Linda Ohler, MSN, RN, CCTC, FAAN, fell into transplantation by chance. “I started my career as a nurse in the intensive care unit, then in the cardiovascular ICU,” she says. “I was teaching in the cardiovascular nursing graduate program at Catholic University and two of my students who were sharing a transplant coordinator job were leaving their jobs.” What started out as a trial position for the summer ended up being Ohler’s calling. She began as a transplant coordinator and eventually became more focused on administratively managing transplant programs.
It started with the heart
With a background in cardiovascular nursing, coordinating a heart transplant program was a natural fit. “My master’s is in cardiac nursing, so I’m passionate about heart transplants,” says Ohler. “I took a course in cardiac physiology that just about killed me, but the heart is still what I know the best.”
Transplant coordinators work with surgeons and other physicians and transplant professionals to ensure to plan the best possible care for each transplant recipient. “Whether it’s a heart, lung, kidney or liver, the coordinator makes sure that the patient is in good shape to receive the organ, and that the donor is a good quality,” says Ohler. Factors considered are the donor’s age, health and overall condition at the time of donation.
However, Ohler recognized a need to understand and assist with other transplant programs. Her career evolved into managing heart/lung transplant programs, then ventricular assist devices–devices used to help with heart function and blood flow in people who have weak hearts. Eventually, she began to manage kidney and liver transplant programs. “I’m learning more about the rules and regulations that go along with kidney transplantation, which I didn’t have an opportunity to learn about when I just focused on heart transplant programs,” she says.
Focused on quality
Ohler’s newest endeavor is consulting with transplant programs that are transitioning to the new regulatory requirements for high quality standards. “As I branched out more and learned more about the different transplant programs for kidney, liver and intestine transplants, I realized that the focus was going to be on the quality of the programs in addition to the outcomes,” she says.
Now, Ohler’s duties focus on ensuring that transplant programs are adhering to government and industry regulations, and that anyone who may be part of a transplant patient’s care team is aware of the regulations and policies for caring for a transplant patient. This, Ohler says, is a critical element to ensuring the quality of a transplant program. “We actually perform an audit once a month to evaluate whether information for a patient has been entered correctly,” she says. “We have all learned that the focus on outcomes is dependent on the accuracy of data entry.”
Making transplants happen
When asked what it takes to make a transplant happen, Ohler is quick to say that experienced transplant professionals are key. “You need committed, experienced people who care about going by the book,” she says. “The regulatory components, focus on quality, and experienced transplant professionals are instrumental to making transplants happen.” In addition, hospital administrators need to be committed to ensuring transplant programs have the personnel and tools needed to ensure the best possible outcomes.
Having worked to set up liver, kidney, and lung transplant programs several years ago in Virginia, Ohler is now part of a team setting up a kidney transplant program at George Washington University in Washington, D.C. She knows first-hand the long road to getting a transplant program started. “First, you complete an application for your program to be certified by the United Network for Organ Sharing,” she says. Programs must have a primary physician and primary surgeon for every organ the program is going to be transplanting, along with UNOS logs of how many patients those physicians and surgeons have cared for and how many transplant procedures they’ve observed and performed. Next is staffing the transplant program with the specialists who help make transplants a reality: transplant pharmacists, social workers patient coordinators, nurses, and more. Programs must also build a team dedicated to quality that will ensure the program adheres to regulatory standards, along with a team of data engineers who input and analyze patient information–an important part of measuring performance and required to be compliant.
What about transplantation has held Ohler’s attention for the nearly 30 years she’s been involved in the field? Part of it is her admittedly unconventional love of policy. “It’s exciting to work with a hospital that doesn’t have a transplant program and help them make it reality, building it from the ground up and creating their policies,” she says. The other part is pure passion for advancing an evolving field. “I get to work with these industry leaders and learn about the history of a life-changing science,” says Ohler. “It’s fascinating. Our transplant pioneers had the knowledge and belief that this would work and what would fix end-stage organ disease. They were passionate about fixing the process when medication failed, and I get to be part of that and move it forward.”