August 10, 2020

Comprehensive Transplant Center

Ohio State University Wexner Medical Center

 

To the Ohio State University Comprehensive Transplant Center:

We need to share with you directly a significant concern we have about patient care in the Comprehensive Transplant Center.

Prior to COVID, it was normal for many Transplant Coordinators to need to work a few hours of overtime in order to complete our weekly work. Since FY 2016, the Transplant Coordinator group has worked between 5,500 and 5,900 hours of total annual overtime, with that number increasing every year. It was clear to all of us that this occasional overtime was completely necessary in order for us to complete our assigned work and to make sure our patients were getting the level of care we are committed to provide.

Starting this spring, we were told there was to be no overtime for Transplant Coordinators at all due to the Medical Center’s financial situation.  While some Coordinators have been able to get by without the additional hours, for about 1/3 of our group, the consequences have been completely unacceptable.  For example, we have seen:

• A delay in diagnosing a graft dysfunction;
• Cancelled living donor surgeries;
• Living donor assessments going untouched for a month;
• Receipt of lab results delayed resulting in sub therapeutic anti-rejection medication levels or organ dysfunction;
• Delayed medication changes resulting in supra or sub therapeutic immunosuppression levels;
• Both new and existing patients seeing delays in scheduling resulting in delays of care; and
• Decreased quality of patient education.

What has shocked many of us is that despite bringing this to our Nursing Director, our Administrative Director, and our Assistant Chief Nursing Officer, there has been no meaningful recognition of the fact that a total ban on overtime has had an immediate and negative consequence for our patients.  When we ask for overtime, we are told to “ruthlessly prioritize” and find “creative” ways to manage our workload – wrongly implying we are not already working creatively or efficiently – or are offered long-term solutions that do not address the immediate problem. We know the CTC continues to perform well, meeting or exceeding FY20 goals, with several organs having record breaking numbers. We are all fiercely committed as a team to continue growing our program with the hopes of having another record breaking year and saving more lives.

Overtime is being offered in other units throughout the hospital to fulfill patient needs. We are asking for the same opportunity so that we can continue providing excellent care and continue to have the superb patient outcomes we all want for our patients.

Over and over we have heard that Transplant is an important part of the Medical Center’s long-term strategic plan.  We believe that it is both necessary and smart to invest in the areas the Medical Center wants to be successful, not to institute an arbitrary and unnecessary cost containment measure at the cost of our patients.  We hope you agree and that you will share this concern with Medical Center leadership.

Sincerely,

Transplant Coordinators

Comprehensive Transplant Center

Ohio State University Wexner Medical Center