Organ Offer Management at Keck USC Transplant Institute
Keck USC Transplant Institute is a multi-organ transplant center with a dedicated team managing organ offers. The team structure includes RN-Transplant Coordinators, Call Team Managers, and Donor Allocation Specialists. They handle a range of tasks from reviewing offers with physicians/surgeons to patient calls and special projects. The management ensures day-to-day operations run smoothly, with a focus on quality control, staff management, and data collection.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
Megan Bell, RN, BSN, CCTC & Courtney Lepis, RN, BSN REGION 5 COLLABORATIVE TRANSPLANT CENTER OFFER MANAGEMENT- INTERNAL CALL TEAM AUGUST 21, 2019
Keck USC Transplant Institute Multi-organ transplant center Heart, lung, liver, kidney, pancreas COE for kidney transplant Large living donor program for liver 155 transplant employees
History of Handling Organ Offers at Keck USC Traditional method May 2017 Office coordinators rotate call Transplant Coordinators had just become union positions Coordinators are in the office M-F Call a hot issue 1 coordinator on for liver, 1 for kidney/panc, 1 for heart, 1 for lung Idea of separating out call developed Two organ allocation managers hired Backup call as needed Structure of call redefined 4 primary coordinators paid per day plus 1-2 backups a day Call is a side task not a primary job Done in office M-F 8-5 At home nights/weekends/holidays
Layers of Call Team/Call Team Structure RN-Transplant Coordinator Call Team Managers 2 on call managers Donor Allocation Specialist (DAS) 5 FTE 4 FTE Non licensed 1 on call at all times 2 per-diem hiring a 3rd Hourly position Step in to help with issues 1 on at all times (12 hour shifts) Assist the RN as directed Middle man with physicians/surgeons/OPO Cover call for all organs Review offers with physicians/surgeons Review of all cases, patient charts Implement processes/protocols Write up offers Patient calls for all programs Case set-ups Scheduling, training, etc. Transfers, re-MELD s, urgent listings, status updates Special projects as needed All team members are home based
Management of Call Department Day to Day On call as back up 24/7 Middle man for doctors/preferences Ensure consistency Quality control-QA charting, etc. Manage work flow Ensure safe staffing levels determine when to call in extra staff and who to call in Transportation guidelines Avg Calls per Day Monthly Big Picture Data Collection Structure How many special projects going at any given time Offer Decline Reports Transplant Log Protocols Dash Boards Processes Billing Workflows Schedule PI Projects 4 weeks Vacation 15-20 per day most days Changes As little as 10 Staff Management 100+ on busy days
CALL TEAM RESPONSIBILITIES PATIENT MANAGEMENT Review chart for readiness OFFER OTHER PROJECTS MANAGEMENT Review/write up offer Partner with waitlist teams TIEDI forms Call patient to let them know we have an organ patient assessment in real time Present offer to physician Assist living donor team Code appropriately in UNOS Remove all living donor recipients from UNOS within 24 hours of transplant Case setup/patient admission Follow cases to see outcome Patient calls- Pre & Post Communicate with OPO staff Facilitate getting vessels from other transplant centers or OPO s as needed Lab reviews Transfers Eval Reviews Re-melds, urgent listings, status updates Calling patients after-hours as needed
PATIENT CALLS/ TRANSFERS Call team handles for all organs Transfers Average of 10-12 a day Facilitated by call team Urgent listings Guidelines in place on what to call on and what to handle Call team manager directs All critical labs called Ad hoc committee Med refills handled by nurse Status updates Re-MELD all in house patients Heart status updates
Patient called for transplant by RN or DAS evaluation of patient done Issues escalated to in-house team/coordinator if needed Patient Communication Email sent out to in-house team so they know patient is being admitted/ stand-by
Patient calls Waitlist follow-ups Case set-ups Daily report sent out to each organ program Waitlist meetings Communication with In-House Teams Share point to document needed follow-up Emails
Call Team Communication Report Charting Housed in SharePoint Call Team Meetings Weekly conference calls Dedicated conference line that all incoming/outgoing and manager call in to twice a day Real time documentation of offers, patient calls, follow-up needed Committees to encourage staff participation Scheduling Case set-up forms Staff Development Recipient forms Education Call Bible Technology Special Projects Special Trainings
Call Team Implementation Timeline Summer 2017 Spring 2018 Union/HR negotiations for positions Training of call team July 1 2018 Structure of team developed Fall/Winter 2017 Go live : organ offers for liver & lung Positions posted Patient calls for liver, kidney & lung September 2018 Interviews held Jan/February 2018 Organ offers for kidney/pancreas 5 RN and 5 DAS (donor allocation specialist) hired Heart case set-ups August 2019 Organ offers/patient calls for heart
10 staff started and needed to be trained at once Utilized NATCO online training Filtered through all departments & clinics Shadowed call with managers Call Team Training Real time training to alter the process
Challenges Faced Clinical Logistical Union negotiation Emotional Changing a culture call team now off site/covered by a different group Training a brand new department Staffing needs/call team design Not just one way to do call Physician & staff buy-in Budgeting constraints Development of processes and protocols Ongoing & expected challenge Scheduling model-24 hour call vs 12 hour call Charting & documentation of call
Own the process Can shape/develop as your institute sees fit what works for one center, may not work for another Benefits of an Internal Call Specialize to different departments Change as programs change and grow Team Not everything needs to be a formal process 24/7 coverage for after hour projects feast or famine Build relationships with OPO s
Future of Call at Keck USC Continue to fine-tune the process Growth of each organ department growth of call team Written Processes Consistency MD Preferences Department Partnership
