Introduction: Our program has grown over the past several years, necessitating additional staff at all professional levels. As staff numbers have grown there has been increasing problems with communication between subservices. Increased sub-specialization of tasks has resulted in isolation of groups providing sequential services within the kidney transplant program, spanning from intake/referral through post-transplant care. This is likely a contributing factor to the increase in complaints from both referring physicians and patients regarding communication.
The Challenges and Changes:The greatest challenge is fostering and maintaining a sense of teamwork with a common mission. Due the number of employees needed to run our service, subgroups have developed and become isolated, focused on their respective responsibilities, with a loss of understanding of how each group contributes to the overall goal of providing the best possible care. The workload is challenging and we are unable to add additional staff due to budget restraints, so improved cooperation is crucial. If everyone, from administrative assistants to physicians better understood the challenges we each face, we may together find ways to identify to improve efficiency and foster respect and understanding.
Stakeholders: The principal stakeholders are those ultimately responsible for the running of the transplant service. This includes the leadership core including our chief operating officer, our service manager, the chief of abdominal transplantation, and the medical director.
Methods:
Proposed Solutions

• Develop a stronger sense of team with a patient centered focus
• Educate different aspects/subunits of the teams about the roles and responsibilities of each subunit.

Proposed Strategies

• Develop a mission statement for the transplant service that is congruent with the institutional mission statement
• Have each subunit of our service develop their own mission statement that is congruent with our service mission
• Have each subunit share their mission statement at the staff meeting
• Emphasize the ultimate goal of our service to provide the best care for the patient.
• Emphasize the importance of fostering relationships with the referring physicians. Without referrals we do no transplants.

Impact of a Successful Project: Successful implementation of this project would result in the following:

• Better team dynamics and a sense of belonging to a greater mission
• Improved communication within the service
• Better communication with patients and referring physicians

Metrics for Evaluation of Success

• Improved satisfaction amongst employees. The goal is to have employees at every level understand the importance of their contributions and the contributions of others to the transplant service. This can be measured with People Pulse.
• Decrease in number of complaints from referring physicians about communication
• Decrease in complaints from patients regarding responsiveness to their needs (Press-Ganey surveys)