Donor Data Quality Monitoring in the OPTNUNOS Organ Center

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Donor Data Quality Monitoringin the OPTN/UNOS
Organ Center

• Roger Brown BS, CPTC
• Manager, Organ Center
• United Network for Organ Sharing

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Who are we?
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Organ Centers Role

• Organ Placement (29 per day)

• Kidney
• Pancreas
• Kidney/Pancreas
• Heart
• Heart/Lung
• Lungs
• Liver
• Intestine

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Organ Centers Role

• 24\7 OPTN/UNOS member support
• Policy resource
• UNetSM/DonorNet troubleshooting
• Waiting list maintenance
• Donor/Potential Recipient Match Runs
• Organ Transportation

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What is Quality Monitoring?

• We made it up!
• Air, Water, and Call Centers are monitored for
  Quality
• Donor Data Quality Monitoring is a quality
  improvement PDSA.

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What is Donor Data Quality Monitoring?

• A focused review of all available donor
  information looking for inconsistent data
• DonorNet electronic data
• Donor Snapshot data at the time the match was
  initiated
• All paper chart attachments

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Why did we start?

• Natural progression
• all Organ Center Cases audited
• Saves
• Correct data from the start decreases errors
  found downstream

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What do we look for?

• Any inconsistent data value that impacts match
  screening or sorting
• Age
• Height/Weight
• Lab Values
• Serologies

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Match Grid
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Where to look?

• DonorNet electronic data
• Donor Snapshot data at the time the match was
  initiated
• All paper chart attachments

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DonorNet
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Donor Snapshot
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Attachments
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What do we do when we find an inconsistency?

• Contact the OPO to notify them and to determine
  which value is accurate
• Ask that they correct the inaccurate value(s)
• Re-run any matches run with incorrect data
  (prior to organ placement)

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Why Monitor Donor Data?
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Accurate Data is Necessary
Acceptable Organ OR Unacceptable Organ?
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Data is Collected

• Through a shared Access database
• Initial process included a co-worker secondary
  review
• Analysis showed this was not necessary
• Data entry audited by reviewing data several ways
  to see if results are the same

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One Year - Preliminary DDQM Data

• 10/01/07 09/31/08
• Total Cases through Organ Center 4900
• Total Cases with incorrect match data point
  identified 256 (5.1)

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One Year - Preliminary DDQM Data

• Total Cases with incorrect online data point(s)
  identified 765 /4900 (15.6)
• These are data points not associated with the
  match the Organ Center was asked to place from.
• This includes match related data points for other
  organs 30 of which could impact another organ
  match. (up to 10 of all matches)
• And other donor data inconsistencies that do not
  impact organ matches, but could impact organ
  acceptance.

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Incorrect Match Data- Preliminary Analysis

• 70 of matches run with incorrect data are
  different when run with the correct data.
• Some matches are identical
• Some change a little bit
• Some are VERY different

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Incorrect Match Data - Differences in Matches

• HLA corrections - 0 to 5547 patients
• Donor DCD Status Y to N, and N to Y
• 85 to 2893 patients
• Creatinine (Peak or Final)
• Range 0.1 to 10.0 (decimal place typo)
• 0 to 8691 patients

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Incorrect Match Data- Differences in Matches

• Donor Height Range 1 in. to 5 in.
• 0 to 182 patients
• Donor Weight Range patients
• (LARGE potential for impact on organs not placed
  through the Organ Center)

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of Matches Corrected by OPO
Note All matches corrected prior to placement.
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Matches Corrected and Total Matches by OPO
Note All matches corrected prior to placement.
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Time Study

• Quality Monitoring does takes time but not too
  much and its worth it
• 174 cases studied
• Average DDQM time is 11.1 minutes
• Range is 2 to 35 minutes

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Who Needs Donor Data Quality?

• OPOs
• Transplant Centers
• The System Promotes Equity
• Patients on the waiting list

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Does DDQM Satisfied Customers?

• Depends on who the customers are
• OPOs
• Transplant Centers

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Looking ahead

• Further analysis of matches
• Is there an acceptable margin of error for
  certain data fields on matches?
• Do all OPOs know about this?
• Is this a service that we could provide that is
  valuable to our members?
• Your feedback

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THANK YOU