Why Transplant Centers Need Bi-Directional, Closed Loop Communication

Breakdowns in communication slow down the entire transplant process, frustrating transplant teams and keeping them from being able to fully focus. 

Even though modern communication technology is designed to help people communicate quickly, often it causes inefficiency, redundancy, and frustration for transplant teams. 

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Today, it’s almost impossible to keep transplant teams, OPOs, and dialysis facilities on the same page, resulting in constant, back-and-forth texts and emails trying to clear up communication breakdowns. 

Even worse, these communication notifications and alerts are actually contributing to the distractions and interruptions that medical staff face as frequently as once every 2 minutes and that create dangerous environments for patients. According to The Joint Commission, communication breakdowns are one of the top three root causes of sentinel events that result in death of a patient or physical or psychological injury to a patient. 

Traditional Communication Doesn’t Work

Organ offers and patient information rapidly fly back and forth between transplant centers and OPOs and patient referrals pile in from dialysis clinics or other medical teams.

This flood of communication inevitably breaks down. Rarely is there one standardized way to share information with everyone who needs it, resulting in a communication cluster. Transplant centers send out hundreds of text messages, emails and voicemails each day. However, this cluster of critical information often gets mixed up, delayed or lost on its way to the right person. 

For example, many times teams end up confusing patient information because text and email threads may contain conversations about multiple patients and organ offers. As a result, transplant surgeons end up having to repeat instructions, answer redundant questions, ask for clarification and untangle messes. 

This breakdown in communication wastes valuable time and causes frustration for surgeons and their teams.

Transplant teams need a better communication system that overturns the status quo of traditional communication. 

What is bidirectional and closed loop communication?

Just like a bidirectional roadway where traffic flows in two opposing directions, bidirectional communication allows information to be sent in two directions by using a standardized transfer tool. This type of communication would allow transplant teams to communicate with everyone they need to in a streamlined way.

Closed loop communication helps both the sender and receiver understand the message in the way it was intended, leaving little space for communication breakdowns. 

TeamSTEPPS further defines effective clinical communication with these four standards: 1) complete - all relevant information is communicated fully but avoids irrelevant details that may confuse; 2) clear - words and terms are easily understandable by the receiver; 3) brief - no extraneous detail is necessary; and 4) timely - frequent, avoids delays, and dependable.

Additionally, this communication needs to take place in channels and through methods that are “known and recognized by all involved.” In other words, teams need standardized processes to communicate that all internal and external parties are familiar with and can use.

Who to keep in the loop

Transplant teams need a standardized communication process that keeps everyone in the loop and updates patient information in real time to speed up the transplant process and keep patient referrals moving along.

Inside team members

When an organ offer comes in, surgeons, transplant coordinators, and other staff need a specific set of information to support their decision. However, this information often comes in piecemeal as transplant teams go back and forth with OPOs to get what they need.

Outside organizations

CMS allocation rules are changing, meaning more imported organ offers from OPOs across the country  to transplant teams. In addition, the recent executive order on advancing American kidney health will likely result in more ESRD patient referrals from dialysis.

Transplant teams also have to develop and maintain communication protocols with outside organizations, including OPOs, dialysis clinics and living donor advocate teams. These protocols include emergency preparedness programs and hospital-approved selection criteria.

Additionally, disparate EHRs silo patient information, so transplant teams may not have the information dialysis or OPOs do and vice versa. 

Standardized communication for transplant teams

To close the loop in this communication cluster, transplant teams should implement a standardized system that can integrate with other tools and platforms, allowing them to communicate with everyone they need to in a streamlined way. A standardized information transfer system would reduce frustration and confusion that teams face with the current communication system.  

For example, an information transfer system would keep patient information up to date for all parties. It would keep OPOs in the loop on surgeon information preferences, while helping dialysis clinics notify transplant teams in real time about changes to a patient’s contact information or health status. 

In addition, communication processes should allow room for surgeon notification preferences so they only receive information when they absolutely need it. This would reduce interruptions by allowing team members, especially surgeons, to turn off or mute notifications until they absolutely need to be looped in. Documenting all the information in one place allows the surgeon to quickly get up to speed on context.

And finally, a standardized communication protocol would reduce confusion by allowing teams to both customize notifications and categorize messages they receive by UNOS number. This ensures that each transplant conversation thread contains the correct information regarding the patient and organ so that the right information is sent to the right people. 

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