Innovations in the assessment of transplant center performance: Implications for quality improvement

D. A. Axelrod, J. D. Kalbfleisch, R. J. Sun, M. K. Guidinger, P. Biswas, G. N. Levine, C. J. Arrington, R. M. Merion

Research output: Contribution to journalReview articlepeer-review

43 Scopus citations


Continuous quality improvement efforts have become a central focus of leading health care organizations. The transplant community has been a pioneer in periodic review of clinical outcomes to ensure the optimal use of limited donor organs. Through data collected from the Organ Procurement and Transplantation Network (OPTN) and analyzed by the Scientific Registry of Transplant Recipients (SRTR), transplantation professionals have intermittent access to specific, accurate and clinically relevant data that provides information to improve transplantation. Statistical process control techniques, including cumulative sum charts (CUSUM), are designed to provide continuous, real-time assessment of clinical outcomes. Through the use of currently collected data, CUSUMs can be constructed that provide risk-adjusted program-specific data to inform quality improvement programs. When retrospectively compared to currently available data reporting, the CUSUM method was found to detect clinically significant changes in center performance more rapidly, which has the potential to inform center leadership and enhance quality improvement efforts.

Original languageEnglish (US)
Pages (from-to)959-969
Number of pages11
JournalAmerican Journal of Transplantation
Issue number4 PART 2
StatePublished - Apr 2009


  • Quality assessment
  • Risk assessment modeling
  • Statistical methodology

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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