Abstract: TH-PO0998
Targeted Quality Improvement Initiative to Increase Kidney Transplant Referrals and Transplant Center Follow-Up at Jacobi Medical Center (JMC)
Session Information
- Diversity and Equity in Kidney Health
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 900 Diversity and Equity in Kidney Health
Authors
- Vashisht, Archana, New York City Health and Hospitals Jacobi, New York, New York, United States
- Aung, Htun Min, New York City Health and Hospitals Jacobi, New York, New York, United States
- Bharati, Bishal, New York City Health and Hospitals Jacobi, New York, New York, United States
- Acharya, Anjali, New York City Health and Hospitals Jacobi, New York, New York, United States
Group or Team Name
- Jacobi Fellows QI Transplant.
Background
Black Americans represent 13.6% of the U.S. population but account for >35% of patients receiving dialysis for ESRD. Only 7% of Black patients receive a kidney transplant within three years of ESKD diagnosis compared to 16.2% of non-Hispanic White patients. Barriers include reduced access to nephrology care, fewer referrals for transplant evaluation, lower completion rates of the transplant workup and social determinants of health. At JMC, majority of the patient population is of African American and Hispanic descent
Methods
QI project was initiated in July 2023 among CKD patients with an eGFR ≤ 20 ml/min. A key component of this intervention was the implementation of a standardized smart text in clinic notes, prompting physicians to address transplant referral eligibility. All referred patients were prospectively followed through May 2025.Exclusion criteria was lack of insurance, severe frailty, comorbidities, prior referral, or unwillingness for transplant.
Results
We retrospectively compared transplant referral rates before and after the initiative, analyzing data from academic years 2022–2023 and 2023–2024. In 2023–2024, 80 CKD patients with eGFR ≤ 20ml/min were screened. Of these, 53 were ineligible for referral. Of 25 eligible patients, 23 (92%) were referred. In contrast, during 2022–2023, 79 patients were screened, and 32 were deemed eligible, but only 14 (43%) received referrals. Among 2022–23 referred patient cohort, 3 patients died, 3 did not follow up, and 8 (72%) initiated transplant evaluations vs 2023–24 cohort, 1 patient died, 1 had improved renal function, 4 did not follow up, and 17 (80%) initiated transplant evaluations
Conclusion
We found 114% increase in transplant referral rates translating to increased rate of transplant center follow up. This demonstrated that simple, systematic prompts within documentation can significantly enhance provider awareness and action, which could lead to more equitable access to renal transplant.
Transplant Center Follow up Rate
| Outcome of Referred Patients | 2022-23(n=14) | 2023-24(n=23) |
| Initiated Transplant Evaluation | 8(57%) | 17(74%) |
| No Transplant Center Follow up | 3(21%) | 4(17%) |
| Died | 3 | 1 |
| Improved Renal function | 0 | 1 |
| Follow Up Rate | 72% | 80% |