Integrating the Jungle into a Book: The Incorporation of a Financial Coordinator into a Transplant Program”   Lori Anderson, RN, MS Manager, MCS Programs Transplant SerVices Tampa GEneral Hospital

It’s a Jungle out there

TEAM Approach to the Care of the Transplant/MCS Patient Discuss the evolution of the Transplant Team Integration of the Transplant Financial Coordinator Role Apply principles of you education, training, and experience to several case studies

History of Transplant in the USA 1954 – First Kidney Transplant; Followed by Liver, Heart, and Lung in the 1960s 1980s – Viable option for End Organ Disease with the inotrduction of Cyclosporin for prevention of Rejection 1984 – Development of OPTN/UNOS

History of Transplant In the USA 1999 – UNOS launches UNetsm, a secure, Internet-based transplant information database system for all organ matching and management of transplant data 2001 - For the first time, the total of living organ donors for the year (6,528) exceeds the number of deceased organ donors (6,081). 2015 – 30,969 Organ Transplants were performed

Team Teamwork is the ability to work together toward a common vision Team Teamwork is the ability to work together toward a common vision. The ability to direct individual accomplishments toward organizational objectives. It is the fuel that allows common people to attain uncommon goals

TEAM Team dynamics are the unconscious, psychological forces that influence the direction of a team’s behavior and performance Team dynamics are created by the nature of the team’s work, the personalities within the team, their working relationships with other people, and the environment in which the team works Team dynamics can be good - for example, when they improve overall team performance and/or get the best out of individual team members.  They can also be bad - for example, when they cause unproductive conflict, demotivation, and prevent the team from achieving its goals

Transplant Team Initially small medical/ clinical groups Recognized need additional perspectives ie Social Work, Dietician As the Programs evolved with increased experience with this complex patient population, call for additional Specialists

Transplant Team Policies have given way with input from Public, Professional organizations, and regulatory bodies Examples include: UNOS Payors NATCO JC

Transplant Team Important for the team to clarify roles Assure there is a common vision/goal Imperative for all team members to have a voice at the table

Patient Centered Care Patient & Family Nutrition Outpatient Clinical Staff Financial Counselor Social Work Pharmacy Psychologist/ Psychiatrist Nutrition Research Nurse Inpatient Clinical/CVOR Perfusion Patient & Family Palliative Care VAD Coordinator Radiology/ GI Services Biomed Staff LTAC/ Rehab Medicine Transplant Coordinator Administration/ Quality Staff/ Consultants Surgeon Community First Responders Primary Care Physicians/ Community Cardiologists Cardiologist

Transplant Financial Coordinator 1992 Recommendation for Financial Specialist to UNOS Bord of Directors Proposal to increase funding for the Patient as well as the Institution Support from other Organizations/Specialist On the Job training for many

Transplant Financial Coordinator 2001 – Professional Organization founded Specialty group to educate within your profession as well as the community Serve as a Patient Advocate – Important for team to understand and appreciate the Patient’s financial health as well.

Tampa General Hospital Private, not for profit, comprehensive medical center with 1, 011 beds serving the residents of West Central Florida Kidney Program est 1974 with > 5,000 transplants done Heart Program est 1985 with > 1,400 transplants done Liver Program est 1987 with > 1,500 transplants done Lung Program est 2002 with > 300 transplants done

It takes a Village… The TGH Village

Case study #1

Case study # 2

TAKE HOME POINTS for your TOOLKIT Connect - Get and stay involved Collaborate – internal and external Communicate – with all

Thank You

Questions??