Agenda - OneLegacy · DCD, another End-of-Life decision DCD Data from other OPOs \ Update from...

$: Agenda - OneLegacy · DCD, another End-of-Life decision DCD Data from other OPOs \ Update from OneLegacy DCD Program Specialist Tasha Querantes, OneLegacy : Suzanne Fidler, M.D.,J.D.,$


Agenda

6 + Eligible Hospitals Summary

Current 12 month Previous 12 month

Donation Development Plan

Regional Reports Summary

Current 12 Months Previous 12 Months

OneLegacy Performance

Donor Designation

Action Guide (Change Package)

Schedule of Events

Directory

Notes

Miscellaneous

Tools/Resources

Table of Contents

Region 5 Collaborative Learning Session June 8, 2010 – Las Vegas, NV

10:00 Welcome and Call to Action Moderator: Jennifer Treece, Region 5 RCL Christine Samuels, Region 5 RCL

10:20 Sharing Regional Best Practices 10:30 Timely Referral Moderator: Megan Shaughnessy, CTDN Session Overview: This session will focus on the concept of timely referral from both the OPO and the

hospital perspective. Speakers will review regulatory requirements and discuss high impact and low impact of timely referral. Participants will be actively engaged in conversation about the “big picture” goal of why timely referral matters and be provided with strategies on ways to maintain organizational focus towards improving our practice and making this a meaningful metric.

11:45 Sharing Regional Best Practices 11:55 Lunch 12:45 Sharing Regional Best Practices 12:50 Region 5 DMG Project Moderator: Darren Malinoski, MD

Session Overview: Participants will be provided with national trends in donor management goals. Regional DMG data will be presented and each DSA will be provided with an opportunity to review their own data and facilitate a discussion among their DSA partners. Information about the development of a regional web portal to facilitate the collection and analysis of donor management data will be presented.

1:35 Regional Success in Hand Transplant Moderator: Jill Stinebring, CASD 2:05 Sharing Regional Best Practices 2:15 The R5 Donor Potential Study Moderator: Jennifer Treece, AZOB

Session Overview: After March’s webinar on analyzing true donation potential, Region 5 is moving forward on its next Regional project to determine our true potential. In this session, Region 5 will define all potential eligible, non-eligible potential, and other factors to determine organ donation potential. We will also define the non-donor. We will also establish timeframes for submitting data and each OPO’s responsibility. This will be an interactive session, please have a representative from each OPO there –as we are voting on what to track and report.

3:30 The Question of Individual Authorization/Consent

And Family Resistance Moderator: Carla Hentz, CAOP Session Overview: The session will involve participants to analyze their DSA practice when they are faced with the difficult question of how to honor the wish of an individual when the family of a prospective registered donor, disagrees with the intent to donate. The session will take a 360 approach to this situation by providing information on the ethical, legal and public perception issues involved in refusing that donor’s explicit wishes.

4:45 Developing a Path for the 2012 Regional Collaborative 5:00 A Moment of Silence – A Powerful Practice 5:10 Closing and Reflections Moderator: Jennifer Treece, Region 5 RCL Leaving In Action Christine Samuels, Region 5 RCL

Agenda

12:00 to 1:00 Meet and Greet Luncheon

Welcome - Question to Run On: “What strategies can we implement to achieve successes in each of our three initiatives: Increased Conversion Rate, Increased Organs Transplanted Per Donor, and Increased DCD donations?”

1:00 – 1:20 Frame the Day

Overview of the Binder

Overview of DSA Data and Top 3 Initiatives

Advisory Board Update

Prasad Garimella, COO, OneLegacy Carla Talley Hentz, OneLegacy Tasha Querantes, OneLegacy Ervin Ruzics, M.D., St. Joseph Hospital of Orange

1:20 – 1:50 Donation after Cardiac Death

DCD, another End-of-Life decision

DCD Data from other

OPOs

Update from OneLegacy DCD Program Specialist

Tasha Querantes, OneLegacy

Suzanne Fidler, M.D.,J.D.,

Desert Regional Medical Center

Margie Whittaker, Mission Hospital

Tasha Querantes, OneLegacy

\

Cherilynne Pugliese, OneLegacy

Break – 1:50 – 2:00

2:00 – 2:40 Conversion Rate

Effective Request Process

DNR Status while still preserving Donation Opportunity

Diane Green, OneLegacy

Darren Malinoski, M.D.,

Cedars-Sinai Medical Center

Lydia Lam, M.D.,

LAC-USC Medical Center 2:40 – 3:10 Organs Transplanted Per

Donor (OTPD) Catastrophic Brain Injury

Guidelines (CBIGS) Donor Management

Goals (DMGs) Lung Recruitment

Protocol

Darren Malinoski, M.D., Cedars-Sinai Medical Center Scott Bunting, OneLegacy

3:10 – 3:30

Wrap-up and Actionable Items UNOS Region 5 Meeting Next Local Meeting Date

July 20, 2011 Open Items

Eric Carr, OneLegacy ALL

UNOS Region 5 Hospital Partners

and OneLegacy Team Meeting

OneLegacy Figueroa Courtyard

Conference Room Thursday

April 28, 2011 12 – 3:30PM

6 + Eligible Hospitals

Click on the link below to access report

http://www.onelegacy.org/site/docs/DDC_SixPlus0211.xls

OneLegacy DSA Donation Development Plan

Measurable P.I. Goals P.I. Strategies Primary Stakeholder

Target Completion

Date

Conversion Rate:

Increase Conversion Rate from 68.3% to 75% GAP: 6.7%

1.

2.

Donation after Cardiac Death: Increase DCD from 7.2% to >10% of Total Donors GAP: 2.8%

1.

2.

Organs Transplanted per Donor: Increase OTPD from 3.15 to 3.75 GAP: 0.60

1.

2.

Comprehensive DSA GAP Data

Click on link below to access report

http://www.onelegacy.org/site/docs/DDC_CompDSAGap0211.xls

Comprehensive Regional Data

Click on link below to access report

http://www.onelegacy.org/site/docs/DDC_RegGap0211.xls

Donation Development

Prasad GarimellaCOO

January 26, 2011

Data Review

“How did we do…..”

