Authorizing Collective Patient and Wait Time Transfers Operations and Safety Committee Fall 2014

Transplant programs may stop performing organ transplants due to:  Long-term inactivity  Withdrawal of membership  Termination of membership Processing large volume of patients who transfer to alternate program or programs is challenging The Problem

Create process to transfer patients collectively  Increases efficiency  Allows for timely response  Creates safe mechanism for restoring transplant opportunities Goal of the proposal

How the proposal will Achieve its Goal  Amend Policy 3.6.C Individual Waiting Time Transfers  Create Policy 3.8 Collective Patient Transfers authorizing the OPTN to collectively transfer patients  Amend Bylaws K.6 Transferred Candidates Waiting Time to outline the process for collective transfers

How the Proposal will Achieve its Goal Requirements before a collective transfer:  Complete existing requirements for patient notification  Written agreement between programs  Patient management plan

How the Proposal will Achieve its Goal Written agreement between closing and accepting programs must contain: Request for collective transfer List of patient names and identifiers Agreed upon transfer date Assurance of required notifications and consent Acknowledgement that records transfer without modification Accepting program becomes responsible for patient notification and management

How the Proposal will Achieve its Goal  Accepting program plan must contain:  Procedure for immediate review and designation of candidate waiting list status  Expected date for completing full evaluations

How the Proposal will Achieve its Goal The OPTN will:  Review agreement and plan Provide expected date of transfer completion Notify programs in writing after transfer is complete

How the Proposal will Achieve its Goal Requirements after a collective transfer:  Send OPTN progress report with updates on each transferred candidate within 90 days post-transfer

Supporting Evidence  Current process designed for individual transfers  Individual transfers take up to 30 minutes each  Collective process used successfully in prior case  Average transplant hospital has 495 candidates  Forms can be lost; data may be erroneously transcribed; and opportunity for transplant delayed if large groups are transferred individually

What Members will Need to Do  There are no new requirements that must be implemented for all programs  If transplant programs enter long-term inactivity, withdraw membership, or terminate membership, the requirements will need to be followed to transfer patients collectively  Process is optional

Specific Requests for Comment  Should deadline be proposed to complete full evaluations following a collective transfer?  Should post-transfer reporting be done every 90 days until post-transfer evaluation plan is complete?  Should a new post-transfer evaluation plan be developed if circumstances change?  Expectations about the receiving transplant program communicating active versus inactive status to candidates?

 Theresa Daly, MS, FNP Committee Chair  Regional representative name (RA will complete) Region X Representative address  Susan Tlusty Committee Liaison Questions?