Definition of a Transplant Hospital

1. Definition of a Transplant Hospital Membership and Professional Standards Committee Fall 2014

2. The Problem • “Transplant hospital” definitions - too simplistic • Makes it difficult for OPTN & MPSC to: • Assess transplant hospitals for outcome performance • Monitor compliance with OPTN expectations • Address important patient safety issues

3. Goal of the Proposal • Better define the basic accountable unit where organ transplantation occurs • Facilitate more accurate and conclusive assessments of transplant programs • Align Policies and Bylaws with the operational definition of a transplant hospital that the MPSC has traditionally used

4. How the Proposal will Achieve its Goal Proposed language: • Clarifies that each organ type is transplanted in a “single, discrete geographic location” • Provides certainty that transplant outcomes, OPTN compliance, and patient safety issues are not a function of different hospital facilities • Prevents possibility of issues at one site going unnoticed due to combining data with a facility that performs substantially more transplants

5. What Members will Need to Do • June 2015: anticipated BOD consideration • Sept. 1, 2015: anticipated implementation • MPSC will review exact geographical locations where hospitals perform transplant surgery • OPTN will notify members not aligned with this definition and give them two years to become compliant • Once implemented, MPSC uses new definition to review all applications

6. Questions? • Jonathan Chen, MD Committee Chair jonathan.chen@seattlechildrens.org • Name Region X Representative Email • Sally Aungier Committee Liaison sally.aungier@unos.org

7. Proposed Bylaws Language Article I: Membership 1.2 Transplant Hospital Members A transplant hospital member is any hospital that currently performs organ transplants and has current approval as a designated transplant program for at least one organ.A transplant hospital member is any hospital that has current approval as a designated transplant program for at least one organ. For the Organ Procurement Transplant Network (OPTN) to successfully meet contractual obligations to monitor member compliance, patient safety and organ allocation, the transplant hospital member must have the following characteristics: • each organ type is only transplanted in a single, discrete geographic location • program management occurs under a single hospital administrative structure • a single, unified medical staff credentialed and governed under the same bylaws exists • a single, unified nursing staff and administration exists Organ transplant service lines, conducted separately for the same organ including adult and pediatric, with each service line’s transplant surgery being performed in non-contiguous buildings are considered distinct and independent for OPTN monitoring purposes. Applicants in this situation need separate transplant hospital member and transplant program approval for each service line. Appendix M: Definitions T Transplant Hospital Member A membership category in the OPTN for any hospital that has current approval as a designated transplant program for at least one organ. Any hospital that has current approval as a designated transplant program for at least one organ.

8. Proposed Policy Language Policy 1: Administrative Rules and Definitions 1.2 Definitions The definitions that follow are used to define terms specific to the OPTN Policies. T Transplant hospital A health care facility in which transplants of organs are performed. Any hospital that has current approval as a designated transplant program for at least one organ. Transplant program A component specialty service group within a transplant hospital that provides transplantation of a particular type of organ.