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American Family Children's Hospital
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Increasing the Potential for Organ Donation

By Sue Berns, MSN, RN

 

Pamela Chambers, BSN, RN, organ procurement coordinator (second from right), and Lauren Reible, BSN, RN, neuro ICU nurse (right), consult directly with a patient’s family to offer sympathy, provide real-time education and preserve the opportunity for donation.An essential aspect of Magnet's Structural Empowerment describes the importance of developing strong partnerships with community organizations to improve patient outcomes and advance health of the communities. The University of Wisconsin Organ and Tissue Donation (UW OTD), is a terrific example of this through its partnering with the community to improve outcomes related to increasing organ donation.

 

Unfortunately, there are more than 120,000 people in the U.S. waiting for organ transplant, and more than 2,200 in Wisconsin. UW OTD is the only Organ Procurement Organization in the nation to launch a local campaign for breakthrough improvement in organ donation. The Forward Focus Collaborative campaign began July 2011, with the UW OTD continuing its improvement work today.

 

In 2013, performance data from the 10 largest donor hospitals in this service area revealed that 35 percent of the total potential for organ donation is at UW Hospital and Clinics. The two units responsible for 70 percent of the donation potential are the Trauma and Life support Center (TLC) and Neuro ICU. Although UW Hospital and Clinics is first for overall potential donation volume, it is the third lowest in true conversion rate (potential donations to actual donations). In exploring reasons why medically eligible patients for donation did not become donors, consent was identified as the most limiting factor.

 

To address this critical issue, the UW OTD set up a performance improvement trial with TLC and Neuro ICU. The goal was to proactively guide each step of the process from referral to consent by having direct conversations with the patient's care team. Through this process, there would be opportunity to build relationships with families and staff, provide real-time education and preserve opportunities for donation. After stakeholder meetings prepared units for the new process, a 60-day trial commenced on May 1, 2014.

 

The trial consisted of:

  • Multidisciplinary morning conferences to discuss referrals and current donation case activity
  • On-site visits to referring units to meet with patient care teams
  • Weekly meetings to monitor progress of project

Prior to the 60-day trial, combined data for these two units indicated a 29 percent conversion rate as compared to an 86 percent conversion rate after implementing the changes identified above. The impact of this work nearly doubled the number of life-saving transplant from 10 organs transplanted in the four months prior to the trial, as compared to 18 organs transplanted during the 60-day trial.