Erin Colleen August

Buckeye Transplant Services

We are the nation's leading provider of specialized services for transplant centers. Since our inception in 2008, we have partnered with transplant centers, research facilities, and OPOs across the country to manage organ offers through donor screening, organ call coverage, transportation coordination, donor management, facilitation of organ recovery and transplantation processes, waitlist management, and transplant patient calls.

We have over 200 staff members, with a large dedicated technical team. Our coordinators have extensive organ placement and transplant experience, made up of registered nurses, respiratory therapists, and procurement transplant coordinators. Our pedigree in the transplant sector has enabled us to develop and invest boldly in technology that has enabled us to bring innovation to our clients and staff.

Job Duties

Facilitate life-saving organ transplants through collaboration with transplant, OPO, and research clients nationwide.

- Screen organs based on Centers' needs and rule out criteria.

-Call on call to discuss potential acceptance.

-Run virtual/physical cross-match.

-Once an organ is accepted, follow DAL and set up a transplant along with Hospital OR and donor OPO.

-Set up a procurement team, Transmedics, and start the communication text thread. Follow the process all the way through, concluding with delisting from the waitlist.

Transport of ECMO patients requires coordination and careful consideration of potential risks and benefits of transport, and is typically accomplished via ground or air. In most cases, the circuit and equipment utilized for mobile ECMO are the same as the components used for in-house ECMO support, with adaptation for the unique aspects of mobile care. Regardless of transport mode or equipment, safety of the patient, transport team, and public is paramount during ECMO transport. There is little evidence guiding the transport of patients supported with ECMO; however, it is recommended that transport be performed by well-equipped teams acquainted with mobile transport. Several case series describe safe transportation of patients supported with ECMO using different models and team structures. The ELSO ECMO Transport guideline is predominantly based on expert opinion.

• Erin August, Co-Author, ELSO ECMO Transport Guidelines.
• Erin August, Contributor, Chapter 46, ELSO 6th Edition RedBook - Transport.
• Erin August, Contributor (In process), ELSO ECMO Specialist Training Manual, 5th Edition.

Best Practice Committee

• The ICCAC Best Practice Committee researches and develops what has been proven to be best practice in patient care for patients who are receiving MCS/ECMO therapies.
• This committee is a governing body of practice that defines the coordinator role as meeting the requirements needed per TJC.
• This committee assists in updating patient management on an ongoing basis, based on the most up-to-date research.
• This committee constantly adds new projects based on areas identified by the TJC and also ECMO/MCS providers.

The MCS Simulation Committee.

• The ICCAC Simulation Committee is a new committee in which I am currently tasked with writing the bylaws for. This committee is necessary to assist Coordinators in gaining confidence in troubleshooting skills, to have proper train-the-trainer education, in order to care for, while also educating, other ECMO/MCS providers.

• Skills - Clinical subject matter expert in ECMO, VAD, transplant, and Critical Care Transport; managerial and technical expertise; well-developed interpersonal communication; Windows Office and presentation skills; organizational and outreach skills.
• Job Duties-
• The ECMO Coordinator is responsible for the following duties:
• Facility education for all ECMO providers.
• ECMO database entry for hospital-specific and ELSO databases.
• Staff scheduling to cover ECMO patient care (CVICU & CCS).
• Budgeting - Capital, labor, conferences, projects for growth, ECMO Specialist certifications, and outreach.
• Invoice coding for payment of ECMO related charges in ECM, now Workday.
• Project management - For growth and development of the program, i.e. ELSO endorsed Course, TALIS, etc.
• Development of EPIC spreadsheets for device/ECMO documentation in-house and on transport.
• Program development - Center of Excellence, ELSO ECMO course endorsement, education, outreach, staff programmatic roles, Cardiogenic Shock.
• Outreach - For referrals, collaborations between programs and to demonstrate leadership in the ECMO Community through presentations and involvements on Committees with outside organizations such as ELSO and ICCAC.
• Fiscal financial planning.
• Tracking of contracted (CCS) time and expenses.
• Asset Tracking and Big Time Inventory.
• Chart audits to ensure daily charges are being entered.
• Final charge review before bill is dropped for insurance payment.
• Monthly MOR.
• Comprehensive Care Services, Perfusion Contract reviews.
• Development of educational offering for bedside staff for care model change.
• Development of ECMO Simulation Lab for Memorial Regional Hospital.
• CALIFIA Simulation training.
• Adult transport of ECMO and all other devices, both temporary and durable, as needed.
• Clinical Expectations:

Setting up and priming the ECMO circuit.

