Audio Transcript Auto-generated
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Hello.
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My name is Paula Blue Samantha and
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I'm presenting in Cleveland clinic located Western florida
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which was founded on february 21st 1921 at Cleveland Ohio by
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four physicians who wanted to unite their expertise and experience caring
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for wounded soldiers after World War One and they wanted to
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serve the community by collaborating as a team to serve patients.
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On that note,
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the transplant program was established in the late
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19 eighties to assist individuals hoping to become eligible
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for a liver transplant and has expanded
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to provide surgeries to other organ candidates.
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The program includes pediatric transplants which occurs
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at the main campus in Ohio.
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While Cleveland clinic at Western completes
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transplants focusing on adult patients.
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We're gonna go to slide number one which has to do with the population served
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and there are three populations served throughout the evaluation process.
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The transplant program in Cleveland Cleveland.
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The first group is identified by the
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organ procurement and transportation network O.
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P. T. N.
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As a candidate.
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As for the O. P. T. N.
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Definition,
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a candidate is a patient referred by his or her physician and registered
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on the organ transplant waiting lists
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at Cleveland clinic and individual may complete
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a self referral to one of the solid organ transplant programs by calling
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either the phone number listed on the website or completing an online application.
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To be contacted.
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These individuals must complete medical and non medical evaluations to
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determine how advanced their medical condition is if transplant is
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an appropriate treatment for them or identify other options and
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to determine readiness for transplant identifying if there are no
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psychosocial factors preventing surgery.
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The second population served by the agency are
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living donors who are described by the O.
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P. T. N.
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As an individual who's alive and willing to donate an
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organ or part of an organ to an eligible candidate.
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The recipient may be a relative friend or someone registered
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in the database whose matched with an eligible candidate.
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In other words, a stranger.
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The third group of populations served by Cleveland clinic
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are potential transplant recipients determined to be eligible for
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transplant and they are ranked in the computer system
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matching him or her to a deceased organ donor.
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There's criterion that candidates must meet to be considered for
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an organ transplant for East Department which includes heart,
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kidney and liver.
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And I'll be discussing some of the requirements
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for each program at Cleveland clinic clinic.
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As the guidance reach center authorized to
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complete a transplant differs such as University of
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Miami and Cleveland clinic might have different guidelines
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as it is allowed by the O.
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P. T. N.
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Um
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For instance,
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the criterion for living donors at Cleveland
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Clinic requires that the individuals fully inoculated
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for the coronavirus is between the ages 18 through 60 compatible blood type.
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Um no historic chemical dependency, physically and mentally well
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understand risks to surgery as we want to make sure that rule out
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that the person has a cognitive impairment and can provide informed consent.
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Again,
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um rule out congress and impairment or that
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the person being coerced and have a social
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a support network.
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Okay, now we're gonna go to site to which has to do with solid organ candidates um,
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that involve the heart transplant patients considered ineligible for a
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heart transplant have medical conditions resulting in heart failure,
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such as the coronary arteries, resulting in one or more heart attacks,
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cardiomyopathy,
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which is a disease of the heart muscle,
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making it difficult to deliver blood to the body and a congestive heart failure,
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which is caused by the heart not pumping blood.
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In other words, it could be linked to retention of fluid and sodium.
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Other criteria include less than 70 years old,
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which is the age that doctors have traditionally said,
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although there is no age limit.
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Um,
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However older adults will undergo more rigorous
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evaluation if they are considered for transplantation
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as they must be screened for neurological abnormalities and
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other comorbidities affecting health outcomes for transplant patients.
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Which ties into reviewing medical records as well as medical evaluations.
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A bio psychosocial assessment is also completed.
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Any evaluation to determine if there are sufficient support systems ensuring that
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the individual is not at risk of severe injury or mortality.
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And now we're gonna go to slide three,
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which has to do with requirements for kidney
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transplant patients consider eligible for kidney transplant,
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have medical conditions and symptoms including end
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stage renal disease and are on dialysis.
