The Kidney Pre-List Chat Program: Elevated Patient Experience and Over $580,000 Saved

UCSF Health’s Kidney Transplant Center’s patient referral, evaluation, and waitlisting practices were based on historical precedent, but when our waitlist grew to more than 4,300 patients, we knew we had to make changes 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, while also creating efficiencies that achieve an annual savings of $584,280.

A key part of our 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%, and we have seen financial benefits in the form of FTE hours saved and reductions in listing and testing costs. Most importantly, we have received great feedback from both our staff and patients!

What We Learned and What’s Next

Through our collaboration, we learned the importance of engaging all stakeholders including front-line staff and providers to achieve successful and sustainable change. We also discovered the power of digital health tools and how they can be employed to most efficiently use our resources in the pursuit of excellent patient care.

We are continually looking for ways to improve the Pre-List Virtual Chat Program and anticipate it will help us to continue reducing the size of our waitlist while improving the patient experience. Some future improvements we are working on include: engaging caregivers with a “caregiver voice” in the chat, increasing overall engagement and utility, fine-tuning the role of our waitlist Navigators, and finding ways to increase the number of living donor transplants in the pre-list population.

To learn more about the work, impact, and lessons learned,

• View our poster at the UCSF Health Improvement Symposium 2022: CAP Project Phase 1: Reimagining the Journey from Referral to Listing for Kidney Transplant Candidates or

• Contact Anna Mello at [email protected] / 415-533-4493