Be able to troubleshoot circuit and console, and exchange circuit/oxygenator as needed. Maintaining ECMO patient at the bedside, sitting up to 4 pumps.

Provide just-in-time device training for staff and physicians.

Maintain physician outside ECMO credentialing files for administrative officers.

Assist with outside programmatic consults with other programs.

On call for ECMO nurse/device nurses and for outside referrals.

Backup Coordinator to the Adult/Pedi VAD Program, as needed.

Backup/assist with temporary device cases in OR and Cath lab.

Assist and work along with biomed on preventative maintenance requirements, as well as when equipment is in need of repair.

Assist with Risk Management and legal with incidents of failed equipment/incidents due to being on equipment and contracting when rental is needed.

Additional Skills: to oversee all temporary mechanical circulatory assist devices at MRH and assist with JDCH pediatric cases as needed.

Support staff with troubleshooting, transfers, and procedures, in addition to tracking data on devices.

Developed strategies to improve operational procedures and reduce costs.

Monitored inventory levels and ordered additional supplies as needed.

Collaborated with vendors to arrange contracts for services or products needed by the organization.

Facilitated communication between different departments in order to resolve issues quickly.

Managed day-to-day operations of the department including scheduling tasks and assigning duties.

Conducted interviews with potential candidates for open positions within the organization.

Organized travel plans for business trips including flights, hotels, car rentals.

Developed policies and procedures related to departmental operations ensuring compliance with applicable laws and regulations.

Coordinated with other supervisors, combining group efforts to achieve goals.

Delegated work to staff, setting priorities and goals.

Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.

Trained employees on best practices and protocols while managing teams to maintain optimal productivity.

Guided employees in handling difficult or complex problems.

Consulted with managers to resolve problems relating to employee performance, office equipment and work schedules.

Developed work schedules according to budgets and workloads, covering priority tasks.

Recommended solutions related to staffing issues and proposed procedural changes to managers.

Recruited, interviewed and selected employees to fill vacant roles for ECMO Specialist/transport.

This position was designed to provide support and leadership in all clinical activities of Procirca. These tasks include, but are not limited to, clinical management of mechanical circulatory support (MCS) recipients within Procirca contracted health centers and industry partners; training of medical staff in the use of MCS devices at Procirca contracted centers; clinical management and training support on behalf of MCS device manufacturers who utilize Procirca expertise. Incumbent will also have a significant role in advancing Procirca business and scope of work. In addition to clinical expertise, the incumbent will be required to participate in a 24-hour call rotation and understand the design and development of innovative cardiac and organ support technologies.

This is a casual role, with department needs determining hours worked for this position. The Sr. Consultant will travel to locations around the U.S, with most travel being across the Mid Atlantic States' accounts.

Candidates must have expereince caring for mechanical cirulatory patients.

Responsibilities:

