Organ Donation

1
Organ Donation

• Huntington Hospital
• 2001-2006

2
Committee

• Julie Anne Miller, LCSW Chair
• Physician Champions Bradley Roth, MD Ash
  Abou-zamzam, MD
• RN staff, LCSW staff, RT staff, Chaplains, RN
  Department Managers, OneLegacy staff
• Representing Med/Surg, Pediatrics, Emergency
  Trauma Services OPO

3
Mission

• To maximize every opportunity for organ donation,
  and support the rights of our patients and their
  families to donate.

4
Goals

• Identify and refer all patients who meet the
  Clinical Triggers
• Maximize the opportunity for eligible donors to
  become actual donors
• Maximize the opportunity for all eligible organs
  to be recovered

5
Policies

• Brain Death Diagnostic Criteria, 8749.196
• Organ Tissue Donation, 8740.109
• Organ Tissue Donation Donation After Cardiac
  Death, 8740.188

6
Achievements

• 1999 Formalized the Organ Tissue Donation
  Committee
• November 2004 Began attending West Coast Organ
  Donation Breakthrough Collaborative (also 1/05,
  7/05, 11/05)
• May 2005 DHHS Medal of Honor for 2004
  conversion rate of 77
• July 2005 Certificate of Recognition for 2005 6
  month conversion rate of 50

7
Conversion Rate

• 2001 8/13 62
• 2002 8/16 50
• 2003 5/8 63
• 2004 10/13 77
• 2005 2/5 40
• 2006 5/8 63 YTD

8
Conversion Rate
9
2005 Review

• 4 of 7 consents (57) were obtained
• 2 cases in which family consented to donation,
  but organs were not recovered because it was
  discovered they were unsuitable for
  transplantation due to serologies and history of
  cancer
• Conclusion No change on the part of the hospital.

10
2005 Review

• 2 Chinese families were approached for consent by
  the OPO, with an interpreter
• both declined donation
• gt1 member of each family was bilingual
• Interpreters were not part of OPO staff
• Interpreters were not trained in requesting
• Conclusion 1) Interpreters need to be bicultural
  as well as bilingual 2) Interpreters need to be
  trained by the OPO in requesting

11
Referral Calls to OPO
12
Donation After Cardiac Death (DCD)

• 2002 Finalized DCD policy
• 2003 1/1donors
• 2004 0/1 donors
• Patient did not expire within the defined time
  frame
• 2005-2006 YTD 0 eligible DCD donors
  OPO develops checklist to
  determine DCD eligibility
  

13
Donation Education

• ½ hour presentation at every RN Orientation
• 8 hour class - Donation A to Z - the organ
  tissue donation allocation processes
• 8 CEUs
• given 2 times/year by OneLegacy
• targeted to RNs, SWs Chaplains
• open to all employees other hospitals
• 4 hour class on Advanced Donor Management
• 4 CEUs
• given 2 times/year by OneLegacy
• targeted to CCU, DOU, ED PICU - RNs RTs

14
Performance Improvement 2005

• Recruited Physician Champions from Trauma
  Pediatric Departments
• Enhanced Committee membership to include
  representation from Pediatrics Emergency
  Departments
• Developed posted new placards with the Clinical
  Triggers for referral in CCU, DOU, ED
  Pediatrics
• Involved EMT in thanking staff who participate in
  a donors care

15
Performance Improvement 2005

• Achieved 100 identification referral of
  eligible donors
• Implemented Team Huddle process to maximize
  effective requesting
• Conducted 2 Donation A to Z classes (3/05,
  10/05)
• Developed curriculum implemented 2 Advanced
  Donor Management classes (1/05, 7/05)
• Finalized new policy Brain Death Diagnostic
  Criteria

16
Performance Improvement 2006

• Ensure 100 identification referral of patients
  meeting the Clinical Triggers
• Finalize Team Huddle process with OPO
• Support bilingual/bicultural requesting through
  OPO staff
• Increase the number of eligible donors for
  Donation After Cardiac Death
• Increase the number of staff receiving Donation
  Education

17
2006 Year-To-Date

• 2 donors from Spanish-speaking families
• 2 Donation A to Z classes (3/06, 11/06)
• 2 Advanced Donor Management classes (2/06,
  10/06)
• Trained all RNs in clinical triggers, referral
  process and documentation
• 100 tissue referral for 2 months
• Participation in the Donate Life float
• Internal external PR highlighting rewards of
  donation