OneLegacy Potential Referrals

Total Potential Referrals

1,9222,185

2,3662,629

2,9033,159

3,595 3,6713,940 3,947

4,061

1500

2000

2500

3000

3500

4000

4500

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010Year

# R

efer

rals

OneLegacy Eligible Referrals

Eligible Referrals

479

554

505

562533

562

630

557

604

516

469

450

500

550

600

650

700

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010

Year

# R

efer

rals

Trauma Center Deaths 2006-2010 YTD

* Donation Service Area Trauma Center Deaths 2006 2007 2008 2009

2010YTD Dec 10

Loma Linda University 102 77 92 90 70

Riverside Community Medical 56 48 49 44 33

St. Bernardine

Medical Center 110 117 101 64 39

Desert Regional Medical Center 65 66 54 45 N/A

Kern Medical Center 111 84 80 97 103

Riverside County Regional 76 64 46 51 39

Mission Hospital 35 38 39 26 19

Western Medical 65 61 55 52 25

UCI Medical 84 79 90 93 72

•

Data represents DSA Trauma Deaths by Trauma Centers Riverside -

San Bernardino–

Orange –

Kern Counties

Consent Rate

Approaches/Consents

Approaches/Consents (BD+DCD)

700741

671 666723

813 816

675612

714 720

410452

468457

498455

405373369

343378

67%67%65%64%

61%

56%56%56%55%

51%49%

100150200250300350400450500550600650700750800850900

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 201040%

45%

50%

55%

60%

65%

70%

Approaches Consents Consent Rate

2010 Eligible Consent Rate

2010 Eligible Consent Rate

66%71%

74%78%79%

63%

70%67%

71%

64%

54%

75%

50%

60%

70%

80%

90%

100%

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

2010 Consent Rate by Ethnicity OL Jan 2010 - Jul 2010 vs. US 2009

OL Jan 2010 - Jul 2010 vs US 2009

56%45%

62%71%

53%68%

57%

81% 85%91%88%99%

0%

20%

40%

60%

80%

100%

White Black Hispanic Asian

Con

sent

Rat

e

0%10%20%30%40%50%60%70%80%90%100%110%

OL

vs U

S

O.L. U.S. OL vs US

2010 Consent Rate by Ethnicity OL Jul 2010 - Nov 2010 vs. US 2009

OL July 2010 - Nov 2010 vs US 2009

78%

62%73%

50%

68%81%

57% 53%

108%94%

110%97%

0%

20%

40%

60%

80%

100%

White Black Hispanic Asian

Con

sent

Rat

e

0%10%20%30%40%50%60%70%80%90%100%110%

OL

vs U

S

O.L. U.S. OL vs US

Organ Consent Rate Trends and Initiatives

• Initiatives– Pairing FCS’s (continuous learning)– Language and Ethnicity-based assignments– Additional training in addressing immediate,

uninformed “No’s”– Recognize the value of sitting and waiting

Conversion

Conversion of Eligibles

Conversion of Eligibles (Eligible Donation Rate)

479554

505562 533 562

630 604

469557 516

283325 303 320 333 351

410364 377

338 306

65%66%62%

65%65%62%62%

57%60%59%59%

0100200300400500600700

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 201040.0%

45.0%

50.0%

55.0%60.0%

65.0%

70.0%

Eligible Referrals Eligible Donors Eligible Donation Rate

2010 CMS Conversion Rate by Month

2010 CMS Conversion Rate

76%

69%67%67%

79%77%

56%

70%

64%65%68%

58%

50%

55%

60%

65%

70%

75%

80%

85%

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Month

Conversion Rate Percentage 2009 vs. 2010

2009

Category Hopsitals Conv Rate Eligible Donors Organs Tx

AA 5 69% 117 82 292

A 13 62% 147 98 308

B 20 69% 109 86 261

C 93 77% 141 115 315

D 23 50% 2 1 6

Overall 154 70% 516 382 1182

2010

Hopsitals Conv Rate Eligible Donors Organs Tx

AA 5 80% 99 86 268

A 13 70% 152 108 401

B 20 63% 94 62 209

C 93 71% 123 93 223

D 23 0% 2 0 0

Overall 154 71% 470 349 1101

Variance

Conv Rate Eligible Donors Organs Tx

AA 11% (18) 4 (24)

A 8% 5 10 93

B ‐6% (15) (24) (52)

C ‐6% (18) (22) (92)

D ‐50% 0 (1) (6)

Overall 1% (46) (33) (81)

Donors

OneLegacy Deceased Organ Donors

Total Donors

349

382

400397

432

373

346

328314

333

287

250

275

300

325

350

375

400

425

450

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010Year

# D

onor

s

2010 Donor Types: SCD Donors

SCD Donors

301329

292 290 285252

373

432396 400 382

349

80.7%76.2%

73.7% 72.5% 74.6% 72.2%

050

100150200250300350400450500

2005 2006 2007 2008 2009 201050%

55%

60%

65%

70%

75%

80%

85%

Perc

ent o

f Tot

al

SCD Total Donors % of Total

2010 Donor Types: ECD Donors

ECD Donors

5887 79 91 73 72

373

432396 400 382

349

20.6%

19.1%

22.8%

19.9%

20.1%

15.5%

050

100150200250300350400450500

2005 2006 2007 2008 2009 20100%

5%

10%

15%

20%

25%

Perc

ent o

f Tot

al

ECD Total Donors % of Total

2010 Donor Types: DCD Donors

DCD Donors

432396 400

349

14 16 25 19 2524

373382

3.8%3.7%

6.3%

4.8%

6.3%

7.2%

050

100150200250300350400450500

2005 2006 2007 2008 2009 20100.0%1.0%2.0%

3.0%4.0%5.0%6.0%

7.0%8.0%

Perc

ent o

f Tot

al

DCD Donors Total Donors % of Total

Region 5 and OL Percentage of All Donors SCD, ECD, DCD Jan - Aug 2009 and 2010

Region 5 and OL Percentage of All DonorsSCD, ECD, DCD Jan - Aug 2009 & 2010

20.2% 18.60%9.60%

73.5%71.80%

6.2%

75.4% 74.20%

17.2% 17.40%8.6% 8.40%

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%

100.0%

OL SCD Region 5 SCD OL ECD Region 5 ECD OL DCD Region 5 DCD

Jan - Aug 2009 Jan - Aug 2010

Organs Transplanted

OneLegacy Organs Transplanted

Organs Transplanted

905

1,0011,045

1,089 1,112

1,208

1,334

1,221 1,2281,182

1,101

700

800

900

1000

1100

1200

1300

1400

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010Year

# Tr

ansp

lant

ed

Organs Transplanted & OTPD

# Organs Transplanted and OTPD

9151,101

400 382 349396432373346328314333287

1,339 1,246 1,234 1,1821,006 1,055

1,104 1,118 1,223

3.153.093.093.153.103.283.233.373.36

3.023.19

0200400600800

10001200140016001800

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 20101.0

1.5

2.0

2.5

3.0

3.5

# O

TPD

Donors Transplanted Organs OTPD

Organs Transplanted Per Donor Trend and Initiatives

• Decrease in Kidney Discard Rate • Increase in Liver and Kidney Utilization• Two Procurement Transplant Coordinators on Cases• Review of all cases to ensure placement by Manager of Organ

Placement and Thoracic Liaison• Initiatives

– Transplant Liaison Role– Heart-Lung Committee Feedback and Guidance

GOALS FOR 2011

– ORGAN• 400 Donors• 3.18 OTPD• 1272 Transplanted

• TISSUE• 1,548 Donors


– Expectations• Take “OWNERSHIP”• Call to action (referrals)• List of champions in the hospital

– Heads up (referral)– Establish contact for PTC, FCS , etc.