• Ordering and maintaining all implant and device-related supplies (disposable and capital components).
• Current MCS systems utilized include: Thoratec Paracorporeal Ventricular Assist Device (PVAD), Thoratec Heartmate II (LVAD), Thoratec Centrimag (VAD), HeartWare HVAD (LVAD), Abiomed Impella (2.5, CP, and 5.0), Syncardia Total Artificial Heart, Jarvik 2000 (LVAD), and intra-aortic balloon pump (IABP).
• The incumbent will work closely with industry to develop or enhance clinical technologies.
• Accompany medical staff during VAD patient rounds.
• Coordinate and administer patient and caregiver education.
• Introduce VAD technologies to VAD candidates and caregivers.
• Address technical device issues during serial clinic visits: VAD equipment examination, VAD settings optimization, component tracking, and data collection.
• Associated clinical research and peer-reviewed publications at national meetings.
• Provide training and oversee competency testing for outpatient facilities, first responders, physicians and clinical personnel in the community.
• Incumbent will be responsible for care of MCS equipment at partnering medical institutions.
• Provide training and oversee competency testing for all hospital staff.
• Implementation of clinical trial and novel technologies.
• Component tracking and inventory management.
• Hemodynamic data collection and documentation in EPIC.
• The incumbent will maintain a regular call schedule to provide clinical/technical support to the MCS population and medical staff.
• Joint Commission preparation for hospital DT recertification.
• Contribute to development of clinical protocols and pathways.
• Administer patient billing activities in the MCS domain.
• On-call for implants, re-operations, clinical/technical emergencies.
• The incumbent will assist medical staff in the setup, operation, and clinical/technical evaluation of such equipment.
• Provide clinical/technical support to outpatient facilities (SNF, LTAC, etc.).
• The incumbent will also provide the following functions to contracted MCS device manufacturers: clinical management of patients supported by the manufacturer's device, medical staff training for health centers using these technologies, troubleshooting/emergency response on-site or remotely via telephone, and assistance with the development of patient-care protocols.
• Under the direction of the Medical Director, the incumbent will serve as senior support staff for MCS recipients supported at partnering medical institutions
• CRNP with no less than 3 years experience with clinical management of MCS technologies or
• BSN nurse with 5 years of clinical experience with MCS and at least 2 years in an MCS program leadership role.
• Engineer possessing Ph.D. or M.S. in Chemical, Biomedical or other related domain including no less than 5 years experience with clinical management of MCS devices and academic research is preferred
• Ability to work independently in a variety of settings including the operating room, catherization lab, intensive care unit, and other clinical settings common in a major health care facility.
• Must have experience teaching and own excellent communication skills and be willing to travel up to 50% of the time on short notice for emergency clinical support needs.
• Must have experience working with clinical trial technologies
• Distinct Computer skills; e.g. Microsoft Office, Excel, Exchange, EPIC, and Internet based software applications.
• Strong interpersonal skills and the ability to communicate well, both orally and in written form.
  
  Licensure, Certifications, and Clearances:
• Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran

MCS Coordinator - HVI VAD - (240000X5)

Description

Job Summary:

The MCS Coordinator is an expert clinician with advanced education and training for the provision of safe, high-quality, evidence-based, cost-effective care for patients with mechanical circulatory support devices from referral throughout their course of support. The MCS Coordinator scope of practice encompasses job responsibilities in clinical management, education (staff and education), research, consultative, and quality. The MCS Coordinator contributes a unique body of knowledge and skill set to the Advanced Heart Failure Multidisciplinary Team. The MCS Coordinator operationalizes the role in the education, functions to coordinate all phases of care and clinical management in the inpatients, outpatient and community. serves as the central point of contact for patients and families who are managed with or are being considered for an MSC device. The MCS coordinator is a clinical resource and is responsible for providing direct, comprehensive patient care management, consultation, education, research, and leadership across the continuum of care for the MCS population. The MCS coordinator is responsible for the clinical assessment and evaluation of the advanced heart failure patient for appropriateness for MCS support. The MCS coordinator is also responsible for performing job duties in accordance with the mission, vision, and values of Tampa General Hospital. The MCS coordinator is responsible for providing care to patients who receive mechanical circulatory support as an advanced treatment for shock/organ failure. They facilitate the process of mechanical circulatory support therapy from patient identification and evaluation through implantation and post-implantation follow up. The MCS Coordinator learns from experience and evidence what to expect in a given situation and alters plans accordingly and has an intuitive grasp of situations and operates from an innate understanding of the
situation. The MCS Coordinator recognizes when situations are outside the expected and uses analytical skills and abilities to investigate alternative perspectives and conducts comprehensive assessments. The MCS Coordinator promotes health and the prevention of injury and disease, serves as an advocate and educator, mentors, delegates, and provides feedback to their support team. The MCS Coordinator participates in quality assurance process improvement to improve clinical practice, patient outcomes, and processes. The MCS Coordinator is responsible for ensuring the coordination of the clinical aspects of patient care permissible within their license and acts as a liaison between Interventional Cardiology, Heart Failure/Transplant Cardiology, Cardiothoracic Surgery, Pulmonary, and Critical Care Intensivists. The MCS Coordinator provides consultation and education to healthcare providers and the community regarding issues. The MCS coordinator possesses an understanding of regulatory requirements and incorporates them into their practice. They also participate in research to improve clinical practice. The MCS Coordinator is also responsible for performing job duties in accordance with the mission, vision, and values of Tampa General Hospital.

