Project plan to increase organ donation rates at Temple University Hospital
Over 88,400 Americans are currently awaiting a life saving organ transplant. As of the end of February there were 4,375 transplants performed from 2,263 donors; 1033 of those donors were living donors (primarily kidney transplants) (UNOS, 2005). Extrapolating this data, this year over 26,000 people will receive a transplant. Hundreds to thousands die each year during that wait.
Our local Organ Procurement Organization, the Gift of Life (GOL) services the eastern half of Pennsylvania, southern New Jersey and Delaware. In this region, 4,556 people are active on one or more transplant lists (GOL, 2005). For example, one person could need a heart and a kidney.
The method by which they receive a transplanted organ or organs starts with a tragedy. A person must be deemed legally brain dead or have a devastating brain injury with no chance of survival and be ventilator dependant to be considered eligible for organ donation. The most common things to render a patient in one of these states are head trauma, stroke and anoxia (lack of oxygen to the brain for a prolonged period of time). The stereotypically transplanted organs are hearts, lungs, livers, kidneys and pancreases. One donor can provide life saving organs for up to seven people. A single donor could touch including corneas, intestines, skin and bone, nearly 100 people's lives (GOL, 2005).
In January of 2004, Temple University Hospital (TUH) was one of 200 hospitals nationwide to become involved with a Department of Health and Human Services (DHHS) collaborative to increase organ donations. Not everyone who is brain-dead is a suitable donor and not all families that are offered the option of having their loved one's organs being used to save the lives of others consent to the procedure. The goal is to have a conversion (also commonly called consent) rate of 75%. This means that three of four families of eligible organ donors that are asked, actually consent to the donation. The consent rate at TUH at the end of 2003 was 60% and dropped to 57% by the end of 2004 (GOL, 2005). At the end of March 2005 (the first quarter), the conversion rate was 43%. The hypothesis is that the proper "best practice" process had not been consistently implemented and that the decreased overall donation rate is largely due to the hospital staff not referring 30% of eligible patients to the GOL.
The number of Americans awaiting a life saving organ transplant greatly out numbers the available organs. What can TUH do differently to increase the number of organ donors to at least the DHHS Collaborative's goal of a sustained conversion rate of 75%?
The internal process
The internal process of organ donation at TUH was mapped (see diagram 1) from the time the patient arrives to the hospital up to the transportation of the surgically recovered organs. The process itself is...