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Um, advanced kidney disease and chronic kidney disease with Type one diabetes.
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There's no age limitation for consideration of a kidney transplant.
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As studies have shown that it can be safe for older adults.
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Um
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and these studies also show them
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that they can live for an estimated five year. That's a survival rate.
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Additional requirements include reveal medical records, medical evaluations,
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gathering information regarding social support networks
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and completion of bio psychosocial assessment.
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And now we're going to go to the next slide,
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which has to do with criterion for liver transplant patients.
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Patients considered eligible for liver transplant have medical
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conditions causing numerous illnesses and irreversible liver function,
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which must be diagnosed by a physician and healthcare provider.
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Some of these chronic conditions resulting
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liver problems are cirrhosis causing healthy,
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causing a healthy liver tissue to be replaced by scar tissue.
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Hepatic vein thrombosis,
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which prevents blood from flowing out of the liver and to the heart.
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And others mentioned in the slide,
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there's no age limit for considerations of a liver transplant and some
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researchers have even documented positive health
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outcomes after surgery for older adults.
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Nonetheless,
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this groups to undergo the rigorous screening process
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as older adults well delivered with liver disease,
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experienced challenges such as um
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additional health problems potentially making the recovery process difficult.
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The transplant team takes into consideration, reveal medical history,
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conduct medical evaluations,
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assessed support systems and conducted bio psychosocial evaluation
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and now we're going to go to the next slide, which has to do with funding sources,
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as there are several funding sources.
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Um, approximately half of the patients awaiting organ transplant.
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The US have private health insurance.
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The remainder of the population waiting for an organ are covered by the government
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either by the federal state level, such as Medicare. Medicaid.
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Um, as many of US know, Medicare,
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Medicaid is a federal program that
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assists disadvantaged groups such as disabled individuals
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and those of lower socioeconomic status and other individuals that meet criteria.
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The transplant programs utilize many funding sources primarily Medicare
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as the Centers for Medicaid and Medicare Services,
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also known as CMS, requires organ transplant programs
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to have a Medicare provider agreement to be reimbursed for transplants.
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Other funding sources
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are also
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um
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private health insurance has mentioned previously
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and the private health insurance covers recipients
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um with their medical expenses.
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And also it covers some medical expenses for liver living donors.
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And it's crucial that living donors follow up with financial coordinator
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before undergoing surgery because you want to make sure that
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the recipients insurance
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covers
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expenses
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for the donation and also evaluation surgery and some follow up tests
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must be done after
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post transplant. And also medical appointments
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and also um the living donor nelson would need to follow
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up with their medical insurance to ensure that expenses are covered
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if needed. And also some other funding sources are government grants such as
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once provided by living organ donor network division of transplantation,
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also known as dot and american transplant foundation.
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And now we're going to go to the next slide,
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which has to do with the mission statement.
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And
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the mission statement initially
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was
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um to better provide care of the sick investigation and
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their problems and further education of those who served.
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That was the initial statement when the when Cleveland Clinic was founded in 1921.
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However,
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this changed during the centennial celebration and the
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new mission statement introduces caring for life,
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researching for health and educating those who served
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and as far as the learning agreement,
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the learning Agreement, how it parallels
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the mission statement that parallels the learning agreements.
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That the learning agreement provides an opportunity for the social work
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intern to identify activities enhancing knowledge
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and competencies while utilizing theories.
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Also the learning agreement parallels the mission of Cleveland clinic ensuring
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patients and their families receive quality
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care while identifying effective interventions.
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And this is important
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because social workers
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as the advocate for their patients and also their families
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want to make sure that the interventions that are provided are
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effective and addressing the needs of these patients and takes
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into consideration the intersecting identities such as also their convictions,
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um their religious or spiritual needs
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also. Um
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there lived experiences, their belief systems,
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their thoughts, their feelings
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to ensure that there's positive health outcomes.
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Although social workers accomplishes again your advocacy on behalf of patients,
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including them in the decision making process because you want to make sure
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that their preferences are taking into consideration
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so that the intervention is effective.
