Case Study: Kidney Transplant Pre-List Virtual Chat Program

• Annual savings of $584,280
• 67% of patients enrolled routinely engage with the pre-list virtual chat program
• additions to the waitlist have been reduced by 30%

UCSF Health’s Kidney Transplant Center’s patient referral, evaluation, and waitlisting practices were based on historical precedent, but when its waitlist grew to more than 4,300 patients, changes had to be made to make it more manageable and more importantly, improve the experience for patients.


During a patient’s evaluation for transplant candidacy, before being waitlisted, patients historically had little to no information on their progress or what changes they needed to make to be an optimal transplant candidate.

Multidisciplinary teams reframed the problem, asking “how might we?” developing workflow changes and deploying digital tools to improve the patient experience.

A key part of the process improvement involved the creation of a pre-listing phase and the use of a virtual chat program to manage patients within this phase. With the Pre-list Virtual Chat Program – the first of its kind in the nation – patients are connected to the UCSF Kidney Transplant team regularly and empowered to take charge of their health.

UCSF Health’s Kidney Transplant Pre-list chat program was launched in 2021 for patients who are not quite ready for a full evaluation, but might one day be candidates for transplant evaluation and waitlisting. Patients enrolled in the program can prepare better themselves for evaluation and get help to meet their individual goals.

How Does the Pre-List Virtual Chat Work?

1. Patients are invited to join the program

2. A live Navigator guides them in the enrollment process over the phone

3. Patients are connected to a virtual chat on their phone or computer and receive helpful educational materials, and monthly automated check-ins.

4. Multi-lingual navigators are available via phone or email to answer any questions about the program or the resources they receive in the chat program

Through the virtual chat – available in English and Spanish – patients receive useful and valuable information and videos on:

• What they can do to better qualify as a transplant candidate

• Education about transplants

• How to maintain a healthy lifestyle

• How to find a living donor

• and more

Since its launch, 67% of patients enrolled routinely engage with the pre-list virtual chat program, additions to the waitlist have been reduced by 30%.

Changes in workflow such as placing patients in the prelist phase versus the waitlist created efficiencies that achieved an annual savings of $584,280.

Most importantly, the team received great feedback from both staff and patients.

• When a case manager presented a patient with the option of UCSF or UCLA, the patient stated, “Because of this call, I prefer UCSF because [UCSF] are the ones reaching out.”
• I really like the user-friendly way of the Kidney Pre-Listing Chats. I take comfort that there are numerous resources I can turn to at this difficult time in my life for support and information. Thank you UCSF!”
• It makes me feel very connected. It makes me feel like I have a support system in place.
• I appreciate the enlightenment of the transplant process. Thank you.

The collaborative teams learned about the importance of engaging all stakeholders including front-line staff and providers to achieve successful and sustainable change. They also discovered the power of digital health tools and how they can be employed to most efficiently use resources in the pursuit of excellent patient care.


The team is continually looking for ways to improve the Pre-List Virtual Chat Program and anticipate it will help continue reducing the size of the waitlist while improving the patient experience.