For transplant administrators like Christopher Fowler, division VP of transplant services for Medical City Healthcare in Dallas, proper staffing is essential to delivering high-quality patient care. It’s also one of the hardest areas to benchmark.

The UNOS Staffing Survey gives participants access to staffing and workload metrics from transplant programs across the country, helping leaders make informed staffing decisions based on objective data. The survey’s interactive tools make it easy to identify trends, communicate findings with stakeholders, and forecast future workforce needs.

Before UNOS developed its Staffing Survey, many programs relied on informal conversations and anecdotal comparisons to understand how their staffing levels compared with similar transplant centers.

UNOS Staffing Survey fills the gap

“I would ask my friends at other centers, ‘How many transplant coordinators do you have?’” Fowler recalled. “But I would not be able to have nice hard data to present to the finance teams or senior leadership teams to justify the staff that I’m asking for. It would all be word of mouth.”

The UNOS Staffing Survey fills the gap by collecting annual data across full-and part-time employees from nearly two-thirds of all transplant hospitals. An interactive benchmarking dashboard, the ability to export data, and a supplemental report allow for easy reporting.

Insight to inform staffing decisions

Fowler says Staffing Survey data is especially valuable for long-term planning. “Transplant staff are not easy to come by,” he said. When developing a five-year plan and forecasting growth, he factors in the additional staff needed to increase transplant volume. “I can set the stage to let finance know I’m going to be asking [for additional staff] so they have heard about it for years before I actually ask for it,” he said.

In an increasingly data-driven healthcare environment, the UNOS Staffing Survey provides actionable insight.

“It develops a level of trust with senior leadership that I am not just making something up,” Fowler said. “I have some real data behind what I am asking for.”

Learn more about the UNOS Staffing Survey

Christopher Fowler’s participation in this article is based solely on his professional experience. The views expressed are his own and do not represent the endorsements of Medical City Healthcare or HCA Healthcare.

In July 2025, the Centers for Medicare & Medicaid Services (CMS) launched the Increasing Organ Transplant Access (IOTA) Model, a mandatory six-year initiative aimed at increasing kidney transplants and improving quality of care. Half of U.S. kidney transplant hospitals were randomly selected to participate, with the other half serving as the comparison group.

To support implementation, UNOS developed the IOTA Dashboard. The tool helps transplant hospitals monitor performance metrics, forecast expected points, and track progress toward IOTA’s three goals:

• Maximizing the use of deceased donor kidneys
• Improving care before, during and after kidney transplants
• Reducing disparities in transplant access and outcomes

Performance year 2 data is now available on the IOTA Dashboard.

A timesaving tool for transplant teams

For Joshua Liggett, transplant quality specialist and applied anthropologist at UC San Diego Health, the dashboard has been a great timesaver.

“This is a fantastic tool,” he said. “It’s so concise, and it puts everything together in such a digestible way to provide a pulse of where we stand on IOTA.”

Liggett uses the dashboard during meetings with UC San Diego’s kidney transplant program leaders and during monthly Quality Assessment and Performance Improvement meetings with interdisciplinary teams. The program pairs the IOTA Dashboard with Scientific Registry of Transplant Recipients’ CUSUM and annual reports to estimate its efficiency score.

Reducing the burden of metric tracking

When UC San Diego Health first learned it had been selected for the IOTA Model, staff were concerned about the administrative burden of tracking the metrics. The IOTA Dashboard reduces that burden by consolidating performance data and clearly displaying scores across each domain. Instead of consulting multiple databases and building presentation slides, Liggett said he can simply share a screenshot of the IOTA Dashboard.

“That’s resource time that can be used on other projects,” he said.

The IOTA Dashboard has also helped UC San Diego Health identify opportunities to improve organ use and patient care.

“We need to be using as many organs as we possibly can to keep our achievement volume up,” he said. “It prompted us to take a look at some of our internal treatment protocols for different types of patients. Maybe we treat our patients in a different way post-transplant to maximize their survival and make sure that they have a good post-transplant experience.”

Useful beyond IOTA participation

Liggett believes the IOTA Dashboard is a valuable tool even for hospitals that are not participating in the IOTA model.

“Everybody should be using it,” he said. “Even if you are not an IOTA participant, it’s still a helpful tool to measure these three critical things.”

Learn more about the IOTA Dashboard

Established by the International Society for Heart and Lung Transplantation (ISHLT) in 1983, the International Thoracic Organ Transplant Registry is the world’s largest source of thoracic transplant data. UNOS has served as the Registry’s Data Coordinating Center since 1992.

After the European Union implemented its General Data Protection Regulation (GDPR) in 2018, Registry data collection was temporarily paused while a new international data-sharing framework was developed. The Registry was later relaunched under a new agreement, and the 2025 and 2026 ISHLT annual reports are based on data collected through this updated framework.

The Registry’s relaunch has re-established an important source of international transplant data and enabled new analyses based on contemporary transplant practices.

UNOS’ role

As the Registry’s Data Coordinating Center, UNOS:

• Maintains the system used by Registry participants to submit data
• Oversees Registry operations and data quality
• Conducts analyses for annual reports, publications and research

Why this matters

UNOS Research helps turn global transplant data into insights that improve patient care and support research. UNOS collaborates closely with clinicians, researchers and Registry leaders worldwide to support participation and strengthen collaboration. Key analyses include:

• Tracking long-term survival after heart and lung transplantation
• Comparing outcomes across regions and patient populations
• Monitoring trends in donor and recipient characteristics
• Supporting international research studies and clinical guidelines
• Producing the annual ISHLT Registry reports used by transplant professionals around the world

Key takeaway

For more than 30 years, UNOS has managed the world’s largest heart and lung transplant registry. Through global data coordination, quality oversight, and analytics, UNOS helps generate evidence that improves transplant care and advances research.

Since the Registry’s relaunch, UNOS has supported the collection and analysis of the data used in the 2025 and 2026 ISHLT annual reports. The 2025 report includes the Registry’s largest international cohort analyses of donation after circulatory death (DCD) heart and lung transplant recipients, providing important insights into this growing donor population.

Looking ahead

UNOS will continue serving as the Registry’s Data Coordinating Center through 2026 and is expected to provide analytical and publication support for the 2027 ISHLT Registry reports. 

About UNOS research

UNOS conducts research as part of its mission to save and transform lives through research, innovation and collaboration.