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Also ensuring that decisions made related to
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medical care and social services are ethical.
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Um not only taking into consideration policies of the
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organization but also the standards and values of the profession
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also recognizes existing barriers impacting patients and families access or
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adherence to medical care while than to find solutions.
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Applying research to determine which evidence based
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interventions are more efficient with specific populations.
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It's important that social workers
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take into consideration the existing challenges that many of our patients
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and families have in accessing healthcare which leads to the apparent
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I'm noncompliance.
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And we have to advocate to ensure that
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these health disparities health inequities are decreased and that
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they have access to the treatment services that they
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need to improve their quality of life and achieve
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better outcomes for themselves.
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Okay.
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Um also evaluate our own practice with patients from
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diverse backgrounds such as interactions as these neighbors,
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all negative health outcomes.
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You want to make sure that you don't include, your biases, your stereotypes,
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your judgments into your interactions and that
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you're not making a decision based on
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your opinion as to what you think would be in the best interests of
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the patient and family.
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You have to take into consideration their preferences,
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um their lives experiences, their opinions or feelings etcetera.
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Um engaging in dialogue with the field,
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instructed to address concerns apprehensions
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and unprecedented situations involving patients,
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identifying solutions while
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using these as opportunities to learn.
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So if I again,
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if I feel uncomfortable in any situation interacting either with a
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patient or maybe even a colleague to address this with my supervisor
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so that we can not only identify solutions
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but uses it as an opportunity for professional growth
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and also
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um
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to enhance my skills and knowledge.
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Okay. The next slide has to do with services at Cleveland clinic.
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I wanted to show some of the services that are offered,
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such as transplant surgeons interacting with transplant surgeons,
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interacting with nephrologist,
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interactions with hepatology, gist, cardiologist, dieticians,
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financial cancers who provide information as to what
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um health coverage the patient has and also what
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their insurance will cover. And also any um
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sources that are available to assist the patient financially and the families.
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Um also
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um pharmacists,
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advocates, physical therapists, occupational therapists,
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infectious disease physicians, nurses, psychiatrists,
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I think I left out social workers.
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But all these team members will be interacting and providing services and
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support to the patients and their
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families throughout the transportation process.
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And now we're going to go to our last
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slide which has to do with the organizational structure
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which um
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it involves
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the program director who's oversees the entire transportation program,
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ensuring policies and procedures are followed.
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The program director supervisor, the surgical director and the program manager.
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Also the transplant surgeons and medical director
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are supervised by the program director.
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The surgical director is a physician who manages the surgical aspects of
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the organ transplant process and supervises the cardio surgeons and cardiology.
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Whereas a surgical director responsible
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for surgical aspects of transplantation,
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the medical director handles the medical aspects and the transplant process.
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On the other hand,
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surgeons meet with patients to discuss the organ transplant process,
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addressing topics such as surgery risk from
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surgery and issues emerging during recovery.
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During the meeting,
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the surgeon will review other options for treatment
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with the patient and these are considered suitable.
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After the medical evaluation is completed.
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The pathologist under the medical director for
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liver transplant meets with patients to diagnose treat
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and manage problems associated to deliver after nephrologist.
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Under the direction of the medical director of kidney transplant,
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responsible for meeting with patients to treat conditions
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related to the kidneys such as infections,
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chronic disease or failing organ.
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The program manager ensures that
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employees are complying with the organization's guidelines
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and those outlined by the O.
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P. T. N. To meet performance metrics of the nationals transplant system.
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Lastly, the program Manager responsible for overseeing
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various departments including transplant nurse practitioners,
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care coordinators which includes liver, kidney and heart transplant assistance.
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The manager of southern Oregon social workers, Dietitians,
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Financial financial coordinators and Transport quality assurance team.
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And well that's my presentation. I hope all of you enjoyed it.
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Hope you learned about Cleveland clinic and
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the transportation process and everything that we do