What is organ offer management? Where did the term come from?
Until Transplant Coordinators of America (a.k.a. TCOA) was founded the service nor the term for the service ever existed. With the communication of organ offers becoming so voluminous and complex, the days of someone just receiving a phone call and taking care of it are over. Transplant centers have been clamoring for years trying to figure out the best way to triage organ offers more efficiently and effectively. There are a variety of methods transplant centers around the U.S. are handling these problems related to staff burnout and escalating budgets associated with Donornet and organ offers.
In 2007 Transplant Coordinators of America was founded to provide outsourced services to transplant centers in hopes to help them provide better patient care and save more lives. Whilst at the same time decrease staff burnout, increase efficiency, reduce wasted time and money as well as provide the industry with something much needed in our field. Sleep and consistency. With that need was born Transplant Coordinators of America (TCOA for short), the first company offering the services of pre-screening organ offers, coordinating organ imports / transport and overall assistance to the transplant centers. When CMO and director of business development James Schiller joined in 2010 he struggled with what to call this new service which otherwise never existed. As there really wasn’t a name or term for it. After some thought and discussion we settled on what is NOW known as Organ Offer Management.
Organ Offer Management primarily consists of two major functions: screening Donornet organ offers to “weed out” and filter offers that surgeons want and do not want that come at all times of the day and night. Most of which are offers that simple waste their time. The other part of this service is expert coordination of getting organs from procurement to the recipient OR as quickly as possible, yet as cost effectively as available. However, in the last few years these services have expanded to such an extent that many centers find that they can completely replace their entire coordinator staff for the services of Transplant Coordinators of America.
According to Barry Marshall, a senior consultant with the national firm Transplant Management Group, based in Mandeville, La., the vast majority of transplant centers have coordinators take the call from their organ procurement organization (OPO). “The exclusionary criteria for organ acceptance is pretty cut and dried,” he says. “Most programs have upper and lower limits for everything associated with that organ. There is no reason a trained transplant coordinator can’t at least take that first call and know that if you’re getting an offer for an 85-year-old kidney for a 14-year-old recipient, the exclusionary criteria requires a ‘no thank you.”
Many centers may be unaware of a new trend in organ offer management: third-party companies who take the call and, if needed, set up the logistics of transportation, staffing and OR booking. They offer 24/7 and night/weekend/holiday coverage.
Nanci Flores, director of transplant services at the University of California, Los Angeles (UCLA) says her center has traditionally used nurse transplant coordinators, previously on an on-call basis and now with a new shift schedule. Issues of both staff burnout and financial constraint have influenced UCLA’s organ offer management. In the past, staff complained of burnout. Betty Crandall – Administrative Director Transplant Services – Wake Forest Baptist Health: “Transplant Coordinators of America has been providing call coverage for our pancreas and KP program since August of 2012. Prior to my arrival as the transplant administrator, my coordinators had completed a review of companies providing call coverage and had recommended TCOA. After my arrival, the surgical director and I did an extensive review of all those who could provide such coverage. We determined that TCOA would best meet our needs clinically and financially. It has been a very smooth transition. My coordinator staff and the surgeons are very pleased. It has greatly contributed to improved job satisfaction among the coordinators”.
TCOA is the largest and most experienced provider of outsourced 3rd party organ offer management with 12 contracted clients (Transplant centers & OPOs), 50+ years in the organ transplant field, and over 6 years offering these services.
Sue Pondrum of AJT Report writes, A recent new TCOA client is the Tulane Transplant Institute in New Orleans, where Barry Marshall is vice president of service lines and business development. Previously, Tulane utilized designated on-call coordinators, many of whom worked from their homes. Then, for financial reasons, they started looking at options regarding overall staffing. “One of those was to outsource call coverage and still maintain the same level of service. For us, the cost savings has been about 20% to 25%,” he says.
As constraints from insurance and government regulations pinch the budgets of transplant centers and OPOs, finding alternative ways to improve their department has become crucial.