RaDIANT Health Systems Intervention

Official title

The RaDIANT Health Systems Intervention for Improving Access to Kidney Transplantation

Overview

The overarching goal of the proposed study is to determine whether the addition of structural interventions at the health system level targeting upstream barriers in the transplant process will improve access to transplant evaluation start.

Interventions

• Other Performance Feedback Reports on Referral and Evaluation Closures
  Performance feedback reports will reflect each transplant center's performance related to kidney transplant evaluation initiation and referral closure. These reports aim to help centers understand common reasons why patients do not initiate the evaluation process or failed to proceed beyond the evaluation process, and to identify patterns in referral and evaluation closure practices. Reports will be individualized and distributed quarterly to the transplant center champion by the intervention le
• Other Dialysis Facility Awareness Campaign
  As part of the intervention, dialysis centers will participate in an Awareness Campaign designed to educate staff about transplant center quality improvement efforts and how they may be contacted as part of the project. This campaign may include brief webinars or informative documents distributed via platforms such as IPRO Learn.
• Other Patient Contact via Preferred Method
  Transplant centers will contact patients using their preferred method of communication.
• Other Phone Call to Dialysis Facility During the Patient's Dialysis Session
  Facilities will enhance their patient communication procedures by making a phone call to the dialysis facility during the patient's dialysis session if the patient has not responded to initial outreach attempts. This additional step increases the likelihood of reaching the patient during a time when they are accessible and can engage in scheduling or follow-up.
• Other Phone Call to Provider
  Transplant centers will enhance their outreach procedures by making a phone call to the referring provider (e.g., nephrologist, medical assistant) or another provider involved in the patient's care (e.g., primary care provider) in the event of self-referral if the patient has not responded to initial outreach attempts or "no-shows" an initial evaluation appointment. This additional step ensures that the referring provider is informed of the patient's progress and can assist in re-engagement or d
• Other Transplant Referral Communication Platforms or Email to Communicate Patient Status and No-Show
  Transplant center staff will utilize transplant referral communication platforms and/or email to communicate updates to dialysis staff regarding patient status (e.g., unable to contact the patient or no-show) before referral closure.
• Other Audit and Tracking of Patient Contact Attempts Prior to Referral Closure
  Transplant center staff will continue internally tracking the frequency that a patient is contacted before closure and the date of closure, in alignment with center standard practice. This intervention introduces an audit process to be conducted before closure to ensure that all contact attempts (including one or more attempts to contact the patient directly, one or more phone calls to the alternate preferred contact, or one or more attempted contacts to the dialysis unit to connect with the pat

Primary outcome measures

• Change in transplant evaluation start within 6 months of transplant referral [Time frame: Baseline, Post Intervention (Up to one year)]

Secondary outcome measures (2)

• Change in transplant waitlisting [Time frame: Baseline, Post Intervention (Up to one year)]
• Change in transplant receipt among those who were waitlisted [Time frame: Baseline, Post Intervention (Up to one year)]

Eligibility criteria

Inclusion criteria

• Five large transplant centers (Emory Transplant Center and Piedmont Transplant Center in Atlanta, GA; Medical University of SC; Duke University in Durham, NC; and Indiana University in Indianapolis, IN) \~800 referring dialysis center referring to these transplant centers

Exclusion criteria

• Individuals referred, initiating evaluation, and waitlisted at non-participating start centers

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

N/A

Model

Single group

Masking

Open label

Primary purpose

Health services research

Study locations

United States · 5 centers

• Piedmont Transplant Institute — Atlanta
• Emory Transplant Center — Atlanta
• IU Health Transplant - Indianapolis — Indianapolis
• Duke Transplant Center — Durham
• MUSC Mid-Carolinas Transplant Center — Lancaster

Identifiers

NCT: NCT07033117 · 18998 - Aim 2 · R01DK136283

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