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Increased Organ Donation and Organ Donor Conversion Rate at a Tertiary Care Urban Hospital With a Free-Standing Transplant Program by Implementing a Multifaceted Program of Known Best Practices
Judith L Pepe, Jami Tyska, Orlando C Kirton, Michael E Ivy
Hartford Hospital, Connecticut, CT
Objective: To improve referral timeliness of potential organ donors, organ donor conversion rate and organs transplanted per donor through best practice changes to multiple processes inherent in organ donation.
Design: Retrospective review of hospital specific data collected by the local organ procurement organization (OPO).
Setting: ICUs at an acute tertiary-care urban teaching hospital
Patrticipants: 985 ICU patients referred to OPO from September 2003 through December 2005 and 94 eligible organ donors from January 2003 through December 2005.
Interventions: In October 2003, implemented best practices including placement of a referral clinical "trigger"card and donor management guidelines at each ICU bedside, daily on-site ICU rounds between OPO coordinators and nurse managers to identify potential organ donors, identification of a physician champion, after action reviews with ICU staff following each donation referral, mandatory pre-approach conference with the health care team, ICU attending physician involvement in donor management, and the establishment of an organ donation committee.
Main Outcome Measures: 1) Timeliness of referral of potential organ donors, 2) Organ donor conversion rate, and 3) Mean number of organs transplanted per donor.
Results: All outcome measures improved from 2003 to 2004. Improvement was maintained in 2005. The changes from 2003 to 2004 were statistically significant for timeliness (p<.0001) and conversion rate (p<.002), but not for organs per donor.
Conclusions: Reengineering of hospital systems based on known best practices inherent in the organ donation process is instrumental in organ donor referral timeliness and conversion rate.
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