teamwork & volunteerism: solutions dept. urologydept. urology dept. nephrologydept. nephrology...

TEAMWORK & VOLUNTEERISM: Solutions

TEAMWORK & VOLUNTEERISM: Solutions

• Dept. Urology• Dept. Nephrology• Medicine Institute• Cleveland Clinic

Interdepartmental Clinical Collaborations

• Wellness Institute• Dept. Pastoral Care Services• Dept. Social Work• Pharmacy• Division of Nursing• Nutrition Services• Institutional Services (Pt.

Education, OPSA, Sponsored Research, etc.)

• Corporate Communications• Governmental & Community

Relations• Diversity• Bioethics• Biostatistics• Cleveland Clinic Lerner College

of Medicine• Lerner Research Institute

Partnerships and Sponsors:Partnerships and Sponsors:

ChurchFraternitySorority

Community OrganizationsCorporateIndividuals

Solutions: Dedicated Health Literacy

Education

Solutions: Dedicated Health Literacy

Education

- Increase awareness of preventive health- Increase health screenings- Promote healthy lifestyles- Promote participation in clinical trials by minorities- Promote awareness of family medical history

• Health Literacy Saves Lives

Solutions:Promote and Empower Patients

Toward Compliance

Solutions:Promote and Empower Patients

Toward Compliance

Patient Compliance: How To Improve It

Solution:Promotion of Family Support Systems and

Awareness of Family Medical History

Solution:Promotion of Family Support Systems and

Awareness of Family Medical History

Solutions:Individual & Community

Empowerment

Solutions:Individual & Community

Empowerment

Solution:Outcomes Research

Solution:Outcomes Research

Analysis of Disparities in Kidney Transplantation by Race at

Cleveland Clinic

Section of Renal TransplantationMinority Men’s Health Center

Analysis of Disparities in Kidney Transplantation by Race at

Cleveland Clinic

Section of Renal TransplantationMinority Men’s Health Center

C. Modlin, C. Zaramo, J. Alster, L. Zhou, D. Goldfarb, S. Flechner,

and A. Novick

Living Related (LR)Cadaveric (CAD)

Health Disparities in Renal Graph Survival in Tx Patients

by Race and Source of Allograft

Dialysis 1st Week Post-TxSignificant Disparities in Dialysis following the First Week of Post Renal Transplantations (Post-Tx, p<0.001*)

52.14%

15%

8.16% 5.14%

0

20

40

60

80

100

Perc

en

tag

e (

%)

African American

(CAD)

Caucasian (CAD)

African American

(L)

Caucasian (L)

Race/ Ethnicity

*p< 0.0001

Post-Tx Serum Creatinine (CAD)Post-Tx Serum Creatinine (CAD)Creatinine Levels from Cadaveric Donors, Significant Difference at 7

Days (p<0.0001), 1 month (p=0.005) and 2 Months (1 Year ) (p< 0.004)

0

1

2

3

4

5

6

7

Day 7 1 3 6 12 36

Time

African American (CAD)

White (CAD* p=0.0001

* p=0.005

* p=0.004

P<.0001 @ 7 daysP<.008 @ 12 mos.

Racial disparities in deceased donor kidney transplantation are compounded by longer pre-transplant dialysis duration in African

American patientsHo Yee Tiong*#, Charles Modlin#, Joan M. Alster**, Ismail R. Saad#, Barbara

Mastroinni, Kathy Savas, and Stuart M. Flechner#Cleveland, OH

#Cleveland Clinic Glickman Urological Institute, Section of Renal Transplantation;

Minority Men’s Health Center**Cleveland Clinic Department of Quantitative Health Sciences

Racial disparities in deceased donor kidney transplantation are compounded by longer pre-transplant dialysis duration in African

American patientsHo Yee Tiong*#, Charles Modlin#, Joan M. Alster**, Ismail R. Saad#, Barbara

Mastroinni, Kathy Savas, and Stuart M. Flechner#Cleveland, OH

#Cleveland Clinic Glickman Urological Institute, Section of Renal Transplantation;

Minority Men’s Health Center**Cleveland Clinic Department of Quantitative Health Sciences

• Conclusions: • Lower deceased donor allograft survival in AA recipients

compared with non-AA recipients occurs despite equivalent donor allocation and immunosuppression.

• Medicaid insurance status and days on waiting list may be surrogate factors for socio-economic status that are different between AA and non-AA recipients. 

• Longer pre-transplant dialysis duration in AA patients compounds the impact of race on allograft survival difference

and should be specifically targeted in programs to improve outcomes.  

Through Our Research, We Have Concluded

that education of AA’s with kidney disease:

The merits and advantages of kidney transplantation over maintenance dialysis

The benefits of living donor renal transplantation over deceased donor transplantation

The merits of preemptive renal transplantation Educating family members of those with

kidney disease regarding early screenings for kidney disease in families

Cleveland ClinicMinority Organ Donation and

Kidney Transplantation Initiatives

Cleveland ClinicMinority Organ Donation and

Kidney Transplantation Initiatives

Promotion of Organ Donor Registration in

African Americans

Promotion of Organ Donor Registration in

African Americans

An Innovation to Promote Organ Donation in African American Populations:

Methodology/Interventions.

Outreach contest strategically targeted towards twenty-eight 28 (n=28) NE Ohio BMVs (March 1st 2007 to June 30th, 2007) to promote, encourage and assist in outreach educational programs regarding organ donation and registry/issuance.

• Transplantation ProceedingsVolume 40, Issue 4 , Pages 1001-1004, May 2008

Culturally Sensitive & Competent Team to Promote Organ Donor Registration

• Cleveland Clinic – Lifebanc Community Partnership to:- Promote Organ Donor

Awareness- Increase Registration among

African Americans- Promote Prevention

AA Kidney Failure in NE OhioAA Kidney Failure in NE Ohio

• >1800 patients in Northeast Ohio are on waiting list for organ transplant, >50% African American.

• Numerous factors persistently limit acceptance of organ donation among AAs:- distrust of health care providers, - limited awareness and health literacy,- poor health among compatible potential

living donors in AAs.

Specific Aim 1: Focus GroupsSpecific Aim 1: Focus Groups• To gain a deeper understanding of NE

Ohio AAs’ knowledge, attitudes and ideas about chronic kidney and organ donation

- Surveys, - Community Conversations/ Focus

Groups• Teleange Thomas• Yolanda Hamilton: Lifebanc Multicultural Council• Robert Allen• Greg Lockhart• Dr. Modlin & MMHC

Organ Donation Grant Focus Groups MODLIN

Organ Donation Grant Focus Groups MODLIN

• http://www.youtube.com/watch?v=DSK9HR8ijqI

Solution:Public Media Campaign

Solution:Public Media Campaign

Green Chair Organ Donation Message

Green Chair Organ Donation Message

• http://www.youtube.com/watch?v=nIUxZsB7DOU

Solution: Promotion of Living Kidney Donation in African

Americans

Solution: Promotion of Living Kidney Donation in African

Americans

Laparoscopic Living Donor Nephrectomy

Laparoscopic Living Donor Nephrectomy

Solution: Promotion of Living Kidney Donation in African

Americans

Solution: Promotion of Living Kidney Donation in African

Americans

• http://www.youtube.com/watch?v=jy0CsHLL8YE

Living Related Renal Transplantation

Living Related Renal Transplantation