DCI Donor Services, Sacramento, California.
Division of Gastroenterology, Hepatology and Nutrition, UPMC Children's Hospital of Pittsburgh.
Curr Opin Organ Transplant. 2019 Feb;24(1):64-72. doi: 10.1097/MOT.0000000000000595.
Pediatric transplantation faces unique challenges in implementing dynamic quality improvement measures because of proportionally smaller volumes compared to adults, logistics of being integrated successfully within larger or complex hospital systems, lack of adult-affiliated transplant centers, varying focus in prioritization of relevant outcome metrics, and potential lack of sufficient resources.
To address these challenges, multiinstitutional collaborations have developed which have proven increasingly effective in driving awareness and quality improvement measures to supplement regulatory efforts in the pediatric population. Relevant work from the Pediatric Heart Transplant Society and Studies in Pediatric Liver Transplantation will be highlighted. The introduction of learning networks such as the Improving Renal Outcomes Collaborative and the Starzl Network for Excellence in Pediatric Transplantation have further focused on continuous learning initiatives in renal and liver transplantation using collaboration and patient informed measures.
Optimal transplant performance improvement is fully integrated into health delivery at all points of the patient pathway. Progress in performance improvement will require ongoing integration of big data solutions, improved patient engagement and technology solutions. VIDEO ABSTRACT:.
与成人相比，儿科移植在实施动态质量改进措施方面面临着独特的挑战，因为儿科移植的数量相对较少，要成功融入更大或更复杂的医院系统，缺乏与成人相关的移植中心，相关结果指标的优先级重点不同，且潜在资源不足。
为了解决这些挑战，已经开展了多机构合作，这已被证明在提高认识和质量改进措施方面越来越有效，可以补充儿科人群的监管工作。将重点介绍儿科心脏移植学会和小儿肝移植研究中的相关工作。引入学习网络，如改善肾脏结局协作组织和 Starzl 儿科移植卓越网络，进一步关注使用协作和患者知情措施，在肾脏和肝脏移植方面进行持续学习计划。
最佳的移植绩效改进完全整合到患者路径的各个点的医疗服务中。绩效改进的进展将需要不断整合大数据解决方案、提高患者参与度和技术解决方案。
