1. Pediatric Transplant Assessment Tool
Molly Dugan, LCSW, CCTSW Cindy deSa, MPH, MSW, LCSW
Heart Transplant Social Worker Liver Transplant Social Worker
1405 Clifton Road, NE Clifton Road, NE
Atlanta, GA Atlanta, GA 30322

2. Why we are here…
At the STSW Conference in Boston, MA, in September of 2014, the Board set a goal to develop a standardized psychosocial transplant evaluation tool for pediatric social workers. 
A committee of pediatric social workers from several institutions representing all transplant disciplines collaborated weekly, producing a comprehensive pediatric transplant psychosocial assessment.
This assessment examines all areas unique to the pediatric transplant population, including those psychosocial factors that could impact post-transplant outcomes.
The purpose of this presentation is to introduce the assessment tool to staff at Children’s Healthcare of Atlanta to increase understanding of the purpose of the pediatric transplant psychosocial evaluation.

3. Objectives
Understand the process by which the committee members developed the Pediatric Transplant Assessment Tool.
Correlate the sections of the Tool to unique pediatric psychosocial factors.
Identify ways in which the Tool will be useful for ongoing post-transplant relationships with pediatric patients and families.

4. List of Pediatric SW Participants
deSa, Cindy (Children’s Healthcare of Atlanta – Liver Tx)
Dodd, Dodd (Cincinnati Children’s Hospital Medical Center – Heart Tx)
Dugan, Molly (Children’s Healthcare of Atlanta – Heart Tx)
Hoffman, Roberta (Boston Children’s Hospital – Kidney Tx)
Holman, Emily (Boston Children’s Hospital – Liver & Multi-visceral Tx)
Kwan, SoYun (Boston Children’s Hospital – Liver Tx)
Koe-Krompecher, Erica (Cincinnati Children’s Hospital Medical Center – Heart Tx)
Luby, Barb (Massachusetts General Hospital – Liver, Kidney Tx)
Nowacki, Amy (Medical University of SC – All pediatric organ groups & adult Kidney Tx)
Puma, Lynn (Levine Children’s Hospital – All solid organ Tx)
Schmidt, Lauren (Children’s Hospital Los Angeles – Kidney Tx)

5. Map of Pediatric SW Participants
Atlanta, GA (2)
Boston, MA (4)
Charleston, SC (1)
Charlotte, NC (1)
Cincinnatti, OH (2)
Los Angeles, CA (1)

6. Historical Timeline Conference Call Dates: 2/17/15 3/3/15 3/9/15
11/19/2014 – meeting with Annette Humberson/Cleveland Clinic, the person who headed up the adult Transplant Psychosocial Assessment Tool
sent out to the list of STSW members who signed up to participate in this process during the STSW Conference in Boston, MA.
Conference Call Dates:
2/17/15
3/3/15
3/9/15
3/17/15 Draft #1
3/24/15
3/30/15
4/8/15
4/14/15 Draft #2
4/29/15 Draft #3
5/13/15 Draft #4
5/27/15 Draft #5
6/10/15 Draft #6
7/1/15 Draft #7 TA Draft #1
7/13/15 Draft #8 TA Draft #2
8/3/15 Final Draft, #9 TA Draft #3

7. Sections of the Pediatric Tool
Identifying
Information
Section 2
Housing/
Transportation
Section 3
Family Background/
Supportive Relationships
Patient and parents/guardian information
Includes education level, employment, primary language
and marital status
Custody questions (if applicable)
Household Composition
Patient’s education and hobbies and interests
Type of housing
Assessment of transportation resources
Identification of potential transportation barriers if applicable
Citizenship information
Sources of support
Parent/caregiver plans
Health status of parent/caregivers
Assessment of other stressors present in the family system

8. Sections of the Pediatric Tool
Finances
Section 5
Understanding of Medical Situation
Section 6
Adherence
Assessment of the financial status of family
Family’s plan for impact of lost wages at the time of transplant
Current financial support (government resources, etc.)
Fundraising
Disability (if applicable)
Insurance status
Assessment of the family’s understanding of patient’s disease process
Assessment of family’s willingness to seek support
Family’s exposure to transplant/any past experience with someone who has had a transplant
Assessment of medication adherence
Assessment of appointment adherence

9. Sections of the Pediatric Tool
Risk Assessment
Section 8
Health Literacy
Section 9
Coping Skills
Section 10
Attitudes toward transplant
Assessment of mental health/substance abuse in the family system
Including mental health diagnosis and course of treatment
Including substance abuse treatment
Assessment of involvement with law enforcement
Assessment of domestic violence
Assessment of child protection issues
Assessment of parents comfort level with medical information
Assessment of parents learning styles
Identification of potential barriers to education in the future
Assessment of how patient and parents/caregivers are coping
Identification of coping skills that are currently helpful
Identification of the patient and parent/caregivers concerns and hopes
Assessment of their readiness for proceeding with transplant listing

10. Clearer picture of the family system
Teen Addendum
Parent
Assessment
Teen
Clearer picture of the family system
Intended to be used with patients years
If possible, meet with the patient alone without parents
This is based on developmental level and parents willingness to allow an interview with patient separately
Assesses level of understanding of medical situation, independence
Assesses coping skills and attitude toward transplant
Assesses risk behaviors, health literacy, insurance status, and future planning

11. Important points to remember
Why do we complete a Psychosocial Assessment as part of the transplant evaluation process?
Explain that there are questions that are personal in nature and required as part of the assessment
Explain the reason for completing the Teen Assessment if applicable
Why do we start out with identifying information…end with coping skills?
What are the expectations of patients who are listed and awaiting transplant at home?
How will the family cope with an extended hospitalization while listed/after transplant?
This tool is meant to be a template and can be modified to suit the needs of a specific program/organ group.

12. DISCUSSION/QUESTIONS/COMMENTS