Sun editorial:
Improving patient safety
UMC should quit making excuses and upgrade its kidney transplant program
Friday, Nov. 7, 2008 | 2:08 a.m.
A kidney transplant program is a valuable health care asset for any community to have, but only if its performance at least matches national standards for the life expectancy of the patients after their operations.
Sadly, this has not been the case with the kidney program operated by University Medical Center, the only one of its kind in Southern Nevada. Hospital officials, assisted by members of Nevada’s congressional delegation, have been scrambling to save the program after the federal Centers for Medicare and Medicaid Services initially announced it would decertify the public hospital’s kidney transplants beginning next month. The federal agency then granted the hospital a reprieve, but only if UMC made major improvements to assure patient safety.
As reported in the Las Vegas Sun on Tuesday by Marshall Allen, the federal agency found that the transplant program had more than twice the expected death rate and was lax in warning patients about the psychological risks of transplants. UMC was also found to be deficient in determining the suitability of donors, and in verifying the compatibility of the donors’ and recipients’ blood types throughout the transplant process.
The Scientific Registry of Transplant Recipients, a national database affiliated with the University of Michigan and relied upon by the federal agency, showed that of the 74 adult UMC kidney transplant patients from January 2005 through June 2007, five died within a year of the operation. The national average would have been 1.75 deaths per 74 patients, based on the registry’s calculations, which include the age and health of the patients.
Even accepting UMC’s argument that one of the patients died as the result of a suicide, that would leave four others who passed away, still more than double the national average. The hospital has also said it suffers from a low number of transplant patients, depriving it of revenue to develop the program, even though the program showed a profit of more than $200,000 last year.
UMC should quit making excuses and take immediate actions to improve patient safety so that its kidney transplant program can serve the 200 individuals who are waiting for an organ donation.
The hospital shouldn’t tolerate substandard care or even mediocrity. Southern Nevada patients deserve better.
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Maybe the solution is to change the physicians in charge, or have stricter oversight of whether standard protocols are followed. The tranplant team (surgeon and staff) have to be up to par. Otherwise, it may be safer for patients to get a tranplant out of state.