Course Outline
Operational best Practices
Basics of strategic planning
Quality oversight & improvement
Notes to Self
Crash with friends!
1. Set up Standing meetings with Medical & Surgical
Directors
2. Attending Selection Meetings
3. Attend M&M
4. Observe Transplants in OR
5. Round with team in hospital & Round on all
transplant staff
The Three C’s
1. Consultants
2. Coaches
3. Connection with Peers outside your
center.
The Gang’s all here
Unlocking the Mystery Behind
Strategic Planning
Gene Ridolfi, RN, BA, MHA
Administrator, Organ Transplant Center
Barnes-Jewish Hospital
Washington University School of Medicine
April,2015
Overview
• Background
• Planning Process
- Preliminary Planning
- Research Analysis
- Issue & Goal Setting
- Strategy Formulation
- Final Plan
• Questions
Purpose
Why Plan?
• Establish a future direction
• Develop goals and strategies to maintain a “top ranked”
position
• Distinguish programs and services from other providers
• Identify “what not to do” as much as “what to do” organizations cannot do everything
• Guide decisions regarding future investments and allocation
of resources
Planning Process
• Use a 4-to-5 step process to facilitate and coordinate planning
• Process can take 6-18 months to complete
PHASE I
Preliminary
Planning
PHASE II
Research &
Analysis
PHASE III
Issue
Identification &
Goal Setting
PHASE IV
Strategy
Formulation
“PLAN TO PLAN”
PHASE V
Final Plan
Development
Preliminary Planning
• Identify goals for the planning process
• Develop a process for planning - timeline & work plan
• Gather background information
• Identify key data
• Identify members for an Oversight/Steering Committee
- Include key stakeholders
• Identify a planning work group
Research & Analysis
PHASE I
Preliminary
Planning
PHASE II
Research &
Analysis
PHASE III
PHASE IV
Issue
Strategy
Identification Formulation
& Goal Setting
PHASE V
Final Plan
Development
“Where is the organization today?”
Research & Analysis
• Assessing the environment: internal and external
• Evaluating trends and the current position of the
program/service
INTERNAL
EXTERNAL
•
Volume
o IP Discharges
o OP Registrations
o Visits
o Surgeries
•
Demographics
o Population Size, Age & Gender
•
Financial:
o Hospital
o University
o Payor Mix
•
•
Market Size
Market Share
•
Outcomes
•
Market Payor Trends
•
Patient Satisfaction
•
Competitor Assessment
•
Access
•
Discovery Trends
•
Patient Origin
•
Technology Trends
•
Medical Staff Profile (# by specialty &
age)
•
Education Profile
•
Research Profile (areas & funding)
Research & Analysis
Sample Graphs/Chart - Clinical
Transplant Volumes - Trended
180
160
140
120
100
80
60
40
20
0
2000
2001
2002
2003
Heart
2004
Lung
2005
Liver
2006
Kidney
2007
2008
Research & Analysis
Sample Graphs/Chart - Clinical
Outcomes
Satisfaction
Observed
Expected
Observed
Nationally
Excellent
82%
Kidney
97.86
97.31
96.08
Very Good
18%
Liver
91.70
87.31
86.82
Good
0%
Fair
0%
Poor
0%
(For Patients Receiving their First Transplant of this
type between 01/01/2004 and 06/30/2006 for the 1
Year Cohorts)
Based on data reported 5/19/08
Research & Analysis
Sample Graphs/Chart – Clinical
Market Share
Region 8 Institutions
Hospital
All 4 Organ # of US
Types?
News
(Yes/No) Specialties
% of Transplants in Region 8 - CY2007
Kidney
Heart
Lung
Liver1
Yes
15
15.6%
18.8%
47.7%
19.3%
Institution #1
No
0
6.3%
n/a
n/a
1.8%
Institution #2
No
2
12.2%
8.7%
n/a
25.1%
Institution #3
No
1
8.9%
0.7%
n/a
8.6%
Institution #4
No
2
6.7%
18.1%
n/a
n/a
Institution #5
Yes
6
10.7%
8.7%
33.3%
18.0%
Institution #6
Yes
9
4.4%
8.1%
4.5%
5.1%
Institution #7
No
1
8.7%
n/a
n/a
14.1%
Research & Analysis
• Interviews are performed in order to obtain feedback on strengths,
weaknesses, opportunities and threats for a program or service.
