"Transplant physician leaders need to be matrix leaders, interacting with a lot of different departments and division leaders," says Kinkhabwala. "They have to be bridge builders to some degree and develop agreements and relationships with everybody from radiologists and other surgeons to operating room personnel. I'm a busy transplant surgeon, but I spend 80% of my time in program administration."
Montefiore has designated transplantation as one of five centers of excellence within the health system. The transplant center has dedicated administrative leadership from the hospital, and separate budgets, marketing resources, and quality oversight. Since Kinkhabwala joined Montefiore eight years ago, kidney transplants have gone from a low of 109 in 2011 to 168 in 2015. "We had a very successful year in kidney transplants. It was a record year," he says.
"When I came to Montefiore, we set out to organize the center of excellence and build on an existing kidney program," says Kinkhabwala. "I knew what I needed in terms of floor capacity, nursing, clinical protocols, and faculty development, but I needed a hospital partner to help me execute that vision." He stresses that the physician leader's vision must be in sync with hospital goals.
Kinkhabwala says the transplant center must operate like a well-oiled machine because of the type of patients it sees. "If there's a problem in one part of the assembly line, the whole thing kind of falls apart. If your flow of patients, for example, is dependent on a financial counselor getting insurance clearance for patients and you have a financial counselor that's not working out well, or you don't have enough of them, then your whole assembly line could stop because of one person, and that could affect hundreds of people."
Success key No. 2: Redefine each patient's experience
USC's Abdominal Multi-organ Transplant Center performed 125 liver transplants and 152 kidney transplants in 2015 as well as six pancreas-only transplants in 2015, according to OPTN. Transplant surgeon Colquhoun, who specializes in liver transplantation and hepatobiliary surgery, has been on the job there for less than a year, but already his top goal will be to take patient experience to a new level in the transplantation world.