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From: McGovern, Fran Sent: Friday, April 15, 2016 9:06 AM To: Soltys, Kyle; Bond, Geoffrey J.; Mazariegos, George; Sindhi, Rakesh (CHP); Squires, James; Squires, Robert; Green, Michael; Blasiole, Brian; Cain, James G; Cassara, Antonio; Cladis, Franklyn; Damian, Daniela; Davis, Peter (ANES); Jones, William; Lang, Robert S; Mchugh, Gregory; Rymer, David B; Visoiu, Mihaela; Aneja, Rajesh; Au, Alicia; Carcillo, Joseph; Clark, Robert (Anes/CCM); Dezfulian, Cameron; Hamilton, Melinda; Churman, Diane L; Bright, Steven; Vish, Jacquelyn; Carnahan, Thomas D; Chaplik, Annette; Corboy, Devin; Geyser, Amanda; Heltman, Laura; Knapp, Christina; Landis, Tammi; May, Nicole; Snatchko, Shannon; Spencer, Todd; Stefanko, Ashley M.; Wasser, Kaitlyn; Cote, Stacey; Garvin, Kelsey; Hufford, Laura; MCGILL, KELLY; Pitschman, Chelsey; Sharrow, Tracey (Presel); Siciliano, Gabrielle; Kachmar, Pamela; McGinnis, Anne; Eicker, Paula; Valenta, Cynthia; Vitalone, Kristin S; Barcellona, Nicholas J; Churilla, Henry; Stanley, Paula B; Cavanagh, Jean; Kavanagh, Kristopher Cc: Zecca, Dale; Basille, Donna; Tavormina, Stefanie; Holden, Joy; Santucci, Janet; Nieman, Natalie; Scanlon (Lucero), Terri L; Ali, Bernadette; Madden, Christina; Belenis, Elaine; Olszewski, Lori Subject: UVA Transplant Kickoff Meeting - 4/25/16 @ 6:30 am Good morning: There will be a UVA Transplant Kick Off Meeting with everyone involved with the UVA partnership (see attached list) on Monday, 4/25/16, from 6:30 7:30 am in the Executive Office Conference Room, Suite #6400, 6 th Floor, AOB. AGENDA: 1) Strategic goals 2) Timeline for first transplant 3) Travel logistics 4) Escalation processes 5) Policies and procedures 6) Other business A call in number will be available as well. If you are unable to attend, please ensure that at least one member from your area is available to attend or participate via conference call. An Outlook invitation will be sent for your calendars. Thank you, Fran McGovern Executive Assistant to Diane Hupp, DNP, RN, NEA-BC Vice President, Patient Care Services, and Chief Nursing Officer Children's Hospital of Pittsburgh of UPMC 4401 Penn Avenue AOB, Floor 6 Pittsburgh, PA 15224 Phone: (412) 692-5126 Fax: (412) 692-5800 fran.mcgovern@chp.edu

Transplant Kyle Soltys Geoffrey Bond George Mazariegos Rakesh Sindhi Peds GI James Squires Robert Squires Peds ID Michael Green Anesthesia Brian Blasiole James Cain Antonio Cassara Franklyn Cladis Daniella Damian Peter Davis W. Scott Jones Robert Scott Lang Greg McHugh David Rymer Mihaela Visoiu CCM Rajesh Aneja Alicia Au Joseph Carcillo Robert Clark Cameron Dezfulian Melinda Hamilton OR Kris Kavanaugh Diane Churman Steve Bright Jackie Vish CHP STAFF INVOLVED IN UVA TRANSPLANT PARTNERSHIP

PICU Nursing Thomas Carnahan Annette Chaplik Devin Corboy Amanda Geyser Laura Heltman Christina Knapp Tammi Landis Nicole May Shannon Snatchko Todd Spencer Ashley Stefanko Kaitlyn Wasser Acute Care Nursing Stacey Cote Kelsey Garvin Burns Laura Hufford Kelly McGill Chelsey Pitschman Tracey Sharrow Presel Gabrielle Siciliano Transplant Coordinator Pamela Kachmar Operations Diane Hupp Anne McGinnis Paula Eicker Cindy Valenta Kristin Vitalone Nick Barcellona Hank Churilla Paula Stanley

Liver Transplant Partnership Children s Hospital of Pittsburgh of UPMC and University of Virginia Medical Center

Pediatric Liver Transplant Partnership Why? Achieving growth utilizing our current model (ie. Transplanting only in Pittsburgh) is limited by: the decreasing availability of organs due to decreasing pediatric donation rates, cross-regional sharing of organs, and increased regional and national competition. 2

Pediatric Liver Transplant Why? (cont.) Partnership The current UNOS allocation scheme strongly favors pediatric programs in regions with limited competition and increased numbers of donors. There are 11 regions in the United States for organ allocation (adults and pediatrics). The regions were developed based on total population, not pediatric. Livers are allocated by medical urgency proximity to the donor hospital 3

Mission and Vision To create a partnership that increases the ability to provide a life saving liver transplant to pediatric patients. Create a world class pediatric liver transplant center at UVA and greatly reduce the need for Virginia children to travel out of state for liver transplantation. Achieve the highest level of quality and sustained excellence in clinical outcomes including patient and graft survival. Provide a safe, outstanding patient and family experience by closely coordinating care in a seamless manner between CHP and UVA.

Pre - Transplant Double list patients Monitor status of each patient and maintain current clinical information UNOS notification CMS notification Organ offer Coordination of prep Licensing of staff

Transplantation Day Assemble team Surgeon, Anesthesiologist, OR specialty RN, PICU RNs Transplant Anes and OR RN return to PGH Surgeon and PICU RN stays PICU RNs cover 24 hours/day Removal of patient from UNOS list

Intensive Care PICU RNs coverage for 24 hours/day Coverage until patient leaves the ICU Daily teleconferencing rounds with CHP intensivists Nurses role: Mentor Patient safety Help with protocols Provide guidance with care

Acute Care Acute care RNs from PGH arrive day of transfer from ICU Cover 24 hours/day upon transfer from PICU then 12 hours/day Surgeon returns to PGH after approximately 5 days Rounding via telemedicine Nurses Role Mentor Guide care through protocols Patient safety Patient education Discharge readiness

Discharge Discharge teaching during acute care stay Self Medication Program Reference binder to family Contact information for outpatient Home Care Follow up plan

Outpatient follow up Clinic visits Lab work Telecommunications to PGH team with any questions Patient return to home: timeline Quality indicators/ statistical tracking

Logistics Travel and Expense Card Housing 2 Hotels identified for staff that are within 2 blocks of the hospital Transportation Car service identified for staff transportation to and from Pittsburgh Pick up/drop off at Children s Hospital Charter flight for team on day of transplant Flight departs from Washington County Airport

Future Outlook 10 year plan Gradual increase in number of transplants performed each year Other Partnerships CHP benefits from collaborative through: Increase in referrals Patients getting transplanted Domino transplants Intestinal transplants

Questions?