STREAMLINING KIDNEY TRANSPLANT COORDINATION THROUGH PROCESS MAPPING: IMPROVING TIMELINESS, REGULATORY COMPLIANCE, AND ORGAN UTILISATION IN A TERTIARY HOSPITAL
Author(s)
Himanshu Sharma, MD1, Soumyata Mishra, MD2, Nirupam Madaan, MD1, Siddharth Sathpathy, MD1.
1All India Institute of Medical Sciences, New Delhi, India, 2Action Balaji Medical Hospital, New Delhi, India.
1All India Institute of Medical Sciences, New Delhi, India, 2Action Balaji Medical Hospital, New Delhi, India.
OBJECTIVES: To map and compare the complete donor-side and recipient-side kidney transplant workflows in a tertiary hospital; and to identify bottlenecks, delays, and opportunities to streamline transplant coordination while ensuring safety and regulatory adherence.
METHODS: An 18-month process-mapping study was conducted on 36 kidney transplant cases (25 donor-role, 11 recipient-role). For each case, every step, responsible personnel, elapsed time, and required THOTA forms were documented using a standardised template. Consolidated donor and recipient process maps were created and analysed against national timelines. Ethical exemption was granted, as the study used de-identified hospital process data.
RESULTS: The hospital acting as a donor required a mean 14 hours from donor activation to organ retrieval (target 8-12 hours). Mandatory dual brain-death certification (6-hour statutory interval), medico-legal clearances, and interdepartmental coordination were major contributors to delay. Recipient-side coordination averaged 8 hours 10 minutes (target 6-12 hours), driven by rapid evaluation, compatibility confirmation, and synchronised transport. Parallel task clusters—laboratory testing, organ-allocation communication, ambulance readiness, and THOTA documentation—were essential for maintaining timelines. Key bottlenecks included delayed police clearance in medico-legal cases, laboratory turnaround time, and inconsistent communication among teams.
CONCLUSIONS: Process mapping revealed that transplant timeliness can be substantially improved through enhanced parallel processing, trained transplant coordinators, checklist-based documentation, and structured communication pathways with external agencies (NOTTO/ROTTO/SOTTO and police). Optimising these workflows strengthens regulatory compliance, reduces avoidable delays, safeguards organ viability, and improves patient outcomes. The mapped processes offer a replicable blueprint for hospitals seeking to strengthen transplant coordination and operational readiness.
METHODS: An 18-month process-mapping study was conducted on 36 kidney transplant cases (25 donor-role, 11 recipient-role). For each case, every step, responsible personnel, elapsed time, and required THOTA forms were documented using a standardised template. Consolidated donor and recipient process maps were created and analysed against national timelines. Ethical exemption was granted, as the study used de-identified hospital process data.
RESULTS: The hospital acting as a donor required a mean 14 hours from donor activation to organ retrieval (target 8-12 hours). Mandatory dual brain-death certification (6-hour statutory interval), medico-legal clearances, and interdepartmental coordination were major contributors to delay. Recipient-side coordination averaged 8 hours 10 minutes (target 6-12 hours), driven by rapid evaluation, compatibility confirmation, and synchronised transport. Parallel task clusters—laboratory testing, organ-allocation communication, ambulance readiness, and THOTA documentation—were essential for maintaining timelines. Key bottlenecks included delayed police clearance in medico-legal cases, laboratory turnaround time, and inconsistent communication among teams.
CONCLUSIONS: Process mapping revealed that transplant timeliness can be substantially improved through enhanced parallel processing, trained transplant coordinators, checklist-based documentation, and structured communication pathways with external agencies (NOTTO/ROTTO/SOTTO and police). Optimising these workflows strengthens regulatory compliance, reduces avoidable delays, safeguards organ viability, and improves patient outcomes. The mapped processes offer a replicable blueprint for hospitals seeking to strengthen transplant coordination and operational readiness.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
HSD70
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas