Multidisciplinary Initiative Leads to More Referrals, Donors, and Transplanted Organs

By Jonathan Springston, Editor, Relias Media

A multiyear collaborative performance improvement project helped a Georgia hospital expand its organ transplant pool through better referral practices that attracted more donors.

In 2017, leaders at the Northeast Georgia Medical Center's hospital campus in Gainesville examined how the organ donation and transplant processes could improve. Initial reviews indicated staff were missing chances to inform families and the public about donations and that there were misconceptions about the process. An advisory committee revised end-of-life care policies to provide better education to staff, who could then provide better and timelier information to patients and families.

Also, the facility raised public awareness by creating an “honor walk” to recognize donors and recipients. Staff raised a “Donate Life” flag on the campus each time a family authorized a donation. The hospital also hosted a remembrance celebration in memory of donors.

Thanks to this project, the number of organ referrals has nearly doubled, from 169 in 2015 to 320 in 2021. The number of organ donors in 2021 was 31, more than the total of 22 donors during the three-year period of 2015 through 2017. Total organs donated in 2021 was 102, up from 16 in 2015. The rate at which an appropriate requestor initiated the conversation about organ donation with the family increased from 52% in 2015 to 90% in 2021.

“By investing in staff members and partnering with bedside providers, our facility improved the organ donation experience for nurses, physicians, donors, and families,” the authors of the initiative concluded. “The outcome of that investment has been a hospital culture that values and celebrates organ donation as a standard of care for patients and families and an important part of honoring end-of-life wishes.”

In March, the Health Resources and Services Administration (HRSA) announced an initiative to improve the nation’s Organ Procurement and Transplantation Network (OPTN). On July 20, the U.S Senate Committee on Finance Subcommittee on Health hosted a hearing that featured testimony from OPTN leadership and others. Congress is considering legislation that complements the HRSA-led overhaul.

“Every member of Congress wants Americans to have the best-in-class organ transplantation system. The finance committee’s bipartisan investigation found critical failures from the current contract holder, especially when it comes to matters such as information technology and logistics,” said U.S. Sen. Ron Wyden, D-OR, chairman of the finance committee. “Our legislation is written from top to bottom to ensure competition for technical functions like these that will help the OPTN perform to the highest possible level.”

Ahead of the subcommittee hearing, the United Network for Organ Sharing (UNOS), a non-profit serving as the nation’s transplant system under contract with the federal government, reiterated its backing for ongoing improvement initiatives.

“As long as there is a waitlist, it is our moral obligation to ensure we are promoting progress and increasing equitable access to lifesaving transplants,” said UNOS CEO Maureen McBride, PhD. “Patients and families are counting on us to pursue improvements that increase transparency, strengthen accountability, and save more lives. We support calls for patient-focused improvements and want to be part of the solution.”

More on this subject will be featured in the upcoming September issue of Medical Ethics Advisor.