 Develop a guide so that consistent information is collected from
interviewees
 Identify list of individuals to interview
 Conduct the interview
 Summarize
Research & Analysis
Sample Interview Guide
1. What are the strengths of xxx service?
2. What are the weaknesses of xxxx service?
3. What opportunities exist for xxxx service?
4. What are the threats to the success of xxxx service?
5. What are some other strategic issues that need to be addressed
for long-term success of xxx service?
6. What would you consider to be the most critical success factors
for the overall success of xxx services?
7. What new technology(s) should xxx service adopt?
8. Who do you see as the primary competitors for xxx service? Why?
9. How can relations with referring physicians be improved?
Research & Analysis
Interview Summary
STRENGTHS
WEAKNESSES
Overall:
• National reputation of faculty
• Long term stability of faculty
Research:
• Establishment of new “xxxx” research
program
• Top NIH ranking
Clinical:
• Excellence in clinical care
• Growth in clinical visits and procedures
Education:
nd
• New “xxx” course for 2 year medical
students
• Resident publishing activities
• Strong fellowship with “x” NIH training grants
OPPORTUNITIES
Overall:
• Recruit faculty in “xxxx”
Research:
• Increase collaborative research
• Develop or expand “xxxx” research programs
Clinical:
• Expand clinical program by moving offsite
• Develop or expand “xxxx” clinical programs
Education:
• Improve residency match
• Improve didactic teaching courses
Overall:
• Lack of endowed positions
• Failure to recruit “xxx” faculty
Research:
• Outdated labs and equipment
• Increase in number of faculty requiring bridge
funding
Clinical:
• Challenged OR access
• Greater than 10% increase in Medicaid over
last 4 years
Education:
• Few MD/PhD students in training program
• Loss of Program Director
THREATS
Overall:
• Faculty retention
Research:
• Slowed growth in NIH funding
Clinical:
• Declining reimbursement for clinical care
• Increased competition from community
hospitals
Education:
• Decline in pool of quality students applying to
medical school
Research & Analysis
Transplant Interview Guide – Key Drivers
1. What are the most important factors that drive transplant
volumes?
2. Of these factors, where do we have the most opportunity to
improve our performance? What are the top 2-to-3 factors that are
critical to this organ that we should focus on to drive more volume?
3. For the top 2-to-3 factors, drill down further:
- Describe what we must do to grow volumes? What are the
specific actions that we need to implement?
- Assess timing: what needs to be done in the next year versus
what needs to be accomplished over the next few years.
4. What are the issues or barriers that need to be addressed?
5. What resources are needed?
6. How much could we increase volumes? ..Estimate 5-year low and
high targets?
Research & Analysis
Transplant Survey – Center Structure
From your perspective as a transplant physician/surgeon, what are the
characteristics of a world-class transplant center? Some qualities to
consider:
Clinical
• Depth/breadth of transplant and related services
• Size of transplant service
• Reputation of clinicians
• Quality of patient experience
• Quality of clinical outcomes and outcomes reporting
• Efficiency of service delivery (for providers, patients, and referring physicians)
• Innovative and cutting-edge therapies, surgical procedures & techniques
• Established brand with marketing and promotion
• State of the art facilities (inpatient & outpatient) and information technology
Research
• Research funding in basic science and translational research
• Clinical trials
Education/Other
• Training programs
• Nationally prominent physicians
Research & Analysis
Summarize…..Summarize….Summarize
• High level executive summary:
- Statements that highlight the key points from the
analysis
- Draws conclusions
- Identifies potential areas of opportunities
Issues & Goal Setting
PHASE I
Preliminary
Planning
PHASE II
Research &
Analysis
PHASE III
PHASE IV
Issue
Strategy
Identification Formulation
& Goal Setting
PHASE V
Final Plan
Development
“Where does the organization
want to be in the future?”
Issues & Goal Setting
•
Data is reviewed with Oversight Committee members
to:
1) Identify issues & opportunities
2) Identify critical success factors
•
Interpret what the data means for your organization
1) Identify major themes/goal areas
2) Form statements of future direction: where does
leadership see this service going in the future
Issues & Goal Setting
Summary of Key Transplant Themes
• We are unique in our broad strength across programs and should
better leverage this.
• End-stage medical disease programs are key feeders for many
transplant programs, and they require an adequate number of
community physicians to provide referrals.
