Abstract

A prospective transplant patient’s work-up is a long and complex process. On the day of transplant, this information needs to be easily accessible and documented in one place. In an evolving environment, healthcare management is becoming a more individual process. Typical issues that became evident at morbidity and mortality meetings were that individual pre-operative concerns were not always highlighted at the time of admission. The published directorate protocol was not being fully initiated. Important discussions regarding donor risk to the patient were being written on pieces of paper, which could be easily lost. Our aim was to produce a document where the admitting doctor could input all of the up-to-date essential information into a single resource. The document included a full clerking of current state of health, background, past medical history, current medications and a pre-operative examination. Any concerns or management plans discussed by the transplant multi-disciplinary team (MDT) at the time of activation onto the transplant waiting list were given a place to be documented. Potential individual complications from the donor’s history were given a clear, defined place in the notes. A checklist was placed so that the department’s protocol was followed in its entirety. The proforma is currently in use on the Cardiff Transplant Unit. Leading the team by implementing a centralised document has enabled effective communication of key information to all relevant members of the team. This has helped to ensure that patient safety is optimised. The main message we would like to convey is the fact that a comprehensive admission proforma can aid in effective handover and communication, along with continuity of care and clarity of information. The proforma has streamlined the admission process, making the overall experience for the patients much more organised and straightforward, factors which are vital in an understandably anxiety-provoking time of their lives.