• MRR• Tissue Donation Development• Digital Donor

– Notes, contact info for key hosp. personnel• Policies

– Know your policies


• Educations– Coroners Law– Tests for determining suitability– UAGA– Authorization (Consent)

» Family» Hospital

• TX Centers• Schedules• Time commitment• Performance

EDUCATION AND TRAINING

– CMS» Certifications» Conditions of participation

– Coroners Law– Tests for determining suitability– UAGA– Authorization (Consent)

» Family» Hospital

– Hospital billing– SAC fees

LET’S TALK!!

Page 1 of 2Printed on 3/10/2011 5:02:37 PM by CORP\chentz

5%5%8%

611

2.072.102.502.501.83

112215511

117225512

5410226

37%37%29%50%32%

9618486

1.471.481.671.001.86

1653110813

26149141619

11221687

11%11%6%12%13%

10720389

3.423.423.923.213.32

909171476163

1,009190506872

26650121919

15%15%10%18%16%

2083971616

2.752.753.102.552.72

1,185223627487

1,3862616989103

43181202932

Dsc Rate

Dsc Organs

OTPD

Txp Organs

Rec Organs

Donors

Dsc Rate

Dsc Organs

OTPD

Txp Organs

Rec Organs

Donors

Dsc Rate

Dsc Organs

OTPD

Txp Organs

Rec Organs

Donors

Dsc Rate

Dsc Organs

OTPD

Txp Organs

Rec Organs

Donors

DCD

Extended Criteria

Standard Criteria

Total

PRJYTDDecNovOctSepAugJulJunMayAprMarFebJan

2011Organ Disposition

69%69%83%60%70%

7013256

69%68%100%86%55%

7013166

82%81%75%100%78%

7013337

67%67%85%57%67%

38873222526

71%71%84%65%69%

590111274440

1,062200278192

4,174786161311314

5,9261,116209443464

CMS Conversion Rate

CNRs

C/Rate Non-Eligible

Cons Non-Eligible

Consent Rate DCD

Consents DCD

Consent Rate Eligible

Consents Eligible

OL Consent Rate

Eligible Refs

Auto Ruleouts

Potential Refs

Referrals


2011Organ Performance

Organ Performance & Utilization ( 2011 )

As Of 3/10/2011 5:02:37 PM


1%1%3%

1%1%3%

11211

11211

611

611

10%9%33%

13%12%10%7%19%

14%14%10%10%19%

438125

489135

611

5410226

5911236

17%17%18%16%17%

17%17%18%16%17%

16321

16321

144277911

144277911

11%11%6%12%13%

64%64%80%55%63%

70%70%85%59%72%

611

2244

326123

27752161620

30357171723

25%25%30%28%19%

25%25%30%28%19%

1122

1122

10720686

10720686

22%22%16%25%23%

70%70%78%67%67%

89%90%93%90%88%

1492811215

16321

1703261313

601113313943

770145375256

Dsc Rate

Txp Rate

Rec Rate

Rsh Only

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Rsh Only

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Rsh Only

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Splt

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Rsh Only

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Imp

Rsh

Dsc

Txp

Rec

Small Bowel

Pancreas

Lungs

Livers

Hearts

Kidneys


2011Organ Statistics


28%28%33%60%21%23%64%

171713337

1.721.722.003.001.002.002.002.202.002.000.801.67

4343232221121045

60603352214213115

25251121151553

39%39%44%47%40%44%21%47%38%38%29%14%57%60%

696912166448532243

1.581.581.501.381.801.252.501.292.001.251.672.401.000.67

1061061518951598551232

1751752734159191713871475

676710135467443533

6%6%1%10%11%6%6%8%8%8%1%4%3%13%

6363177668691525

3.703.703.703.373.294.043.563.843.453.674.533.823.932.92

9529527464569796966999771305935

1,0021,00274696310210110273108761346040

257257201917242725202717341512

12%12%13%22%19%9%8%14%13%10%6%5%17%16%

149149142316101019111267138

3.153.152.942.582.793.593.323.143.213.313.683.642.872.33

1,1011,10191856710411311677106921426642

1,2371,2371041068311312213386118961487850

349349313324293437243225392318

Dsc Rate

Dsc Organs

OTPD

Txp Organs

Rec Organs

Donors

Dsc Rate

Dsc Organs

OTPD

Txp Organs

Rec Organs

Donors

Dsc Rate

Dsc Organs

OTPD

Txp Organs

Rec Organs

Donors

Dsc Rate

Dsc Organs

OTPD

Txp Organs

Rec Organs

Donors

DCD

Extended Criteria

Standard Criteria

Total



323323303222283331243120391815

68%68%76%69%67%67%79%77%56%70%64%65%70%58%

5959355458357545

64%64%60%71%67%75%100%62%50%56%64%60%50%67%

5555356358357334

66%66%50%50%50%50%33%86%100%71%50%86%67%

292911111615264

71%71%77%68%71%74%79%79%65%70%67%71%69%56%

324324303222293331243120391815

65%65%74%67%64%69%76%71%54%64%60%64%59%56%

485485404734424242434534602828

1,1101,1108885907480107921071031108589

3,4713,471293302285269269331271298262313257321

5,1505,150437442426387412484401461421487382410

Eligible Donors

CMS Conversion Rate

CNRs

C/Rate Non-Eligible

Cons Non-Eligible

Consent Rate DCD

Consents DCD


Consents Eligible

Total Consent Rate

Eligible Refs

Auto Ruleouts

Potential Refs

Referrals




As Of 6/3/2011 4:06:09 PM


8812221

8812221

18%18%25%40%14%33%17%11%33%20%50%

15%15%10%9%13%21%12%14%21%22%32%10%17%6%

19%19%10%12%21%24%18%16%21%22%36%15%22%11%

28282723251213

383827444613124

1212121211211

5353333645578441

6565345766579652

18%18%16%8%8%26%13%22%13%22%20%29%26%6%

18%18%16%8%8%26%13%22%13%22%20%29%26%6%

131322211131

131322211131

1261261054159166141023122

1261261054159166141023122

9%9%17%4%22%7%14%5%15%6%13%

74%74%65%79%58%83%79%73%88%72%68%85%61%67%

77%77%74%76%75%79%82%78%83%84%64%82%65%67%

1414131122211

99312111

2323414241412

258258202614242727212317331412

268268232518232829202716321512

35%35%39%21%33%41%35%35%29%44%52%44%13%22%

35%35%39%21%33%41%35%35%29%44%52%44%13%22%

16161122212212

16161122212212

1221221278121213714131734

1221221278121213714131734

17%17%18%32%21%16%9%20%21%14%8%7%23%23%

78%78%74%67%79%81%90%74%79%75%88%83%72%64%

94%94%90%98%100%97%99%93%100%88%96%90%93%83%

129129719691322851115410

2211

114114102110961410845107

542542464438476155384844653323

656656566548566769485648704330

Dsc Rate

Txp Rate

Rec Rate

Rsh Only

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Rsh Only

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Rsh Only

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Splt

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Rsh Only

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Imp

Rsh

Dsc

Txp

Rec

Small Bowel

Pancreas

Lungs

Livers

Hearts

Kidneys




28%28%50%20%45%40%17%27%40%

18182252232

1.961.962.001.002.001.501.502.502.673.001.50

47474286310833

65654410115121135

2424224424312

38%38%27%34%33%48%32%29%67%41%33%58%46%

747431111167475712

1.691.691.602.001.912.001.331.632.430.672.001.671.251.56

1221228821212131721010514

196196118323231924617151226

72725411198735649

9%9%7%6%7%6%16%7%10%13%17%8%6%7%

97977684137513131056

3.543.544.173.783.933.143.683.963.922.673.153.443.653.42

1,0131,01396871146670994788631178482

1,1051,10510393122708310451101761268888

286286232329211925123320342324

14%14%8%8%12%8%25%11%18%16%22%10%13%16%

1891891081972913141923151418

3.093.093.603.343.382.922.753.393.192.502.893.173.172.91

1,1821,18210897135768811267100811309296

1,3661,3661181051548311712380119104144105114

382382302940263233214028412933

Dsc Rate

Dsc Organs

OTPD

Txp Organs

Rec Organs

Donors

Dsc Rate

Dsc Organs

OTPD

Txp Organs

Rec Organs

Donors

Dsc Rate

Dsc Organs

OTPD

Txp Organs

Rec Organs

Donors

Dsc Rate

Dsc Organs

OTPD

Txp Organs

Rec Organs

Donors

DCD

Extended Criteria

Standard Criteria

Total



66%66%68%64%73%62%67%72%60%70%62%75%57%62%

69697516335468453

54%54%58%50%72%50%33%56%33%83%45%43%71%50%

61617513355155354

42%42%60%25%38%57%50%50%50%50%63%17%67%

292932343123512

67%67%68%64%74%58%64%71%67%72%62%76%55%64%

362362282740222732223826412732

67%67%72%64%73%61%64%73%66%72%66%76%61%58%

549549424355384345335342544952

4264261078386767211

3,9393,939350318342265293330312355383355308328

4,3734,373458402432341365330312355384357309328

CMS Conversion Rate

CNRs

C/Rate Non-Eligible

Cons Non-Eligible

Consent Rate DCD

Consents DCD


Consents Eligible

OL Consent Rate

Eligible Refs

Auto Ruleouts

Potential Refs

Referrals




As Of 3/10/2011 4:58:08 PM


2%2%3%3%6%5%5%6%

2%2%3%3%6%5%5%6%

33111

33111

99112122

99112122

30%30%17%80%30%33%27%14%57%17%33%25%

14%14%17%3%18%13%24%29%15%11%12%14%9%

19%19%20%17%25%19%33%29%18%25%15%21%12%

2323411521252

32324232524352

22221432314121

525251748663543

74746510611677664

1%1%6%10%

20%20%30%24%30%8%23%14%21%11%27%15%21%14%

20%20%30%24%30%8%25%14%24%11%27%15%21%14%

272724224221233

272724224221233

2211

1501501814244159991512129

15215218142441691091512129

5%5%4%6%5%26%6%4%5%9%

73%73%83%79%73%69%53%73%81%68%79%80%72%64%

75%75%83%83%78%73%72%67%81%68%82%78%72%70%

552111

5541

151512161112

277277252329181724172722332121

287287252431192322172723322123

35%35%53%41%33%38%38%45%29%13%25%34%34%39%

35%35%53%41%33%38%38%45%29%13%25%34%34%39%

1616213221113

1616213221113

133133161213101215657141013

133133161213101215657141013

21%21%17%6%19%12%33%16%30%25%35%18%20%24%

73%73%72%81%76%85%63%82%67%66%61%78%78%73%

93%93%87%86%94%96%94%97%95%89%93%95%97%95%

109109331066151011971118

11112122211

150150931462010121818141115

561561434761444054285334644548

711711525075506064407152785663

Dsc Rate

Txp Rate

Rec Rate

Rsh Only

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Rsh Only

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Rsh Only

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Splt

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Rsh Only

Rsh

Dsc

Txp

Rec

Dsc Rate

Txp Rate

Rec Rate

Imp

Rsh

Dsc

Txp

Rec

Small Bowel

Pancreas

Lungs

Livers

Hearts

Kidneys



1

Donor Designation in CaliforniaQ4 and Year 2010

Bryan StewartVice President of Communications, OneLegacy

Donate Life California Board of Directors

Why a Searchable Donor Registry?

• Donor assured decision is honored• Family comforted by certainty• Approach & recovery may be accelerated• More organs viable for transplant• MORE LIVES SAVED

National Goal:125 Million Registered Donors

by End of 2012(approx. half of adult population)

Summary: Donor Designations, Q4 2010

• There are 94,669,081 designated donors nationwide

• The number of donor designations increased 9.7% over the last 12 months

• In 2010, donor designation rate increased in 18 of 24 states reporting

0

20,000,000

40,000,000

60,000,000

80,000,000

100,000,000

Q407

Q108

Q208

Q308

Q408

Q109

Q209

Q309

Q409

Q110

Q210

Q310

Q410

Donor Designation in the United States

94,669,081 as of 12/31/10

2

U.S. ADD Pop. 18+ Share, Q4 2010

94,669,081

DesignatedDonors

• 50 states and DC• Period ending

12/31/10• ADD Pop. 18+ Share:

40.3%

U.S. Pop. Age 18+: 234,830,011

3,550,258VA3,340,000*IN

4,345,230PA

3,706,481WA3,832,008GA4,027,363NC

4,985,404OH5,546,142IL5,665,904FL7,751,728CA

ADDState

2,131,848OR2,124,397MD2,064,942MI

2,286,328NY2,159,679NJ

2,308,330MA2,372,825MN2,400,000*CO2,433,337WI2,792,420MO

ADDState

*Estimated

Top 20 State Donor Registries, 12/31/10

Donor Designation Rate, 2010Published in 2010 Report Card

53.5%*IA53.3%ID29.3%IL

36.2%DC37.5%**FL

27.4%*CA

76.0%AK23.7%AZ

65.6%CO

23.2%KY

42.3%HI

38.1%CT

DDRState

53.3%NH31.5%NJ16.4%NV

63.2%MT52.3%NC

16.3%MI

55.7%LA45.2%MD

53.0%MN

44.5%NE

39.5%MO

DDRState

58.9%WA57.6%WI59.6%WY

32.1%TN53.9%UT

34.3%OR

12.2%NY55.2%OH

45.0%PA

31.8%VA

32.0%SC

DDRState

*Q1-Q3 2010 **Q4 2010

60%WY

62%CO61%NM60%MO

69%IN65%ND

72%UT

76%AK76%MT

72%WA

59%MN

62%OK

71%OR

ShareState

ADD Pop. 18+ Share, 12/31/10

49%AL

54%SD52%IA52%GA

56%WI56%LA

57%IL

58%VA58%ID

56%OH

49%NE

55%AR

56%NC

ShareState

34%WV

39%FL38%CT38%DC

44%PA43%RI

47%HI

48%MD48%ME

44%DE

33%AZ

40%NV

44%MA

ShareState

0%VT

16%SC15%NY7%TX

27%MI19%MS

30%KS

32%NJ30%KY

30%TN

40.3%ALL

18%NH

28%CA

ShareState

19%

27%25%

27%

33%

28%30%

38%

33%37%

42%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

Organ Donors Tissue Donors Eye Donors2007 2008 2009 2010

Impact on Donation, 2007-2010Designated Donors Among Recovered Donors

Designated Donors Save Lives!

16513498334

803

414

1837523

0

100

200

300

400

500

600

700

800

900

2006 2007 2008 2009 2010

Organ Donors Tissue Donors

1,300+lives saved

by organ donors!

75,000+saved & healed

by tissue donors!

3

0

1,000,000

2,000,000

3,000,000

4,000,000

5,000,000

6,000,000

7,000,000

8,000,000

Q2 05

Q4 05

Q2 06

Q4 06

Q2 07

Q4 07

Q2 08

Q4 08

Q2 09

Q4 09

Q2 10

Q4 10

Designated Donors in California

8,500,000projected as of July 2011

Donor Designation Rate, California

0%

5%

10%

15%

20%

25%

30%

Aug-06

Nov-06

Feb-07May-

07Aug-0

7Nov-0

7Feb-08

May-08Aug-0

8Nov-0

8Feb-09

May-09

Aug-09Nov-0

9Feb-10

May-10

Aug-10

Q3 2010: 27.9%

Q2 by DMV Channel:Field Office: 24%Mail: 32%Online: 38%

Impact on Donation, California

14.1 %

2,934

414

16.8 %

798

134

2009

25.3%

3.170

803

21.6%

763

165

2010

6.4 %

2,850

183

11.9 %

824

98

200820072006

334Registered Organ Donors

827894Recovered Organ Donors

2.9 %1.4 %Tissue Donors Regist’d

2,593 1,628 Recovered Tissue Donors

7523Registered Tissue Donors

4.0 %0.4%Organ Donors Regist’d

Impact on Donation, OneLegacy DSA

15.3%

1,610

246

13.9%

38253

2009

30.4%

1,272

387

18.1%

34963

2010

6.4%

1,506

126

10.2%

40141

2008200710Registered Organ Donors395Recovered Organ Donors

3.9%Tissue Donors Reg’d

1,412 Recovered Tissue Donors

55Registered Tissue Donors

2.5%Organ Donors Reg’d

OneLegacy Donation Service Area (DSA): Los Angeles, Kern, Orange, Riverside, Santa Barbara, San Bernardino and Ventura counties.

Calif. UAGA (2007): DMV or Online Donor Designation is Legally Binding

(1) By authorizing a statement or symbol indicating that the donor has made an anatomical gift to be imprinted on the donor's driver's license or identification card and included on a donor database registry.

(2) Directly through the Donate Life California…Web site.

7150.20 (a): A donor may make an anatomical gift through any of the following:

Signing Up at the DMV Field OfficeDriver’s License and ID Application/Renewal Forms:

as of July 1, 2011

4

Signing Up Online

OrganRecovery

The Donation Process

Life-Saving Efforts byHospital

Referralto OPO

EvaluatePotentialDonor

ApproachFamily

OPO ConductsDonor Search

OPO Notifies Family, PresentsDocument of Gift

Donor Search Donor Record

NoLimitations

FamilyNotification

Document of Gift

Limitations

FamilyNotification

Document of Gift

5

It Rarely Happens, but…

What if the family objectsto the donor’s

legally binding decision?

7150.35 (a): Except as otherwise provided in subdivision (g) and subject to subdivision (f), in the absence of an express, contrary indication by the donor, a person other than the donor is barred from making, amending, or revoking an anatomical gift of a donor's body or part if the donor made an anatomical gift of the donor's body or part under Section 7150.20...

Calif. UAGA (2007): DMV or Online Donor Designation is Irrevocable

Calif. UAGA (2007): Revoking an Anatomical Gift

7150.25 (d): A donor may amend or revoke an anatomical gift that was not made in a will by any form of communication during a terminal illness or injuryaddressed to at least two adults, at least one of whom is a disinterested witness. The witnesses shall memorialize this communication in a writing and sign and date the writing.

When the Family Says “No”…

• Usually happens when untrained hospital personnel discuss donation with the family

• Sets an expectation that it is the family’s decision to make

• Most often correctable once family understands the patient’s legally designated wishes

What If We Meet Opposition?

• OneLegacy and Hospital will work collaboratively to support the family

• Our responsibility is to fulfill the donor’s wishes• OneLegacy will consult with Hospital

Administration prior to making a decision• OneLegacy will supply spokespeople

6

Partners for Life!

1

Community of Practice Action Guide

In 2011, this guide provides a framework for DSAs in the integration of all partners within the community of practice to achieve successful donation outcomes. Seven key strategies influence the overall direction for action, with specific change concepts providing actions to lead the DSAs.

Community of Practice Partners

Partnerships have a positive impact on service and results & together make a difference.

Organ Procurement Organization Eye & Tissue Organization Donor Hospital Transplant Program

State Donor Designation Team Representative Hospital Association

2

Key Strategies and Change Concepts for Success

1. Unrelenting Focus on Change, Improvement & Results Establish strong culture of accountability for results Establish active leadership & management support Integrate honoring donor designation into the goals of the organization.

2. Linkage

Establish protocols to honor donor designation every time. Utilize opportunities to recognize donors (donor flag, memorial areas.) Support donor families in real‐time.

3. Integrated Donation Process Management

Catastrophic Brain Injury Guidelines (CBIG) Advocate donation as the mission Education

4. Aggressive Pursuit of Every Donation Opportunity

Advocate for donation Develop a Community of Practice Communication

5. Intent ‐ A culture of accountability for high yield (E/O/T every time)

Culture a community of practice in which all participants “walk the talk” the mission of achieving high procurement and transplant rates Empowering Infrastructure: Develop effective governance structures across the donation system

6. Effective Relationships – A rapid response network responsible for donor management, organ recovery, and placement

Cultivating Commitment Motivating Results

7. Advanced Practice – Accountability for aggressive clinical care of the potential donor, the donor, and all eyes, organs and tissues

Intensive Patient Care Identify and deploy advanced critical practice expertise for advanced clinical donor management, aggressive organ acceptance and recover

3

Strategy & Change Concepts Expected Outcomes Community of Practice Partners

1. Strategy: Unrelenting Focus on Change, Improvement & Results Hospitals, in partnership with local procurement organizations, maintain a rigorous focus on and joint accountability for increasing the number of donors and donor designees by developing and maintaining a seasoned staff and creating a culture of excellence where honoring donor designation and donation is a priority.

1.01 Establish strong culture of accountability for results:

1.01.1 Review conversion rates, OTPD, DCD on scorecard, measure against team goals

Identify opportunities for improvements and focus.

Hospital, Transplant Center & OPO

1.01.2 Review local transplant center acceptance rates for donors Increased OTPD Transplant Center & OPO

1.01.3 Track compliance of referrals relative to timeliness, clinical triggers & continuity of care until OPO evaluation of potential.

Increased referrals, conversion rate, OTPD & DCD

Hospital & OPO Quality

1.01.4 Incorporate staff performance accountabilities. Quality Performance and increased donation rates.

Hospital, Transplant Center & OPO Quality

1.02 Establish active leadership & management support:

1.02.1 Provide timely, specific feedback to hospital/clinical leadership. Increased awareness of donation performance and opportunities for improvement.


1.03 Integrate donor designation registry strategies into activities:

1.03.1 Track donor designation percentages for the service area. Increase conversion rate OPO Leadership & State Donor Designation Team Rep.

Community of Practice Action Guide

4

1.03.2 Integrate honoring donor designation into the goals of the organization.

Increased community awareness for registry.

State Donor Designation Team Rep.

1.03.3 Share E/O/T outcomes and frequency of honoring donor designation among hospital personnel.

Increased donor designation awareness and opportunities for improvement.

Hospital & OPO

2. Strategy: Linkage Key hospital and procurement organization staff are linked in a timely manner to potential donor families.

2.01 Establish protocols to honor donor designation every time. Increased conversion rates & registry Hospital & OPO

2.02 Utilize opportunities to recognize donors (donor flag, memorial areas.)

Increased conversion rates Hospital & OPO

2.03 Support donor families in real‐time. Increased conversion rates Hospital & OPO 3. Strategy: Integrated Donation Process Management

Hospitals and procurement organizations establish and manage an integrated donation process that clearly defines roles and responsibilities and provides feedback.

3.01 Catastrophic Brain Injury Guidelines (CBIG)

3.01.1 Establish donor management guidelines to ensure donor quality and transplantable organ.

Increased OTPD Hospital, Transplant Center & OPO

3.01.2 Schedule after action reviews with key procurement organization, hospital, and transplant program staff to assess donor management, organ utilization, and transplant outcomes to identify what worked, why it worked, and what to do more of, better, or differently in future cases.


3.01.3 Debrief staff performance and accountability relative to case outcome.

Increase OTPD and meet regulatory compliance for quality performance.

Hospital, Transplant Center & OPO Leadership/Quality

5

3.01.4 Partner transplant surgeons with critical care physicians who are familiar with state‐of‐the‐art and emerging transplantation techniques and have experience with ECD and DCD organs.


3.02 Advocate donation as the mission:

3.02.1 Identify champions in each donor hospital and transplant center. Increase overall donation performance and support for process improvements.


3.02.2 Establish DSA wide multi‐disciplinary donation council and/or individual hospital councils to review scorecards, donor cases, hospital plan, donation policies and processes. (Clinical Trigger, Timely Referral, Effective Request, After Action Reviews, etc.)

Identify areas for improvement and establish roles and responsibilities.

Hospital & OPO

─ 3.02.2.1 This one is kind of a duplicate of 3.012

Maintain a formal process for comprehensive immediate follow‐up between procurement organization(s) and hospital on every donor referral regardless of the outcome (after action review); system to include guidelines for in‐person follow‐up, debriefing and mutual critique of process as well as written correspondence and email communication to facilitate timely feedback where access is difficult.

Increase referral rate and conversion. Hospital & OPO

3.02.3 Develop hospital action plan in collaboration with hospital champion/leadership to assure respective roles are known and understood.

Increased conversion, OTPD, DCD and overall donation performance.

Hospital & OPO

3.03 Education:

3.03.1 Provide physician and staff in‐services on the donation process, donor management and understanding of policies.

Increased conversion, OTPD, DCD and overall donation performance.


3.03.2 Communication process in place for each donor case to monitor the actions of each organization that will affect the donation process. (Team Huddle)

Increased conversion rate, OTPD & DCD Hospital, Transplant Center & OPO

4. Strategy: Aggressive Pursuit of Every Donation Opportunity Every possibility for increased donation is maximized and routinely evaluated through death record reviews, evaluation of

6

donation benchmarks, frequency of honoring donor designation, re-approach, donor management and improved yield.

4.01 Advocate for donation:

4.01.1 Conduct death record reviews (DRR) to identify missed opportunities, follow‐up if needed with involved staff, and test indicated changes to prevent recurrence.

Increase conversion rates Hospital & OPO

4.01.2 Maintain a quality review mechanism for ensuring hospital policies and procedures provide 1) timely notification of all brain injured patients, and 2) maintenance of physiologic function until the OPO) has determined suitability and families are offered the option of donation (3) mechanism to honor donor designation

Increase conversion rates & OTPD Hospital & OPO

4.01.3 Systematically implement DCD policies and procedures in the hospital.

Increase DCD rates Hospital & OPO

4.01.4 Partner with procurement organization(s) to devise a multi‐level decision process (medical director, administrator on call, and local, regional or national experts) to rule in all possible potential E/O/T donor cases.

Hospital & OPO Management

4.01.5 Establish a mutually agreed upon on‐site response time by procurement agency coordinator or designee to every appropriate referral, such as within one hour.

Increase early referral rates, conversion rates and OTPD

Hospital & OPO

4.01.6 Assess and re‐evaluate reasons family has declined donation and consider re‐approaching if appropriate.

Increase conversion rates Hospital & OPO

4.02 Develop a Community of Practice Communication:

4.02.1 Integrate critical care professionals into organ donation process; assure an intensivist is involved in appropriate organ donation opportunities.

Increase conversion rates, OTPD and DCD

Hospital Intensivist & OPO

7

4.02.2 Increase the interaction between OPO medical director and hospital physicians by identifying physician champions and establishing QI/QA processes with physicians through one‐on‐one case reviews and education.

