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Can you change anaemia management
in your transplant patients?
Measure it!
• How many patients are anaemic?
• What is range, mean, median Hb?
• Compare with national/local recommendations or
local/national results
• Present your results
Centre protocol
• If no written protocol/standard – write one with a
nephrologist and get agreement. National/European
guidelines are useful starting points
• If protocol exists, who monitors deviation from target?
Success usually depends on:
• Spending time to understand the cues and clues
• Accurate summary of issues raised, and control of
direction of discussion
• In-depth agreement to ensure an action is on a solid
• Attention to the political processes of the organisation
and the involvement of relevant people
• Delivery of any promises on time to the required
• The management of the project by establishing a
structure or forum to highlight/resolve issues
Reasons for failure
• Not involving influential people early - the make or
break people
• Proposing solutions before problems are diagnosed
• Presenting reports full of content without an equal
regard for the process of discussion
• Moving too quickly, causing surprises and creating
defensive behaviour amongst others
• Not recognising the effect of change in one part of the
system on another part of the system
Margerison CJ (1988) Managerial Consulting Skills - a practical guide; Gower