(1706) More Lives Saved Through Hospital and Organ Procurement Organization Partnership

Introduction: Collaboration between critical care providers and an organ procurement organization (OPO) is paramount to increasing the organs available for transplant. This critical collaboration includes timely notification of a potential donor and cohesive engagement with the family of a donor for a donation discussion. Our OPO defines and measures these two factors as positive indicators to authorization outcomes (legal permission for donation) and hypothesized increasing the timeliness of referrals and collaborative discussions would yield an improved authorization rate resulting in more organs transplanted.

Methods: We developed a process to evaluate the impact of a timely referral from a hospital to our OPO by measuring authorization outcomes when a referral is made timely (based on cues for referral) versus an untimely OPO notification of a potential donor. Further, we measured the effectiveness of a Collaborative Donation Process (CDP) defined by a donation discussion that occurs when the OPO and hospital collectively establish a plan to introduce the topic of donation to the decision makers of a donation candidate.

Results: Over 5 years, our OPO conducted 5313 donation discussions with potential donor families. Of these, 4720 (89%) were timely referrals from hospitals and yielded an 8% increase in authorization over untimely referrals (after end-of-life discussion or brain death declaration). Further, the authorization rate was 12% higher when the OPO and the donor hospital established a collaborative approach to engage the patient’s family for a donation discussion. These increases in authorization rates when the referral was timely and the discussion was collaborative, were observed even in the absence of first-person authorization (where the individual previously made a decision to register to be an organ donor). In the non-registered group, when the referral was timely the authorization rate was 6% higher; when the discussion was collaborative, the authorization was 12% higher.

Conclusions: To improve the organ donation and transplant process, a deep partnership between the hospital and the OPO must exist to optimize the referral and authorization practice ultimately resulting in an improved donor family experience and more lives saved through increasing the organs available for transplant.