Health andConsumers

Health andConsumers

Premysl Fryda, KST, Prague, CZBrussels, 10-11 September 2014

55..11..11. National Action Plan –. National Action Plan – CZECH REPUBLICCZECH REPUBLIC

9th Meeting of National Competent Authorities

for Organ donation & transplantation

European Commission

Directorate-General for Health & Consumers

Unit D4 - Substances of Human Origin Team

Health andConsumers

Health andConsumers

Czech Republic: facts and figures

•Population 10.5 million

•7 transplant centers (2 multi-organ)

•Transplant programmes: kidney, heart, lungs, liver, pancreas

•Deceased donors: 20.6 pmp (2014)

•Living donors: 7.7 pmp (2014)

•Kidney waiting list: + 500

•GDP: 25 000 US$ per capita

•Big Mac index: 3,6 US$ (- 22%)

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Health andConsumers

Statistics: Hearts 2004 - 2013

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Health andConsumers

Statistics: Kidney 2003 - 2013

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Health andConsumers

The EC Action Plan

•Communicated Dec. 2008

•3 Main Challenges:

- Increasing organ availability - Efficiency and accessibility - Quality and safety

•10 Priority Actions

•Mid-term review

Health andConsumers

Health andConsumers

The EC Action Plan

•Communicated Dec. 2008

•3 Main Challenges:

- Increasing organ availability - Efficiency and accessibility - Quality and safety

•10 Priority Actions

•Mid-term review

The Czech National Action Plan

•Approved by the Govt. May 2010

•3 Specific Areas:

- National Donor Program - Legislation - International cooperation

•14 Key Elements

•Regular annual evaluation

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Health andConsumers

Priority action 1:promote the role of transplant donor coordinators

• Cooperation with the Ministry, health insurance, medical associations, patients societies

• Job description of „donor consultants“ prepared (DC)

• Health insurance DC codes approved

• Rules for DC´s remuneration formulated

• During 2011-2012, 208 physicians and hospital officials trained in total

• The Parliament turned down proposal for DC´s in all hospitals

• Part-time DC approx. in 1/3 hospitals

• Potential donors being indicated from „new“ hospitals

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Priority action 2: Promote Quality Improvement Programmes

• Quality and safety (QaS) standards prepared and maintained

• ISO 9001 or national equivalent in all transplant centers

• KST preparing General Working Procedures for transplant centers

• System for reporting/evaluation SAR/E introduced

• KST + MoH auditing transplant centers

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Priority Action 3: Exchange of best practices on living donation programmes; Support registers of living donors

• Regular monthly meetings of TC coordinators and KST

• Project MODE – exchange of best practices (Portugal)

• Financial incentives:

• lost income refund for living donors

• income tax statement deduction for living donors

• National Register of Donors

• Automatically linked with the police register (deceased)

• Increase of living donors from 17 (2010) to 83 (2013)

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Priority Action 4: Improve the knowledge and communication skills of health professionals and patient support groups

• Training courses for health professionals

• KST publishing official statements on hot issues

• KST publishing info newsletter

• TV, radio, newspaper, journal interviews

• KST having organized a concert and a holly mess for organ donors

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Priority Action 5: Facilitate the identification of organ donors across Europe

• Legislative regulations for non-residents on WL

• Procurement from foreign deceased donors possible

• SOP for identification of donor, relatives

• Analysing cross border organ exchange conditions (COORENOR)

• Preparing the FOEDUS IT portal and mobile application

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Priority Action 6: Enhancing the organisational models in the EU MS

• Utilization of marginal donors (mean donor age in 2013 – 51 years)

• Donors age group 60+ (mean age - 68)

• Healt Insurance covering pulsatile perfusion

• Ex Vivo Lungs Perfusion, Heart Mate

• MODE project – exchanging best practices

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Priority Action 7: Promote EU-wide agreements on aspects of transplant

medicine

• KST agreements with PL, IT, HU, ETI

• KST observer in SAT

• Active participation in ETN, BSA, DOPKI, EOEO, EUROCET, IRODAT, SOHO, MODE, COORENOR, FOEDUS, ACCORD ...

• WP leader in EU projects

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Priority Action 8: Facilitate the interchange of organs between national authorities

• Enhanced participation in international projects

• Analysing conditions for international organ exchange (COORENOR)

• Launching 1.0 version of IT Portal

• Upgrading the IT Portal (FOEDUS):• OREXIS – Organ Exchange Information System

• ETMA – European Transplant Mobile Application

• EUROTIP – European Transplant Information Portal

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Priority Action 9: Evaluation of post-transplant results

• Follow-up in each transplant center :

• Within 2 weeks after release of a recipient

• Regularly – annual

• Reported to the Czech Transplant Society

• All performed transplantations registered in the National Register

• Follow-up recently audited in two biggest transplant centers by an international auditing team (ACCORD) - OK

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Priority Action 10: Promote a common accreditation system for organ donation/procurement and transplantation programmes

• 6 KST coordinators passed international TPM courses

• 5 KST coordinators on study visits to NTO´s in IT, SP, SLO, PT

• KST audited by international auditors (ACCORD)

• 3 specialists passed training course for international transplant auditors

• KST regularly audited ISO 9001, ISO 27001

• 2 Czech transplant centers passed international audits (ACCORD)

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SUMMARY

National Action Plan Priority AP - PA

OK

National Donor Program

Education of professional public 1, 2 Donor consultants in all hospitals 1 International certification of coordinators 10 Public awareness and support 4 Improving quality of TX centers 1, 6 Follow-up registries 9 Marginal donors 6

LegislationForeign donors 5, 8 Financial incentives for donors/relatives 3, 6 Management of quality 2, 10 Legislative awareness 1, 4

International cooperationParticipating in international projects 7, 8 Suppressing negative aspects 7 Best practices sharing 2, 3

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Health andConsumers

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

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Health andConsumers

Thank you!