BOX 4-2

Regulation and Accreditation

Centers for Medicare & Medicaid Services (CMS): CMS is responsible for certifying OPOs and transplant center hospitals for Medicare coverage. The conditions of participation for OPOs and transplant centers are in the process of being revised to address requirements of the Organ Procurement Organization Certification Act of 2000. The proposed rules increase the recertification cycle from 2 to 4 years and establish multiple outcome and process performance measures, including changes in measurements of donor potential by replacing the current use of population data with data based on hospital referral calls to OPOs. Data submission and outcome requirements for transplant centers are also proposed to be modified to consider the care being provided rather than relying on underlying policies and procedures. The proposed rule expands outcome measures to include graft survival rates (CMS, 2005).

Organ Procurement and Transplantation Network (OPTN): OPTN develops policies and procedures for organ recovery, allocation, and transplantation and conducts reviews and evaluations of each member OPO and transplant center for compliance with OPTN policies.

Joint Commission on Accreditation of Healthcare Organizations (JCAHO): Since January 1988, JCAHO has required its member hospitals, as a prerequisite for accreditation, to develop policies and procedures on the identification and referral of potential donors. JCAHO requires hospitals that recover organs to have an agreement with an appropriate OPO and at least one tissue bank and one eye bank. JCAHO describes procedures for notifying the family of the option to donate and for maintaining the records of potential donors. A standard which became effective in July 2005 requires hospitals to measure the effectiveness of their organ procurement efforts. According to this standard, the conversion rate data must be collected and analyzed, and steps must be taken to improve the rate whenever possible (JCAHO, 2005).

Association of Organ Procurement Organizations (AOPO): AOPO sets organizational and ethical standards for OPOs and offers a voluntary accreditation program to its members. The peer review accreditation process helps ensure compliance with federal regulations as well as AOPO standards. The period of accreditation is 3 years, after which the OPO must apply for reaccreditation to maintain its status. Recent standards include an emphasis on continuous quality improvement practices.

American Board for Transplant Certification (ABTC): ABTC develops certification standards and programs for certification testing for transplantation clinicians. Specifically, clinicians may receive certification as a certified procurement transplant coordinator, a certified clinical transplant coordinator, or a certified clinical transplant nurse.

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