On-call brain removal teams
The maintenance of a rapid autopsy program requires sufficient staffing to prevent “burnout”. Most rapid autopsy programs fail because of understaffing. Our experience has led to the conclusion that it is advisable to limit on-call periods for any one individual to no more than 4 months per year. The minimum number of persons required for each callout is two, for both safety and efficiency reasons. We have three rotating on-call teams, each consisting of a team leader and one assistant. The team leaders, who are employees of the Neuropathology Core of the Brain Donation Program (they also serve as histology technicians during regular hours), receive training from the neuropathologist and coordinator and are on call every third month, while the assistants, derived from volunteers amongst the entire SHRI scientific, technical and administrative staff, generally serve for 1–3 months per year. Team leaders and assistants are paid a bonus for each callout. As another strategy to avoid on-call team burnout, we continually optimize procedures to minimize brain processing time. Generally we complete all procedures in less than 2.5 h and the total time a team member spends on a call, including transportation to and from their home, is between 3 and 4 h. To expedite brain processing, we always have made preparations for 2–3 autopsies into the future. Having a permanent dedicated autopsy suite enables all tools and equipment to be laid out ready for use; we also prelabel all containers and bags.