Qualifications

Required Skills:

RN - Required

CHFN - Preferred

BSN - Required

2 years of critical care experience - Preferred. CHFN within 3 years of hire.

JOB SUMMARY

The LVAD Coordinator RN is a licensed professional who uses the Company nursing professional practice model to coordinate patient care delivery by the health care team and coordinates evaluation, admission, discharge of assigned Left Ventricular Assist Device (LVAD) patients. Using the nursing process, the RN assesses the patient, identifies nursing diagnoses based on responses to health problems, implements an individualized plan of care, evaluates the patient's response and documents outcomes. The RN delegates interventions to health care personnel based on the Texas Nursing Practice Act, each patient's condition and the competencies of the employee.

ESSENTIAL FUNCTIONS OF THE ROLE

• Clinical Judgment: Using clinical reasoning, conducts accurate clinical assessments according to practice standards. Identifies and prioritizes patient and family needs. Implements the nursing plan of care. Modifies plan to meet clinical outcomes.
• Clinical Inquiry: Systematically evaluates the quality and effectiveness of nursing practice, including, but not limited to, nursing delicate indicators. Helps practice changes through research utilization and experiential learning.
• Caring Practices: Creates an attentive, helpful, safe and therapeutic environment for patients, families and staff. Manages both fervid and physical pain with the aim of promoting relief and healing and preventing unnecessary suffering.
• Response to Diversity: Recognizes, appreciates and incorporates a patient's and family's unique differences, such as culture, spiritual beliefs, gender, race, ethnicity, lifestyle, socioeconomic status, age, and values, into an individualized plan of care.
• Advocacy and Moral Agency: Preserves and protects the confidentiality, autonomy, dignity and rights of patient and family. Creates an individualized plan that accurately reflects patient and family values and goals. Identifies and helps resolve ethical and clinical concerns.
• Facilitation of Learning: Facilitates the learning for patients and families, nursing staff, other members of the health care team and community; integrating education throughout the delivery of care, including changes in level of care and discharge to home or other facility. Assesses and documents learning needs and outcomes.
• Partnership: Works collaboratively and interdependently with colleagues and community to develop and implement an integrated plan of care. Open and delicate to all team members unique contributions. Delegates tasks and care to appropriate staff and ensures timely follow-up.
• Systems Thinking: Uses strategies and available resources for problem-solving for patients, family and staff. Recognizes that resources are limited and considers factors related to safety, effectiveness and efficiency in planning and delivering patient care.
• Professionalism: Improves nursing practice and the work environment through participation in mutual governance and the conclusion-making processes, and meaningfully recognizing the contributions of others. Identifies personal goals and seeks opportunities to pursue life-long learning through continuing education, networking with professional colleagues, membership and involvement in professional nursing organizations, self-study, professional reading, certification and seeking advance degrees. Contributes to the professional development of peers, colleagues and others.

KEY SUCCESS FACTORS

• Knowledge and expertise of nursing for long term mechanical circulatory help devices, patient care standards and procedures.
• Coordinates and participates in the clinical management of potential and post VAD patients in partnership with physicians and the multidisciplinary team.
• Oversees the coordination of VAD patients across the continuum and requires the ability to interface successfully with patients and their family, physicians, heart transplant coordinators, nursing, and other clinical staff.
• Educates nursing staff, patient and caregiver on VAD equipment and care.
• Provides education to the community, who will help these patients post-discharge.
• Must be able to communicate thoughts clearly, both verbally and in writing, with social skills to interact with a wide range of constituencies.

