KMC CARES Our Story

1
KMC CARESOur Story

• Presented by
• Toni Smith, MSN, RN,C
• Director, Patient Care Services

2
IN THE BEGINNING

• Historical Assets
• Very busy ER
• Inherent knowledge of organ donation
• Good relationship with OPO
• Did moderately well
• Took statistics seriously

3
In the Middle

• Invited to participate in DHS Director Tommy
  Thompsons First Collaborative
• Education plus ???
• Planted the seed
• Result Hard Work at Home
• Get down to brass tacks
• Development of infrastructure
• Project team

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Triggers
5
More Triggers
Neonatal Clinical Triggersfor Early Referral and
Timely Notification of a Potential Organ Donor

• Refer Neonates who meet the following criteria
• Severe Brain Injury
• Requiring Mechanical Ventilation
• Weighing gt 6 lbs.

• Call Immediately if
• 1st EEG is isoelectric
• - or -
• Discussion for withdrawal of ventilator
• or vasopressor support are initiated
• by the family or physician
• - or -
• End of Life/Comfort Care measures are
• being considered
• - or -
• Donation is mentioned

• Call within 24 hours if
• Absent Pupilary reflexes (pupils fixed/
• dilated)
• - and -
• Unresponsive to painful stimuli
• - and -
• Absent Orophrangeal reflexes (no cough,
• no gag, elicited with suctioning)
• - and -
• No spontaneous respirations

[phone] OneLegacy 24-hour Donor Referral
Line
A Collaborative Trial
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What next?

• Timely Referral Procedure
• Team Huddles
• Performance Measures
• Processes to Increase Consent Rate
• Attendance at more Collaboratives
• Policies
• Shared Best Practices
• Education and more Education

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Along the Way

• Discovered the Heart of the Program
• Not the policies
• Not the triggers
• Not the statistics
• Commitment of the People
• Administrators
• Staff to include Physicians, RNs, RTs,
• Social Service, Public Relations

8
Along the Way

• When did it really start?
• Different for each one of us
• Watching an OPO team member discuss donation with
  a family?
• Receiving a note of gratitude from a donor family

9
Along the Way

• Administration showing their support with a
  willingness to address the Board of Supervisors
• With the look in a mothers eyes as she found
  meaning in the tragic death of her son?
• With the realization that each staff member that
  a family comes in contact with makes a difference

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A New Beginning

• Culture reflecting that
• Organ Donation is a Continuum of Death
• We learned
• Patients and families remain our focus of care
• They deserve the opportunity for organ donation
  in times of tragedy and
• Each must be honored with the right to decide

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Next Steps

• Continued desire to learn so that we may help
  families share in this great opportunity
• Post donation recaps
• Each employee anxious to walk the walk