case length matthew bock. 43% 18% 23% serology testing evaluation phase declaration, consent,...

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Case length Case length Matthew Bock Matthew Bock

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Serology testing Evaluation phase Declaration, consent, med-soc, diagnostic testing Allocation phase Recovery phase Match runs, tissue typing, more diagnostics Organ offers Transportation and surgical recovery Three phases of an organ donation

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Page 1: Case length Matthew Bock. 43% 18% 23% Serology testing Evaluation phase Declaration, consent, med-soc, diagnostic testing Allocation phase Recovery phase

Case lengthCase length

Matthew BockMatthew Bock

Page 2: Case length Matthew Bock. 43% 18% 23% Serology testing Evaluation phase Declaration, consent, med-soc, diagnostic testing Allocation phase Recovery phase

10:59

15:4018:27

22:39

0:00

6:00

12:00

18:00

24:00

HH:M

M

2006 2007 2008 2009

Case Length Interval: Brain Death Time to OR Incision Time

Overall Median

43%

18%

23%

Page 3: Case length Matthew Bock. 43% 18% 23% Serology testing Evaluation phase Declaration, consent, med-soc, diagnostic testing Allocation phase Recovery phase

Serology testing

Evaluation phase

Declaration, consent, med-soc, diagnostic testing

Allocation phase

Recovery phase

Match runs, tissue typing, more diagnosticsOrgan offers

Transportation and surgical recovery

Three phases of anorgan donation

Page 4: Case length Matthew Bock. 43% 18% 23% Serology testing Evaluation phase Declaration, consent, med-soc, diagnostic testing Allocation phase Recovery phase

Serology testing

Evaluation phase

Declaration, consent, med-soc, diagnostic testing

Allocation phase

Recovery phase

Match runs, tissue typing, more diagnosticsOrgan offers

Transportation and surgical recovery

Three phases of anorgan donation

New serology process

Page 5: Case length Matthew Bock. 43% 18% 23% Serology testing Evaluation phase Declaration, consent, med-soc, diagnostic testing Allocation phase Recovery phase

Serology testing

Evaluation phase

Declaration, consent, med-soc, diagnostic testing

Allocation phase

Recovery phase

Match runs, tissue typing, more diagnosticsOrgan offers

Transportation and surgical recovery

Three phases of anorgan donation

Recruitment:Serial echo protocolLung recruitment

New serology process

Page 6: Case length Matthew Bock. 43% 18% 23% Serology testing Evaluation phase Declaration, consent, med-soc, diagnostic testing Allocation phase Recovery phase

Serology testing

Evaluation phase

Declaration, consent, med-soc, diagnostic testing

Allocation phase

Recovery phase

Match runs, tissue typing, more diagnosticsOrgan offers

Transportation and surgical recovery

Three phases of anorgan donation

Recruitment:Serial echo protocolLung recruitment

New serology process

New national organoffer procedure

Page 7: Case length Matthew Bock. 43% 18% 23% Serology testing Evaluation phase Declaration, consent, med-soc, diagnostic testing Allocation phase Recovery phase

Serology testing

Evaluation phase

Declaration, consent, med-soc, diagnostic testing

Allocation phase

Recovery phase

Match runs, tissue typing, more diagnosticsOrgan offers

Transportation and surgical recovery

Three phases of anorgan donation

Recruitment:Serial echo protocolLung recruitment

New serology process

New national organoffer procedure

Increased emphasison thoracic organs

Page 8: Case length Matthew Bock. 43% 18% 23% Serology testing Evaluation phase Declaration, consent, med-soc, diagnostic testing Allocation phase Recovery phase

Serology testing

Evaluation phase

Declaration, consent, med-soc, diagnostic testing

Allocation phase

Recovery phase

Match runs, tissue typing, more diagnosticsOrgan offers

Transportation and surgical recovery

Three phases of anorgan donation

Recruitment:Serial echo protocolLung recruitment

New serology process

New national organoffer procedure

Increased emphasison thoracic organs

New HLA testingfor kidney match

Page 9: Case length Matthew Bock. 43% 18% 23% Serology testing Evaluation phase Declaration, consent, med-soc, diagnostic testing Allocation phase Recovery phase

Evaluation phase Allocation phase Recovery phase

Serial progression

One stage follows the other

Page 10: Case length Matthew Bock. 43% 18% 23% Serology testing Evaluation phase Declaration, consent, med-soc, diagnostic testing Allocation phase Recovery phase

Evaluation phase

Allocation phase

Recovery phase

Three phases inparallel (overlap)

Page 11: Case length Matthew Bock. 43% 18% 23% Serology testing Evaluation phase Declaration, consent, med-soc, diagnostic testing Allocation phase Recovery phase

Case moves fromreferral to active

Serology testing

Pt goes to the OR

Evaluation phase

Declaration, consent, med-soc, diagnostic testing

1st match run

Allocation phase

Recovery phase

Match runs, tissue typing, more diagnosticsOrgan offers

Set theOR time

Set-up, transportation and recovery

First:The duration of each phase should be limited by it’s longest unalterablefactor.

Second:Phases should be overlapped as much as possible rather than strungtogether.

Third:Pt families and hospital staff should have expectations that match thereality of case length.

3 major themes in case length reduction

The big picture fororgan donation case length