Transplant duties include: patient education (pre/post), teaching meds/nutrition/do's and don'ts, signs and symptoms of rejection, triaging calls, scheduling tests and appointments, and monitoring labs to ensure proper med levels are kept and anything unusual is caught right away.

ECMO Transports- Arranged ECMO transport for the ECMO team both ground and fixed wing.

Lead Coordinator Heart/ Lung Transplant/VAD/ECMO Transport and Donor Call

Skills:

Clinical and technical expertise, well-developed interpersonal communication and presentation skills, and effective organizational skills

Responsibilities:

As Lead Coordinator my responsibilities are as follows:

· Achieve, Maintain CMS & Joint Commission Certifications

· Chair Selection & Quality Meetings

· Evaluations

· Education to staff, physicians & patients

· Outreach

· Donor call

· Patient call

· Listing patients & TEIDI reports

· Setting up ECMO transports for ECMO team to outside facilities by ground and by fixed wing.

· Education and support to fellow coordinators

· Coordination of care & follow up on pre and post lung patients, post heart transplant patients & pre and post VAD patients.

Education

• Develops, coordinates, implements, and evaluates educational programs/projects for patients, staff, and the community, including support groups, device specific education, initial VAD implant education, post-implant inpatient teaching, readiness for discharge teaching, and preparation of the patient’s community for support of the VAD implanted patient at home. Educates the local primary care physician and/or cardiologist, and prepares the local emergency medical service and local hospital emergency department providers.
• Educates patients and families who have been identified as possible candidates for VAD placement.
• Educates the ICU and telemetry nursing staff in order to assure competency in caring for the VAD patient.
• Facilitates collaboration of multiple team members to include troubleshooting of devices, identifying proper function and alarm conditions, knowing how to respond and who and when to call for assistance.
• Working together with Transplant Coordinators for BTT VAD patient listings and transplants.

Program Development/Outreach

· Involved in continuing professional development such as serving on professional/community groups, representing the center at internal, community, regional, and national meetings, and maintains contact with professional organizations.

· Arranges for and coordinates outreach site visits in conjunction with the physician and director.

· Works closely with Marketing to develop marketing materials as well as identifying and communicating possible VAD-related stories to Public Relations.

· Works closely with financial coordinator on billing and coding as well as device company auditors to ensure proper documentation and reimbursement.

· Develops pre, intra, and post-op VAD management policies and protocols, including end-of-life situations.

· Reports outcomes on a six-month basis to the Patient Selection Committee.

· Identifies performance improvement opportunities for the VAD patients. Leads the collaboration effort of working with staff on the various units to address any concerns.

· Serves as the lead person in obtaining The Joint Commission VAD disease-specific certification as a center of excellence in destination therapy.

· Participates in research activities, including participating in the Institutional Review Board’s required activities.

· If requested, obtains clinical certification and maintains that certification

RN Ventricular Assist Device (VAD) Outreach Coordinator VAD and Heart Transplant & Adult ECMO Coordinator

Purpose:

To describe the responsibilities specific to a RN VAD Outreach Coordinator at Seton Heart Specialty Care and Transplant Center in addition to the responsibilities, qualifications, and work environment described in the Seton Family of Hospitals’ VAD Outreach Coordinator job description.

My position is responsible for the overall development and growth of the VAD, Heart Transplant and ECMO program including provision of care in conjunction with the medical director.

Skills:

Clinical and technical expertise, well-developed interpersonal communication and presentation skills, and effective organizational skills

Responsibilities:

Coordination of Care

· Is responsible for planning and coordinating the care of VAD patients throughout the continuum of care

· Assures the performance of necessary testing to determine a patient’s candidacy for VAD placement including pre-operative risk scoring and review of inclusion and exclusion criteria.

· Maintains appropriate monitoring of patient’s status through the work-up and then on a regular basis depending on whether the patient is explanted, transplanted, or expires.

· Communicates all patient issues and concerns to the physician or APN.