• To attract referrals from regional providers, the hospital/university
must have presence, access, and availability.
• Outreach to surrounding areas should be coordinated and
cooperative amongst all transplant services.
• Research and academic programs should differentiate the
hospital/university from other providers.
Issues & Goal Setting
Mission
Vision
Goals
Strategies
“Who We Are”
Organization’s
purpose/reason for
existence
“What Do We
Want To Be”
Describes future
direction for an
organization
“What Do We Want
To Accomplish”
Identifies targets to
achieve the vision
“How Do We Get
There”
Steps to
implement vision
& goals
Strategy Formulation
PHASE I
Preliminary
Planning
PHASE II
Research &
Analysis
PHASE III
PHASE IV
Issue
Strategy
Identification Formulation
& Goal
Setting
PHASE V
Final Plan
Development
“How should the organization
get there?”
Strategy Formulation
Strategy 1
Goal #1
Strategy 2
Strategy 3
Goal #2
Strategy 4
Mission
Vision
Strategy 5
Goal #3
Strategy 6
Goal #4
Strategy 7
Strategy 8
Strategy Formulation
Volume
Growth
Success
Measures
Grow transplant volume so that the institution is able to
improve quality and expectancy of life for as many patients on
its wait list as possible
• Strong physician outreach to support transplant services in
liver and heart failure
• Strong, collegial relationships with referring physicians (e.g.,
telephone and internet responsiveness, information transfer)
• End stage disease management programs
• Physician capacity to support pre-transplant, transplant and
post-transplant volumes
• Optimal acceptance and utilization of donor organs
• Having a wait list of sufficient size to transplant all organs
offered
• Strong marketing to support transplant services across organ
sites (e.g., new website, physician liaison service, advertising)
• Implement community outreach and education programs
(initially in dialysis centers)
• Heart, lung, liver and kidney growth targets for referrals,
evaluations and transplants
Strategy Formulation
Resources
Resources
Recruitments
2009
- Hire 2 health care providers for outreach to
dialysis centers
- Hire additional diabetes nurse educators for
the Diabetes Center
- Hire nurse practitioner
2012
- Evaluate possible 3rd nephrologist
- Support for end-stage renal outreach location:
- Verify if a 4th nephrologist is needed to do outreach
nurse, clinic space & transportation
or if the 3rd new recruit could also do outreach
Kidney
- 2 nephrologists (approved & recruited):
- GS to start July 2009 (FY10)
- CK to start Aug 2009 (FY10)
- 1 kidney/pancreas surgeon (FY10)
Final Plan
PHASE I
Preliminary
Planning
PHASE II
Research &
Analysis
PHASE III
Issue
Identification &
Goal Setting
PHASE IV
Strategy
Formulation
“How do we implement?”
PHASE V
Final Plan
Development
Final Plan
Volume Projections
• Estimate future volumes based on implementation of
strategies
Actual
Aggressive
Modest
Historical
140
126
114
120
104
98
100
80
96
88
85
71
90
85
88
90
87
89
101
97
93
91
93
60
40
20
Actual Growth
Projected Growth
0
2005
2006
2007
2008
2009
2010
2011
2012
2013
Final Plan
Resources
• Summarize resources that are being requested to
support the strategies
Resource
Goal
Funding
Source
Funding
Status
Included
in Hospital
Pro forma
Estimated
Expense
Yr1
Comments
Yr2
Yr3
Yr4
Yr5
# of Additional FTEs by Year
Hospital
Nurse Educator
Goal #1
Hospital
Approved
Yes
$65,000
Psychologist
Goal #2
Hospital
Pending
Approval
Yes
$100,000
Social Worker
Goal #2
Hospital
Pending
Approval
Yes
$25,000
Child Life Specialist
Goal #1
Hospital
Approved
Yes
$37,400
School Liaison
Goal #3
Hospital
Approved
Yes
$30,000
Nurse Practitioner
Goal #3
Hospital
Pending
Approval
Yes
$108,800
Total
$366,200
Organize support
groups.
Provide clinical
psychology and
neuropsych
testing.
Identify
resources,
reinforce
compliance,
conduct
educational
intervention.
Dedicated to IP
and OP care.
Coordinate school
support.
Assist with both IP
and OP.
