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Forum Newbie
Group: Forum Members
Last Login: 1/20/2010 9:29:24 AM
Posts: 2,
Visits: 24
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| My liver program has a process that i would like to streamline. I have both evaluation and high MELD coordinators. Our low MELD patients are managed mostly by NP's in our outreach clinics with the support from our hepatologists. My eval coordinators do about 300 evals annually. They do not do any waitlist management. Patients are added to the UNOS list with MELDs of 8 or above. They are made Status 7 until there MELD scores reach 16 or above or their condition deteriorates. The high MELD coordinator spends her time making sure any testing to "CLEAR" them for txp is either completed (if missed) or redone if outdated. This seems to be a burden on my high MELD coordinator as she is often told to URGENTLY clear someone. My question is really: how do other centers do this? Do you make sure all evals are TOTALLY done and activate and manage? I am looking for any suggestions!! thanks all. LC 
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Forum Newbie
Group: Forum Members
Last Login: 3/8/2011 6:11:26 AM
Posts: 1,
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| Every liver center I have worked at (2), made sure that each pt's testing was kept up to date in order to prevent the problem of a pt who was doing well, 'crashing', and having workup that was no longer useful or even correct. (ie, changes in cardiac status) Wish I had a great answer for this one, but it does seem a bit lopsided to me.:
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Forum Newbie
Group: Forum Members
Last Login: 7/18/2009 2:36:39 PM
Posts: 1,
Visits: 7
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| We will not list a patient until everything is done and cleared, goes to candidate selection, etc. Since we list pt's with high melds, we want to make sure that everything is good to ok at listing. the only exception is HCC patients. We will make sure they clear all their consults (social work, cards, etc) but if all they need to complete their eval is say a mammo or colonoscopy, will will discuss at candidate listing meeting, if approved, list the patient and put an "internal hold" on them till their mammo or colon is received. This is to allow the HCC patients to at least start gaining time since it takes awhile for them to work their way up the list. Of course if the pt is an AB or a B, we may wait till all testing is done. Hope this helps.
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