Improve donation process and increase donation opportunities.

Hospital physicians, OPO clinical staff and Medical Director

4.02.3 Hospital and procurement organizations partner with medical examiners/coroners to establish expectation of no (zero) denials.

Decrease coroner declines Hospital, OPO and coroners

─ 4.02.3.1 Consider advocating legislation (see Sec. 4.11.a, HHS Secretary's Advisory Committee on Organ Transplantation. Recommendation #10 states that legislative strategies are adopted that will encourage medical examiners and coroners not to withhold life‐saving E/O/Ts from qualified procurement organizations).

4.02.4 Establish hospital protocols that include a provision for maintaining hemodynamic support for potential donors, inclusive of cases where family has requested a DNR order without knowledge of donation options.

Increase conversion rate and OTPD Hospital intensivist & OPO

─ 4.02.4.1 Educate hospital and procurement organization staff regarding impact of DNR/CMO status on the potential for E/O/T donation. Sessions will include knowledge, skills, practice, and role‐playing on authorization, communications, and discussions surrounding end‐of‐life decision making.

Hospital & OPO

5. Strategy: Intent ‐ A culture of accountability for high yield (E/O/T every time) There is clear intent to maximize the number of organs, tissue, and eyes transplanted. It is expressed and tracked as a mission: every donor, every organ, every tissue, every time. Actions and interactions among donor hospital, procurement organizations, and transplant program staff demonstrate that everyone is committed to the mission. There is rigorous use of goals benchmarked with national best practice that are routinely

8

reviewed for performance.

5.01 Culture within the community of practice in which all participants “walk the talk” the mission of achieving high procurement and transplant rates:

5.01.1 Integrate donation into the mission statement of the organization. Increase donation awareness and support of opportunities for improvement.

Hospital

5.01.2 Consistently recognize and commend outstanding achievements in E/O/T procurement in the hospital.

Increase conversion rate and develop donation champions through recognition.

Hospital Leadership and OPO

─ 5.01.2.1 Identify and support a champion at the hospital to ground the work of the team.

5.01.3 Develop and collect a “dashboard” of indicators on donation, donor designation, transplantation, and other key parameters to reflect hospital performance.

Data driven process improvement. Hospital, Transplant Center & OPO

─ 5.01.3.1 Benchmark hospital utilization rates (such as organs transplanted per donor or OTPD) to local, regional and national performance leaders.

5.01.4 Utilize procurement agency and/or hospital effective requesters in every case.

Increase conversion rate Hospital, Family Support Staff and Effective Requestor

5.01.5 Test and implement improvements to the donation authorization process and practices using after action reviews.

Increase conversion rates and identify areas of improvement for family authorization process.

Hospital, OPO Family Support and Hospital Development staff

─ 5.01.5.1 Utilize re‐approach strategies when authorization for all 8 organs, eye, and tissue is not obtained. Identify and address the family’s reasons for restricting authorization.

Increased OTPD Hospital, OPO Family Support, Clinical and Hospital Development

9

5.02 Empowering Infrastructure: Develop effective governance structures across the donation system:

5.02.1 Participate in donor‐specific procurement organization committees to develop policies and evidence‐based clinical protocols to support high E/O/T utilization.

Establish strong relationships and identify opportunities for improvement.

Hospital and OPO team

5.02.2 Support hospital clinicians to participate on procurement organization boards and committees to advocate for all organ types.

Ensure clinician support on all donation cases.

Hospital leadership & OPO

5.02.3 Systematically capture and make use of data across the continuum from frequency of honoring donor designation to pre‐donor management

Increase performance, donation awareness and relationship building.

Hospital & OPO

5.02.4 Collaborate with procurement organizations to regularly monitor and report E/O/T specific utilization data to donor hospital leaders.

Develop hospital leadership and support for the donation process.

Hospital & OPO

─ 5.02.4.1 Partner with procurement organizations to create a dashboard report with clinical indicators for E/O/T utilization rates including reasons why E/O/Ts are not recovered and transplanted. Share performance benchmarks with other hospitals to foster DSA‐wide improvement.

6. Strategy: Effective Relationships – A rapid response network responsible for donor management, organ recovery, and placement Build and sustain a network of quick response, collaborative relationships with donor families, hospital staff, E/O/T procurement organization staff, state-based donor designation teams, transplant physicians and surgeons, and transplant program staff. Necessary and sufficient skilled hospital, E/O/T procurement organization and transplant program staff are in place and ready to respond. Policies, processes and communication channels with partners are well defined, practiced, and monitored. Deep relationships assure timely and

10

correct responses that promote high E/O/T transplantation rates.

6.01 Cultivating Commitment:

6.01.1 Participate in DSA E/O/T specific committees including transplantation, critical care, and procurement experts to review and discuss local protocols in light of national recommendations.

Improve overall donation process and relationship building.


6.01.2 Dedicate efforts to cultivate and maintain hospital commitment to achieving high rate of E/O/T utilization and honoring donor designation

Increase conversion rate Hospital & OPO

6.01.3 Provide positive feedback to hospital unit staff about how their efforts have affected the lives of E/O/T transplant candidates.

Promote relationship building and increased donation rates.

Hospital & OPO

6.01.4 Actively participate in achieving seamless integration among the procurement organizations, donor hospital, and transplant program to achieve a high transplantation rate.

Strengthen communication between the organizations having an impact on the donation process.


─ 6.01.4.1 Encourage procurement organization presence into the institutional functions of high volume donor hospitals.

Ensure real time referral response, hospital development and education.

Hospital & OPO

─ 6.01.4.2 Create network among procurement organization(s), hospital, and transplant programs to identify specialists (cardiology, pulmonology, etc.) essential to donor evaluation.

Increase OTPD with proper clinical expertise.

Hospital & OPO

6.01.5 Establish multi‐disciplinary teams to test and implement effective changes.

Quality Improvement Hospital & OPO

6.01.6 Treat increasing E/O/T transplanted per donor as an area of unrealized potential for narrowing the gap between the demand and supply of E/O/Ts.

Increase OTPD and narrow the gap. Hospital, Transplant Center & OPO

6.01.7 Conduct pre‐recovery briefings for OR staff in partnership with procurement organizations.

Real time OR education and relationship building.

Hospital & OPO

11

6.01.8 Standardize core competencies for critical care staff in regards to E/O/T donation and designation.

Increase expertise and knowledge base to support the donation process.

Hospital & OPO

6.02 Motivating Results:

6.02.1 Nurture procurement organization, hospital, transplant program, and state‐based donor designation team relationships with accountability for data proven results.

Structure and purpose of DSA Action Team

Community of Practice Partners

6.02.3 Celebrate and honor hospital (specific units) contributions to increasing E/O/T utilization.

Create donation champions and promote early referrals.

