ONE DAY RENAL TRANSPLANT WORKUP PROGRAMME – A PATIENT-CENTRED, EQUITY FOCUSED QUALITY INITIATIVE
Dr Scott Crawford1, Richard Germann
1Hauroa A Toi, Bay Of Plenty, Tauranga , New Zealand
Transplantation is the best option for patients with renal failure. Making it on the transplant list requires navigating a complex system, undergoing numerous appointments over long months or even years.
Patients encounter barriers that increase disparities in accessing care and timely listing:
- Significant ‘unaccounted’ waiting time for each test.
- Multiple visits to multiple sites mean multiple days away from employment, whānau commitments.
- Difficulty of tests being prioritised in a busy planned care environment.
- Significant financial cost to patients and whānau – loss of work, transport costs, parking, accommodation.
- Increased time collecting co-morbidities.
These barriers and inequities are disproportionately felt by Māori, especially those living in regional, rural, or remote settings.
The Bay of Plenty One Day Renal Transplant Workup (ODRTW) programme started in 2023. The patient and whānau centred, equity focused initiative aims to perform, on a single day, the majority of investigations required for successful listing, e.g., cardiology, radiology, dental, and clinical physiology – dramatically cutting listing time.
This programme consists of:
- a single familiar point of contact for patients – centralised scheduling, coordination, communication.
- provides early manaaki (support) for patients by Tauwhiro/social worker.
- supplying parking/food/accommodation/off-work certificates to reduce hidden costs and burdens.
With 29 patients enrolled, one has been transplanted, 10 have been successfully listed – one in only 86 days, another in 132 days. The programme has contributed to patients listed for transplant in Bay of Plenty, lifting from 11 (2022) to 38 (2024).
Given the enhanced accessibility and diminished inequality for patients, Health New Zealand Te Whatu Ora supports the national implementation of ODRTW as the standard model of care for transplant assessment.