1
0
0
0
0
1
0
1
0
0
0
0.5
0
0.5
0
1
0
0
0
0
0.5
0
0.5
0
0
0
1
0
0
0
3.5
1.5
1.5
0.5
0.0
Final Plan
Proforma
Heart and Vascular Excluding Transplant or
VAD Patients MYM Growth
• Highlights the impact of plan
implementation on the
organization’s/service’s
finances.
• Includes one-to-two years of
actual or budgeted financials
and several years of
forecasted financials.
• Includes additional revenues
from growth as well as
additional resource
expenses.
Actual
YR 2009 Base
for Financials
Incremential Projections
Yr 2011
Yr 2012
Yr 2013
YR 2014
Yr 2015
VOLUME:
Inpatient
Outpatient
Total
74
1,142
158
2,319
310
3,534
469
4,787
593
6,079
1,216
2,477
3,844
5,255
6,672
474,362,200
40.5%
192,223,628
6,838,204
199,061,832
10,841,851
39.5%
4,280,062
62,515
4,342,576
22,862,700
39.2%
8,953,919
131,828
9,085,747
38,207,731
39.0%
14,913,312
220,309
15,133,621
55,060,177
38.8%
21,371,930
317,483
21,689,413
69,340,931
38.2%
26,480,166
399,827
26,879,993
(109,476,740)
(2,408,115)
(5,081,062)
(8,561,699) (12,387,114) (15,495,595)
(32,522,290)
(34,171,087)
(176,170,117)
(54,733)
(500,000)
(410,000)
(384,000)
(1,348,733)
(316,226)
(338,838)
(4,411,912)
(54,733)
(54,733)
(54,733)
(54,733)
(562,754)
(546,364)
(530,450)
(515,000)
(461,459)
(448,018)
(434,969)
(422,300)
(150,818)
(146,425)
(392,161)
(638,020)
(1,630,053) (1,412,313) (1,195,540) (1,229,765)
(669,336) (1,144,765) (1,666,834) (2,100,534)
(716,763) (1,224,647) (1,782,668) (2,236,670)
(8,097,215) (12,343,424) (17,032,156) (21,062,564)
9,237
35,527
44,764
Incremental from Base year 2010 (Inpt + Outpt)
REVENUE:
Gross Revenue
Payment Percentage
Estimated Payment with Settlements
Other Operating Revenue
Total Revenue
EXPENSE:
Direct Variable Cost:
Capital:
Additional Expenses:
Depreciation Expense
Marketing
Additional Salary and Benefits
MD Support
Total Additional Resources:
Indirect Variable (incremental allocated at 50% )
Fixed Cost (incremental allocated at 50% )
Total Expense
Contribution Margin (Pre-Split)
50,224,598
1,555,721
3,203,520
5,206,848
7,317,982
8,884,036
Contribution Margin (Pre-Split) % Est. Payment w Settlements
Presplit Margin
22,891,715
(69,336)
988,532
2,790,197
4,657,257
5,817,429
WUSM Profit Split
(10,301,272)
31,201
(444,839)
(1,255,589)
(2,095,766)
(2,617,843)
BJH Post-Split Operating Margin
12,590,443
(38,135)
543,693
1,534,609
2,561,491
3,199,586
0
54,733
54,733
54,733
54,733
54,733
12,590,443
16,599
598,426
1,589,342
2,616,225
3,254,319
Depreciation Add-Back
Cash Flow
forward
4 yr Net Present Value Incremental Cash Flows 2010 4,258,465
Hurdle Rate
14.50%
Final Plan
Implementation Plan
• Identifies tasks to execute strategies as well as the
individuals responsible for implementing the strategies
and target completion dates
STRATEGIES/TACTICS
1. Link with Community Hospital
to develop network for tertiary
services
1.1 Assess necessary IT/EMR
infrastructure
1.2 Approach existing partners
1.3 ETC.
TARGET
DATE
PERSON(S)
RESPONSIBLE
RESOURCES
REQUIRED
STATUS
Oct-14
A. Jones
$50,000
Complete
Jul-14
M. Smith
COMMENTS
 Partners
identified
Final Plan
Measure
Scorecard
Diagnostic/Interventio
nal Cases
Hybrid Procedure in OR/Lab
Anesthesia
Total Case Count
Performance
Target
Yr1
Yr2
Yr 2 Target
584
615
627
6
11
10
654
1300
2,016
4,794
CY 2011
CY 2012
Echos
10,886
11,013
11,343
ECGs
10,824
11,697
12,047
Fetal Encounters
325
333
343
Fetal Echos
668
692
712
2013
Target
Total Anesthesia Time in Hours
Heart Station
Total (including Fetal)
Strategic Growth
• Shows progress in plan
execution
• Can include metrics such as
clinical volume, quality and
patient safety standards,
research funding, etc.
