Authorizing Collective Patient and Wait Time Transfers

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

2. The Problem 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

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

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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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?

13. Questions? • Theresa Daly, MS, FNP Committee Chair thd9003@nyp.org • Regional representative name (RA will complete) Region X Representative email address • Susan Tlusty Committee Liaison susan.tlusty@unos.org