provide major survival benefits to the population of wait-listed patients.
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              Association between Kidney Transplant Center Performance and the Survival Benefit of Transplantation Versus Dialysis

              Despite the benefits of kidney transplantation, the total number of transplants performed in the United States has stagnated since 2006. Transplant center quality metrics have been associated with a decline in transplant volume among low-performing centers. There are concerns that regulatory oversight may lead to risk aversion and lack of transplantation growth.
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                Author and article information

                Journal
                Prog Transplant
                Prog Transplant
                PIT
                sppit
                Progress in Transplantation (Aliso Viejo, Calif.)
                SAGE Publications (Sage CA: Los Angeles, CA )
                1526-9248
                2164-6708
                9 April 2020
                June 2020
                : 30
                : 2
                : 172-176
                Affiliations
                [1 ]Health Informatics, University of Iowa, Iowa City, IA, USA
                [2 ]Research, OmniLife, Inc, Lexington, KY, USA
                [3 ]Research, Relational Coordination Analytics, Inc, Canton, MA, USA
                [4 ]Quality, Iowa Donor Network, North Liberty, IA, USA
                [5 ]Transplant Center, Iowa Methodist Medical Center, Des Moines, IA, USA
                [6 ]Transplant Center, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
                Author notes
                [*]Eric Pahl, Health Informatics, University of Iowa, Iowa City, IA, USA. Email: eric-pahl@ 123456uiowa.edu
                Author information
                https://orcid.org/0000-0002-8635-3012
                Article
                10.1177_1526924820913503
                10.1177/1526924820913503
                7218344
                32270741
                aa3a54c1-1392-4f4d-8e15-c5eba6b9a1e8
                © 2020, NATCO

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Funding
                Funded by: U.S. National Library of Medicine, https://doi.org/10.13039/100000092;
                Award ID: 1R43LM012575-01
                Categories
                Performance Improvement
                Custom metadata
                ts3

                relational coordination,process improvement,clinical communication,mobile app,smartphone,medical group chat,information technology,deceased donor organ recovery,procurement,transplantation

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