• Compares actual
performance to historical
performance and to targets
established during the
planning process
Cath/EP Labs
Fetal
Assist Devices
Ventricular assist device total # of
patients
Lung assist device total # of patients
Surgical Cases
Total Number of Major Closed
Cardiac Cases
Total Number of Major
Open Cardiac Cases
Total Number of Heart Transplants
2011
2012
4
16
17
3
1
2
2011
2012
2013
Target
110
106
108
265
208
212
18
19
22
Post Planning
Communication:
• Individuals within the organization need to understand the strategic
direction.
• Includes senior leadership and key stake holders and individuals
responsible for strategy implementation
Plan Review
• The plan is reviewed periodically by senior leadership/key
stakeholders to monitor implementation.
Plan
Approved
Plan
Implementation
Implementation
Evaluation
Plan
Modification
Questions
?
Managing Transplant Outcomes
The Quality of Care and Outcomes
Management Movement
The Quality of Care and Outcomes
Management
O The need for detailed information on quality of care and
outcomes management is one result of the recent
restructuring of the healthcare system and the evolution
of managed care health delivery systems.
O The ongoing debate on quality of care calls attention to and the
need for our physicians to understand and be a part of it
The Basics
O Outcomes management attempts to systematically assess what
works, what does not work, and why
O Outcomes measurement examines the quality of care being
given by a provider or group of providers. In other words:
O Are we doing things right
O Are these deficiencies in quality anywhere along the structured
process continuum that is limiting effectiveness?
Outcomes Measurement is essential to the success of
outcomes management because you cannot manage
what you do not measure
The Transplant Center Quality and
Outcomes Imperative and Current
Environment
What is driving this movement?
O
O
O
O
O
O
O
Advancing quality of patient care
Effort to better identify centers performing at a lower than expected level of quality
Increasing regulatory scrutiny
Development of small center of excellence networks
Increasing complexity of statistical methods to assess a centers performance
Ever evolving and changes to statistical methods, (CUSUM, Bayesian,)
Increased scrutiny placed on transplant centers for robust QAPI programs
Transplant Center Outcomes
Measurement
Our Challenges and Limitations
O
O
O
O
O
O
O
Delayed outcomes reports (SRTR CSR) are to late to impact change
Incorporation of data collection in daily transplant related activities
Developing and sustaining physician/surgeon engagement and leadership
Mandatory vs. Voluntary data collection
Trained personnel for data collection, interpretation and development of predictive
modeling
Training
You cannot manage what you cannot measure
Benefits and Opportunities for Robust
Outcomes Data
Creating A Sustained Value Proposition
•
•
•
Optimize clinical
decision making
Refine policies and
procedures Support
Research
Optimize clinical
outcomes
•
•
Maximize Operational
efficiencies
Manage available
risks and cost
•
Maximize targeted
growth opportunities
Transplant Center Outcomes
Measurement:
Available Tools
O Centers must be proactive in identifying tools that allow them to
actively review and manage outcomes in a real time scenario.
O Current products and tools available in support of transplant
center outcomes:
SRTR Center Specific Reports (18 month delay)
O Monthly CUSUM Charts
O RAPID (Real Time Analytics) Currently only available for Kidney and Liver
outcomes
O Other (Available through the ASTS)
O
O Home grown – Appendix
O Vendor specific products
SRTR
The program-specific reports (PSRs) contain 12 tables and a summary
table that report statistics for individual transplant center programs.
When the report refers to statistics for a center, it indicates the statistics
for a particular transplant program, i.e., a specific organ program at that
center. The statistics in these tables are based on data available from
the Organ Procurement and Transplantation Network (OPTN) as of most
available cohort. Tables contained in the report are described individually
on next slide. A table is suppressed from the report if there are no
patients for that specific table for the relevant center.
http://www.srtr.org/csr/current/Tech_notes.aspx
Specific Report Tables
Table 1
Table 2
Tables 3-6
Tables 7-9
Tables 10-11
Waiting list activity (eg, additions, reasons for removal).
Characteristics of waitlisted patients.
Transplant and mortality rates for waitlisted patients.