Hospital & OPO

6.02.4 Embody an attitude that all types of donation are of equal importance to donor families.

Preserve the donation opportunity for all families and donors.

Hospital & OPO

6.02.5 Support state registry by offering donor designation opportunities in the hospital and the local community.

Create donor designation education and awareness.

Hospital, OPO Hospital Develop and State Donor Designation Team Rep.

6.02.6 Participate in the Workplace Partnership for Life program. Create community awareness and increase registry.

Hospital & OPO State Donor Designation Team Rep.

7. Strategy: Advanced Practice – Accountability for aggressive clinical care of the potential donor, the donor, and all eyes, organs and tissues Practice continuity of aggressive clinical care for all E/O/Ts from timely referral, through brain death declaration, to recovery. Access and use advanced clinical practice support and best practices. Recognize the physiology of brain death and incipient herniation and implement standardized approaches to the declaration of death, obtaining donation authorization, and medically managing the donor. Optimal management ensures that the donor somatically survives to procurement and that the E/O/Ts are maintained in optimal condition leading to higher utilization rates.

7.01 Intensive Patient Care:

12

7.01.1 Stress and maintain continuity of aggressive intensive clinical care throughout brain death declaration process.

Increase conversion and OTPD Hospital & OPO

─ 7.01.1.1 Implement a standardized brain death declaration protocol that achieves timely declarations.

Increase conversion and OTPD Hospital & OPO

─ 7.01.1.2 Continually re‐evaluate the status of all 8 organs and tissues including eyes throughout the donor management process. Re‐invigorate organ placement efforts if clinical status improves.

Increase OTPD Hospital, Transplant Center & OPO

7.02 Identify and deploy advanced critical practice expertise for advanced clinical donor management, aggressive organ acceptance and recover:

7.02.1 Establish and maintain continuity of intensivist/pulmonary involvement in donor management in the peri‐ and post pronouncement of death time period (in consultant role) – joint OPO/intensivist involvement.

Increase OTPD Hospital & OPO

7.02.2 Implement an evidence‐based donor critical pathway and track involvement.

Increase overall donation rates. Hospital & OPO

7.02.3 Assign OPO and/or hospital staff with critical care experience to manage the care of organ donors and utilize advanced practice clinical staff (NP/PA/other) for challenging cases.

Increase conversion rate and OTPD Hospital & OPO

7.02.4 Partner with procurement organization to help develop advanced practitioners that are able to perform donor management procedures 24/7 that are typically performed by physicians or other advanced clinicians.

Increase overall donation rates and identify champions.

Hospital & OPO

7.02.6 Deploy highly skilled teams to participate in the organ procurement procedure. (Recovery Technicians)

Increase O/E/TPD while establishing OR relationships

Hospital & OPO

7.02.7 Schedule the timely transport of deceased donor to appropriate area of hospital for tissue and eye recovery.

Increase eye and tissue recovery Hospital & OPO

13

Regulatory & Data Resources: Centers for Medicare and Medicaid Resources: State Operations Manual Appendix A - Survey Protocol, Regulations and Interpretive Guidelines for Hospitals see: � §482.45(a)(1) – (5))- http://www.cms.hhs.gov/manuals/Downloads/som107ap_a_hospitals.pdf � § 482.45 Conditions of participation: Organ, tissue, and eye procurement-http://edocket.access.gpo.gov/cfr_2004/octqtr/pdf/42cfr482.45.pdf The Joint Commission Resources: Revisions to Standard TS.01.01.01, EP 9 – Applicable to Critical Access Hospitals and Hospitals- http://www.jcrinc.com/common/PDFs/fpdfs/pubs/pdfs/JCReqs/JCP-03-09-S6.pdf Data Resources: DSA, Hospital & Regional Gap Reports www.healthcarecommunities.org

Donation and Transplantation Community of Practice

Meeting Events: Please mark your calendars!

Meeting Date/Location Target Audience

DSA/Regional Strategy Meeting

March 15-16, 2011 Sheraton Crescent

Phoenix, AZ

DSA Action Leaders Regional Action Leaders DSA Team Members

- OPO Executives and Staff

- Donor Hospitals - Transplant Centers - Donor Designation - State Hosp. Assoc.

Pediatric Forum July 12-13, 2011

Sheraton Downtown Denver, CO

Pediatric Critical Care Physicians and Nurses

OPO Medical Director OPO Clinical Director & staff Pediatric Transplant

Physicians OPO COO

Performance Improvement Summit

August 17, 2011 Swissôtel

Chicago, IL

OPO CEO/Executive Director Performance/Quality

Committee members Board members interested in

performance improvement Chief Operating Officer Vice President/Director of

Quality

Donor Management Summit

September 20-21, 2011 Westin

Kansas City, KS

Critical Care Physicians and Nurses

Transplant Physicians OPO Medical Director OPO Clinical Director OPO COO

CEO Summit October 18-19, 2011

Ritz-Carlton St. Louis, MO

CEOs of OPOs, Hospitals, and State Hospital Associations

OPO COO OPO Board members

National Learning Congress 2012

October 4-5, 2012 Gaylord Texan Grapevine, TX

All members of the Donation and Transplantation Community of Practice

SAVE THE DATE

OneLegacy will host its annual

Organ & Tissue Donation Symposium

Tuesday October 11, 2011

Pasadena Convention Center 300 E. Green Street Pasadena, CA 91101

Learn Best‐Practices to: Increase the Conversion Rate Increase Organs Transplanted per Donor Increase DCD Donation Increase the availability of life‐saving organs for

transplantation

New this year: A Physicians Track focused specifically on physician to

physician education

More details to follow as the date approaches

UNOS Region 5

What to expect:

Day One:

Fly into Las Vegas the evening of June 7th

Team Dinner 8 PM

Day Two:

Conference 10-5

Conference begins at 10:00 a.m.

Adjourns at 5 p.m.

This Action Team will:

Participate in building our DSA

strategy for eliminating all gaps

in order to achieve OTPD and

Conversion Rates while

identifying best practices for

spread!

OneLegacy Is inviting you to: Continuing the Climb 2011 the time is now!

Bellagio Hotel 3600 south Las Vegas Boulevard Las Vegas, Nevada 89109

Phone: 213 229-5634 Fax: 213 633-1634 E-mail: [email protected]

RSVP with your airline preference to Clinique by May 6th.

Contact person: Clinique Burrell 213 229-5634

OneLegacy Is inviting you to: Attend the Region 5 conference

This June 7th and 8th

In Las Vegas

Conference Topics:

Defining Our True Donor Potential

Donor Management Goals and What’s Next

The Question of 1 st Person Consent

Region 5 Data Review—Strategies for nar-rowing the Gaps

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