A. D. Love1, L. R. Herbst1, D. R. Helfer1, S. Rasmussen1, M. Johnson1, J. M. Konel1, J. R. Wellen2, S. Nazarian3, T. B. Dunn3, E. A. King1, D. L. Segev1, A. M. Cameron1, M. L. Henderson1, E. J. Gordon4, J. M. Garonzik Wang1 1Johns Hopkins University School Of Medicine,Surgery,Baltimore, MD, USA 2Washington University,Surgery,St. Louis, MO, USA 3Hospital Of The University Of Pennsylvania,Surgery,Philadelphia, PA, USA 4Feinberg School Of Medicine – Northwestern University,Surgery,Chicago, IL, USA
Introduction: The Live Donor Champion (LDC) intervention is designed to increase transplant candidate knowledge about living donor kidney transplantation (LDKT) and ability to find a potential living donor through advocacy training. Our goals were to assess facilitators and barriers to intervention implementation at two diverse transplant centers.
Methods: Semi-structured interviews were conducted with key stakeholders (members of the transplant and donor navigation teams) at the University of Pennsylvania and Washington University in St. Louis prior to LDC implementation to assess facilitators and barriers to successful implementation. Interview questions were driven by the Consolidated Framework for Implementation Research. Interview transcripts were inductively analyzed for themes.
Results: In total, 16 stakeholders participated (response rate of 94%). Key facilitators to implementation included institutional awareness of the potential to increase LDKT rates and help centers compete in the transplant market. Elicited barriers concerned inner setting constructs and intervention characteristics (Figure 1). Barriers influenced by inner setting constructs included competing occupational priorities, the lack of infrastructure supporting collaboration between medical and non-medical management teams, and increased workload processing donor referrals. Barriers influenced by intervention characteristics included patient needs in navigating the new experience of identifying champions as health advocates, the adaptation of an LDC intervention with fewer meetings and unique obstacles in using donor/recipient panels.
Conclusion: Study findings suggest that the promise of increased living donation rates drove uptake of the LDC, yet the challenges of implementing LDC pertained to its fit within organizational workflows, privacy, and access to the transplant center. Efforts to successfully implement LDC to centers must address center compatibility and infrastructure as well as patient needs unique to the program. Future research should assess how these facilitators and barriers affect LDC implementation over time at these two centers.
