Issue link: https://beckershealthcare.uberflip.com/i/1539852
10 PATIENT SAFETY & OUTCOMES HHS to reform organ transplant system By Paige Twenter A n HHS agency has directed the Organ Procurement and Transplantation Network to improve national monitoring and to reopen an investigation into a Louisville, Ky.-based organ procurement organization. e Health Resources and Services Administration is pursuing "a major initiative to begin reforming the organ transplant system" aer an investigation conducted during the administration of former president Joe Biden was closed without action, according to a July 21 news release from HHS. e HRSA investigated 351 transplant cases coordinated through Network for Hope, previously known as Kentucky Organ Donor Affiliates before a merger. e probe focused on patients' suitability for donation aer circulatory death. e audit found that, among about 350 cases in which Network for Hope halted organ procurement plans, 73 patients showed improving or high levels of consciousness. No surgeries occurred, but multiple patients who underwent preparation for an organ removal showed signs of pain or distress, according to the report. HRSA also said it found evidence the organ procurement organization attempted to pressure families into authorizing donation and hospital staff to remove life support prematurely. Network for Hope denied the finding, said it adheres to federal regulations and is considering updating its practices. "Patient safety is our top priority. Network for Hope looks forward to working collaboratively with HHS and HRSA and encourages the development of policies that support the betterment of the organ transplant system as a whole," a spokesperson told Becker's. In a May letter to the Organ Procurement and Transplantation Network, HRSA said it has received reports of high-risk donations aer circulatory death procurement practices at several other organ procurement organizations. HHS also directed the OPTN to enhance its policies and report safety- related stoppages of organ donation to regulators. A day before the HHS announced its plan to overhaul the nation's organ transplant system, e New York Times reported that some organ procurement organizations "are aggressively pursuing circulatory death donors and pushing families and doctors toward surgery." n 344 EDs do not have 24/7 physician coverage: What to know By Mariah Taylor I n 2022, at least 7.4% of emergency departments across the U.S. did not have an attending physician on-site 24/7, a recent PubMed Central study found. Published in February, the study drew data from 4,621 EDs surveyed in the National ED Inventory-USA survey. The 2023 survey was administered to all EDs open during 2022 and asked, "Is at least one attending physician (not resident) on duty in the ED 24 [hours per day]?" Here are six things to know: 1. Three hundred and forty-four EDs reported they did not have 24/7 attending physician coverage. The study is the first of its kind so there isn't proof that such staffing arrangements are increasing, Carlos Camargo, MD, the lead author and a professor of emergency medicine at Harvard Medical School, told KFF Health News. 2. The states with the highest percentage of EDs that lacked 24/7 coverage were North Dakota with 58%, South Dakota with 56%, and Montana with 46%. 3. Among the 344 EDs, 92% had annual visit volumes under 10,000. 4. Of EDs without 24/7 physician coverage, 89% were a critical access hospital, 72% were rural and 2% were freestanding. 5. Allowing EDs to operate without a physician is a controversial practice. Associations like the American Medical Association and American College of Emergency Physicians support laws or regulations that would require EDs to staff a physician 24/7. However, others say that advanced practice providers with the right experience and support are capable of overseeing the ED. 6. Dr. Camargo told KFF some physicians say that lawmakers need to pay hospitals more if they are going to require 24/7 on-site physician coverage in EDs. n