Donor Care Network (DCN) Centers of Excellence are Committed to:
- Only kidney transplant programs with no donor deaths over the prior 10 years are invited to participate in the DCN.
- Only kidney transplant programs with normal complication rates over the prior five years are invited to participate in the DCN.
- Donor surgeons at DCN Centers of Excellence must have completed at least 300 laparoscopic donor nephrectomies, in the aggregate, over the prior five-year period.
- DCN Centers of Excellence must have a laparoscopic procedure utilization rate greater than 95% for nephrectomies over the prior two-year period.
- Provide efficient online donor screening and medical history data collection.
- Email a lab order to the donor to facilitate local pre-workup lab testing at no cost to the potential kidney donor.
- Offer Monday through Friday donor workup appointments to accommodate the donor’s schedule.
- Organize the standard donor workup so it can be completed in one day.
- Provide a dedicated living donor transplant team to support kidney donation.
- Provide laparoscopic nephrectomy including single port, full or hand assisted techniques.
- Proactively let donors know all common pains and problems resulting from kidney donation surgery along with the typical duration of the pain/problem and the best remedies.
- Minimize pain from the donor surgery when medically appropriate by:
- Utilizing a TAP block.
- Evacuating as much of the gas as possible before closing.
- Carefully positioning the donor during surgery to minimize back pain.
- Use IV to deliver pain medication until the donor can manage oral pain medications.
- Promote, encourage, and facilitate walking as soon as possible after surgery.
- Provide a dedicated recovery facility or transplant floor for kidney donors and recipients.
- Provide donors and caretakers with a recovery plan explaining what the donor must do before:
- The urinary catheter can be removed.
- The IV can be disconnected.
- The donor can be discharged.
- The recovery plan should include approximate time frames for each step of the recovery process.
- Minimize extraneous tape/bandages and remove them from the donor as soon as possible.
- Collaborate with the donor to set a discharge time that meets the needs of the donor.
- Discharge donors within 15 minutes of the promised discharge time.
- Remove all bandages, tape and related markings from donors prior to discharge.
- Call the donor or caretaker within two days after discharge to see how the donor is feeling.
- At the first follow-up appointment (one to two weeks after surgery) run donor labs to ensure there are no abnormalities.
- Provide the ability for donors to utilize local labs for post-surgery follow-ups.
- Provide comfortable sleeping accommodations for caretakers in the patient’s room.
- Provide timely updates to caretakers throughout the surgery and recovery process.
- Provide a convenient and secure method for patients and caretakers to store personal belongings after their hospital check in to avoid carrying personal items around the hospital.
- Provide donor satisfaction surveys to gather feedback throughout the donation process.
- Review donor satisfaction survey feedback and make any appropriate improvements.
- Do not send hospital bills for medical services to donors.
- Do not send solicitations for financial donations to donors.
DCN Centers of Excellence are committed to sharing and adopting best practices that will improve the donation process such as:
- What is the best approach for post-surgery pain medication that minimizes donor pain and maximizes speed of recovery?
- What is the best way to determine the discharge date/time?
- What is the best way to assist donors with pain and problem remedies after discharge?
- What is the best physical organization of the donor clinic?
- What is the best way to maximize caretaker comfort and convenience?
- What is the best way to consistently prevent the donor from being billed and from being sent fundraising solicitations?
- What is the best way to organize the basic workup (guide, map, schedule, transportation, etc.)?
- What is the best way to proactively predict an increased risk of donor complications or poor outcomes?
- What has the most impact on the donor’s perception of a positive donation experience?
- What is the best way to get candid and actionable feedback from donors?
- Achieve NKR Partner Center status.
- Offer all donors the option to utilize the Donor Connect service.
- Provide Donor Shield protections and support for all donors (through the KFL expert system or Donor Shield Direct).
- Utilize the DASH automated donor follow-up to maximize donor convenience.
- Utilize the DASH intake system for all donors to maximize donor convenience.
- Assign a guide to accompany the donor during the workup and pre-op visits.
- Provide a 3D picture/map and clear directions for donor movement within the hospital.
- Offer valet parking for donor and caretaker.
- Pay for or validate donor and caretaker parking.
- Provide car service for donor travel to and from the center.
- Offer Monday through Saturday workup appointments.
- Provide a donor reception area that is clearly marked and easy to find.
- Reduce the number of different employees that interface with donors to <5.
- Provide timely email updates to the donor throughout the entire donation process.
- Provide urologist style bathrooms for convenient urine specimen collection so that donor’s do not need to carry around urine samples.
- Create a dedicated streamlined donor clinic (see example).
- Provide chairs in the recovery area outside the operating room so that caretakers can sit down.
- Provide donor surgeon(s) profile and performance statistics:
- Laparoscopic nephrectomy performed supporting kidney donation
- Percent of donor surgeries that were laparoscopic
- Donor surgery complication rate
- Other information relevant to donors
- Minimize back pain
- Offer manual physical therapy to donors experiencing back pain after surgery.
- Utilize recovery beds that minimize back pain.
- Free Wi-Fi high speed internet.
- Provide inpatient rooms with:
- Private bathroom.
- Private shower.
- Room service so that caretakers do not need to leave the room for meals.
- Assign only one nurse per shift to support a donor after surgery.
- Minimize the number and frequency of hospital staff entering the inpatient room.
- Provide a TV in the donor’s inpatient room.
- Utilize private in-patient rooms as a waiting/luggage staging area for donors and caretakers prior to surgery.
- Provide a comprehensive discharge care package that includes:
- BP monitor.
- Appropriate OTC medications (e.g., Maalox, Gas-X, Tylenol, etc.).
- After care brochure/instructions.
- Pillow to place over incision for the car ride home.