· Leads the multidisciplinary team including physicians, APNs, RNs, social workers, dieticians, pharmacists, case managers, and non-clinical staff in defining the process of post-op care and planning for discharge, beginning prior to surgery. Conducts regular multidisciplinary team meetings, provides updates on where each patient is in the inpatient process in order to provide effective, efficient care.

· Assesses patient and family resources and communicates with the team members. Involves social workers and financial coordinator as needs arise, especially with financial concerns.

· Collaborates with financial coordinator to ensure authorization by the insurance carrier/case manager to obtain appropriate approvals prior to implant, through hospitalization, and then post-discharge care.

· May facilitate a bioethical consult for patients or families in distress. May also need to work with palliative care if patient’s condition changes.

· Collects data to meet clinical, regulatory, and financial requirements. Enters data into the INTERMACS data registry. Completes device tracking forms and provides information to device manufacturers.

· Serves as a patient advocate and acts as a liaison between patients, families, and other health care team members.

· Arranges for clinical services, evaluates clinical data, and triages clinical questions/concerns to appropriate members of the team. Participates in clinic and inpatient rounds within the RN scope of practice.

· Serves as a resource and assists with troubleshooting during the post-op course in ICU and telemetry.

· Oversees the transition from ICU to step-down including preparation of the patient for self-care after discharge. Provides ongoing physical assessment for

signs and symptoms of infection with prompt recognition and treatment, indications of change in mental status, assessment of pump pocket for pain and signs of swelling. Continuously monitors for proper device function.

· Works with dietary and nursing staff to ensure early initiation of nutrition.

· Serves as one of the program’s primary contact 24 hours a day/seven days a week.

· Coordinates and participates in transporting a VAD patient from an outlying hospital by ground or air service.

· Maintains an up-to-date inventory on all device equipment that is kept in the transplant office and assists the CVOR nurse specialist in maintaining OR inventory. Maintains records on equipment maintenance schedules and facilitates provision of maintenance with SMCA Biomedical Engineering personnel and device manufacturers.

Education

· Develops, coordinates, implements, and evaluates educational programs/projects for patients, staff, and the community, including support groups, device specific education, initial VAD implant education, post-implant inpatient teaching, readiness for discharge teaching, and preparation of the patient’s community for support of the VAD implanted patient at home. Educates the local primary care physician and/or cardiologist, and prepares the local emergency medical service and local hospital emergency department providers.

· Educates patients and families who have been identified as possible candidates for VAD placement.

· Educates the ICU and telemetry nursing staff in order to assure competency in caring for the VAD patient.

· Facilitates collaboration of multiple team members to include troubleshooting of devices, identifying proper function and alarm conditions, knowing how to respond and who and when to call for assistance.

Program Development/Outreach

· Involved in continuing professional development such as serving on professional/community groups, representing the center at internal, community, regional, and national meetings, and maintains contact with professional organizations.

· Arranges for and coordinates outreach site visits in conjunction with the physician and director.

· Works closely with Marketing to develop marketing materials as well as identifying and communicating possible VAD-related stories to Public Relations.

· Works closely with financial coordinator on billing and coding as well as device company auditors to ensure proper documentation and reimbursement.

· Develops pre, intra, and post-op VAD management policies and protocols, including end-of-life situations.

· Reports outcomes on a six-month basis to the Patient Selection Committee.

· Identifies performance improvement opportunities for the VAD patients. Leads the collaboration effort of working with staff on the various units to address any concerns.

· Serves as the lead person in obtaining The Joint Commission VAD disease-specific certification as a center of excellence in destination therapy.

Participates in research activities, including participating in the Institutional Review Board's required activities.

· If requested, obtains clinical certification and maintains that certification

Work Environment:

Generally experiences exposure to blood borne pathogens on the job.

Supervision Received:

Director of Seton Heart Specialty Care and Transplant Center; works under the direction of an APN who serves as the team leader.

ECMO-

· Responsible for Data collection and entry into ELSO.

· Responsible for supplying ongoing support and communication to Physicians and team members.

Responsible in helping lay the groundwork for a sustainable VV-VA program.

Responsible for Adult ECMO Outreach and Outreach education to Community and outlying facilities.