Characteristics of recipients, donors, and transplant
procedures.
Graft and patient survival rates compared with expected
values.
[Source of outcomes in transplant regulations]
http://www.srtr.org/csr/current/Tech_notes.aspx
Timeline for Program-Specific Reports
O Updated every 6 months (January, July).
O Patient and graft survival tables report 1-month, 1-year, and 3-year
outcomes for 2.5-year cohorts of recipients.
O 18 month delay
http://www.srtr.org/csr/current/Tech_notes.aspx
CUSUM
Cumulative Sum Charts (CUSUM), are designed to
provide continuous real time assessment of clinical
outcomes. Through the use of currently collected
data, CUSUMs can be constructed that provide risk
adjusted program specific data to inform quality
improvement progress.
http://www.srtr.org/csr/current/Tech_notes.aspx
What is CUSUM?
O Gives timely and easily interpreted summaries of outcome data
O Accumulates evidence about program performance over time
O Produces a “signal” when a clinically meaningful level of evidence has been
reached
O Mathematically, compares the difference between the cumulative number
of failures the program experiences and the expected number of failures at
the program based on national performance
http://www.srtr.org/csr/current/Tech_notes.aspx
CUSUM: Technical details
Timeframe?
Which
recipients
included?
• Rolling 3-year window advanced monthto-month
• Any recipient alive during the window and
during their first year post-transplant
Which
outcomes are
tracked?
• 1st-year all-cause graft failure (including
death)
• 1st-year death
Which
subgroups are
provided?
• Living vs. deceased donors
• Adult vs. pediatric recipients
http://www.srtr.org/csr/current/Tech_notes.aspx
Examples and Interpretation
A period of experiencing graft
failures at about the expected
rate.
http://www.srtr.org/csr/current/Tech_notes.aspx
Examples and Interpretation
A period of experiencing
graft failures at a rate
higher than expected.
http://www.srtr.org/csr/current/Tech_notes.aspx
When to be concerned? The one-sided CUSUM
The trigger line indicating when to
be potentially concerned.
http://www.srtr.org/csr/current/Tech_notes.aspx
What’s the relationship?
CUSUM
trigger
?
PSR flag
http://www.srtr.org/csr/current/Tech_notes.aspx
CUSUM signals and MPSC flags
CUSUM Charts
PSR Metrics Supplied to MPSC
Designed for programs to monitor
own outcomes
Identify programs for MPSC review
Cover all recipients at risk during 3year interval
Cover all recipients transplanted
during a 2.5-year interval
Produce signal if outcomes are
Produce a flag if average outcomes
substantially worse than expected for meet specific performance criteria
some time interval, even if outcomes
are good at other times
http://www.srtr.org/faqs/15.aspx
Do the CUSUM triggers predict PSR flags?
Not necessarily:
O The sets of recipients included are not the same
O The time intervals are not the same
O The CUSUM will signal if there is a streak of poor performance even
if average performance is OK
O The PSR will flag if average performance meets criteria, even if there
isn't a streak of poor performance
http://www.srtr.org/faqs/15.aspx
CUSUM Reports and PSRs
O CUSUM reports complement the PSRs, and would potentially allow
programs to determine trends in performance in an expedited manner
http://www.srtr.org/faqs/15.aspx
Rapid (Beta test only)
What is it:
Real Time Analysis and Process Improvement Dashboard
Data Source:
O
O
The system utilizes two different data sets, which you will load
directly into the database.
This is a manual process because UNOS and SRTR do not have
an authenticated web services API.
O
O
UNOS custom monthly report
SRTR program specific reports
Example Reports:
Events affecting SRTR score
Example Reports:
Example Reports:
Example Reports:
Kidney Transplant Volumes
Our Challenge
• How To Effectively Integrate Different Tools and Data Sets Into a QAPI
Program
• Physician engagement and leadership
• Changing methodologies
• Resource requirements
In Conclusion
O Improving Quality and Performance depends on
having shared goals that unite the interests and
activities of all stakeholders.
O Everyone needs to be well informed and
concerned about the quality of care.
O The quality of care can be measured and
improved.
O That quality of care should not be ignored in
pursuit of cost control.
Notes to self
Reflections from experienced Transplant Administrators.
What was I
thinking?
Resource Guide section:http://organdonationalliance.org/transplantquality-resource-guide-tools/
Transplant Pro: http://transplantpro.org/