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. 2023 Nov;23(11):1793-1799.
doi: 10.1016/j.ajt.2023.08.020. Epub 2023 Aug 30.

What is visible is fixable: Visual dashboards for multi-domain assessment of organ procurement organization performance

Brianna L Doby  1 , Kylie Casey  2 , Katie Ross-Driscoll  3 , Musaddiqur Rahman Ovi  4 , Md Shabbir Hossain Bhuiyea  4 , Istiak Ahmed Isty  4 , Raymond J Lynch  5
Affiliations

What is visible is fixable: Visual dashboards for multi-domain assessment of organ procurement organization performance

Brianna L Doby et al. Am J Transplant. 2023 Nov.

Abstract

With stakeholder focus on the United States organ procurement system, there is a need for tools that permit comparative assessment of organ procurement providers. We developed a public-facing dashboard for organ procurement organizations (OPOs), using data from multiple sources, to create an online, readily accessible visualization of OPO practice conditions and performance for the period 2010-2020. With this tool, OPOs can be compared on the CMS metric of donors procured per 100 donation-consistent deaths, as well as donation after circulatory death procurement, procurement of older and minority patient populations, procurement in smaller hospitals, and procurement of patients without a significant drug history. Patterns of higher performance were identified, and 74% of differences in overall donor procurement rates could be explained using model variables. Procurement differences were affected to a greater and more reproducible degree by OPO performance among Black and non-White patient populations, as well as in smaller hospitals, than by donation service area characteristics. Dashboards such as ours support OPOs and stakeholders in quality improvement actions, through leveraging benchmarked performance data among organ procurement clinical providers.

Keywords: CMS; Centers for Medicare & Medicaid Services; HRSA; Health Resources and Services Administration; OPO; deceased donation; organ procurement; organ procurement organization; policy.

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Conflict of interest statement

Declaration of interests

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1.
Figure 1.
Pictorial representation of overall and selected-domain OPO characteristics, 2010–2020. Individual graphs show dispersion in performance domains (A-C, E, G, H) and distribution of hospital and patient case mixes (D, F) across DSAs.
Figure 2.
Figure 2.
Comparison of procurement practice and DSA conditions by overall OPO performance quartile, 2010–2018. Quartiles are shown with US average values for each domain depicted as dashed gray line for comparison. Note that OPO quartiles are non-overlapping in procurement practice domains, despite overlapping DSA characteristics.
Figure 3.
Figure 3.
Comparisons between OPOs by overall performance and selected OPO/DSA characteristics, 2010–2020. Gray dotted line shows average values for US procurement performance within each domain for comparison.
Figure 4.
Figure 4.
Visualization of procurement performance by domain over time for two different OPOs. Gray dotted line shows average values for US procurement performance within each domain and era for comparison. Axis labels simplified for clarity, lighter shading indicates earlier cohorts for comparison.
See this image and copyright information in PMC

References

    1. Organ Procurement Organizations Conditions for Coverage: Revisions to Outcome Measure Requirements for Organ Procurement Organizations. In: Centers for Medicare & Medicaid Services HaHS, ed. 86 FR 7814. Vol 42 CFR 4862021:1.
    1. Doby BL, Ross-Driscoll K, Yu S, Godwin M, Lee KJ, Lynch RJ. Examining utilization of kidneys as a function of procurement performance. Am J Transplant. 2022;22(6):1614–1623. - PMC - PubMed
    1. Southward CP M. OPTN/UNOS Ad Hoc Committee on Geography Geographic Organ Distribution Principles and Models Recommendations Report. OPTN/UNOS Mini Brief Web site. https://optn.transplant.hrsa.gov/media/2506/geography_recommendations_re.... Published 2018. Accessed May 29, 2023, 2023.
    1. Lynch RJ, Magliocca JF, Hundley JC, Karp SJ. Moving past “think local, act global”: A perspective on geographic disparity. Am J Transplant. 2019;19(7):1907–1911. - PubMed
    1. HRSA Announces Organ Procurement and Transplantation Network Modernization Initiative [press release]. Washington DC: Department of Health and Human Services, March/22/2023. 2023.

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