Legislation threatens transplant programs in Washington state

March 7, 2019

Rigid restrictions on the use of on-call staffing could mean hospitals won’t have access to staff when organs become available and patients could miss out on critical matches

Health care leaders are ringing alarm bells over how on-call language in proposed legislation in Olympia could threaten access to solid organ transplants throughout Washington state.

Section three of House Bill 1155/Senate Bill 5190 contains language prohibiting hospitals from using overtime and pre-scheduled on-call as tools for staffing the services patients need, except in emergency situations. Under the proposed law, organ transplants wouldn’t qualify, as they likely wouldn’t meet the exemption criteria for patient care emergencies. Emergencies are those things that could cause death or disability without immediate care.

People in need of organs spend months or years on a wait list. While most will eventually die without a new organ, they will not immediately die. And organ transplant cases are never scheduled. An organ typically becomes available because of the organ donor’s death, which is not predictable. Hospitals do not have transplant teams for various organs staffed and standing by at all times. Instead, because of the unpredictability of organ donations, hospitals use on-call staff to cover transplant surgeries.

“The language in these bills eliminates an important staffing tool that allows hospitals to respond to the changing needs of patients,” said Cassie Sauer, chief executive officer of the Washington State Hospital Association. “Organs must be transplanted quickly. Without this flexibility, our hospitals’ ability to provide transplants before organs start to degrade will be put at risk, and available organs may go to patients in other states — states without the restrictions included in HB 1155 and SB 5190.”

Seattle Children’s Hospital, the University of Washington Medical Center, Providence Sacred Heart Medical Center, Swedish Health Services and Virginia Mason each perform life-saving organ transplants for patients of all ages, from infants and young adults to seniors. Read their letter to legislators expressing their concern on this issue.

According to the United Network for Organ Sharing, 1,681 Washingtonians are on the organ transplant wait list. If this bill becomes law, hundreds of Washington state residents could miss their opportunity for a new organ each year.

The threat to solid organ transplant is just one example of the numerous unintended consequences that will occur if this bill becomes law. Delaying non-emergent care may result in great harm to many other patients, such as those waiting for placement of a heart stent or a port for chemotherapy.

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