March 17, 2006

Organ donation rates get boost from collaborations

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VUMC’s organ donation program is benefiting from taking part in two awareness collaboratives, and is performing ahead of national benchmarks.

Organ donation rates get boost from collaborations

Vanderbilt University Medical Center has joined with Tennessee Donor Services in two collaboratives aimed at increasing both the national organ donation rate and the number of organs transplanted per donor.

Organ Donation Breakthrough Collaborative, a two-year study, was geared toward increasing overall donation rates in the United States.

The top 200 hospitals with the highest potential for organ donors were asked to measure their progress using the following four tools: referral rate, timely notification rate, appropriate requestor rate and conversion rate. A goal for each category was established by the Collaborative.

Vanderbilt used data from the following units for baseline percentages: the Trauma Unit, Neurological Intensive Care, Pediatric Critical Care, Cardiovascular Intensive Care and Surgical Intensive Care.

“While we have yet to meet our goal in conversion rate, in 2005 we were above the national performance percentage of 61 percent for conversion rate,” said Carol Eck, M.S.N., administrative director of Vanderbilt's Transplant Center. “The conversion rate refers to the number of families asked for their loved ones to be an organ donor and the number of those asked, who agreed.

“We experienced an increase in all four areas and saw significant improvement in our conversion rate percentage while continuing to outpace the national performance figures.”

After completing the first collaborative, Eck said the Medical Center accepted the offer to participate in a second effort called the Organ Transplantation Breakthrough Collaborative in hopes of increasing the number of organs that could be used per donor.

Because of the critical shortage of organs, transplant centers are working hard to not only increase organ donation, but to also procure as many organs from a single donor as possible.

“In the first reporting quarter, November 2005 to January 2006, we were actually at 3.77 organs per donor, just over the collaborative goal of 3.75 organs per donor,” Eck said. “With 83 teams participating, Vanderbilt was one of only five teams that exceeded the goal in this action period. Basically, we are doing really well.”

The national average was 3.07 organs per donor.

Since enrolling in the collaboratives, Vanderbilt has made huge strides to pursue every donor opportunity, and to date has exceeded the national performance levels for both initiatives.

Various members of the Vanderbilt team attend grand rounds, in-service and staff and unit board meetings in an effort to educate the organization about the goals of the collaborative and to ensure that Vanderbilt continues to excel.

Nationwide there are 90,000 patients waiting for an organ, 2,200 of whom are pediatric patients. Tennessee has 1,820 patients on the waiting list for an organ. According to Eck, most patients wait between one and two years, and during that time, 17 patients die every day, “which is why it is so important to highlight the need for organ donation.”

It is also essential that the physicians in these critical care areas work with the designated personnel with Tennessee Donor Services to maintain organ viability, she pointed out.

Vanderbilt has taken the five metrics for measurement and turned them into pillar goals for the institution as part of the institution's elevate program.

The team created a way to monitor the performance of the intensive care units that have the potential for organ donation called the Organ Donation Quality Pillar Dashboard.

“This printed report shows us month by month how each area is doing,” said Eck, also administrative director of the Cancer Patient Care Center. “It is a color-coded chart that will immediately alert the staff if attention is needed in one of the metrics (or measuring tools).

“This has helped us to be successful in coming closer to our goals. The monthly report is a way for the staff and faculty to measure the progress. We all do better when we get feedback on a regular basis.”