878

Abstract

Introduction: Timely referral of patients following asystolic death to an organ procurement organization (OPO) may increase tissue donation rates. Notification of the OPO following asystolic death at our hospital was formerly the responsibility of the admitting office. Timely referral was lacking and our tissue donation rates lagged behind other regional hospitals. Hypothesis: Changing the responsibility from the admitting department to the declaring physician for calling the OPO will increase timely referral and tissue donation rates. Methods: In 2006, the instructions accompanying the working copy of the death certificate were altered to require the attending physician or resident to call the OPO within one hour of death. The hospital chief medical officer concurred with the approach. From 10/2006 to 2/2007 intensive communication and in-servicing was carried out in all intensive care units on our two campuses concerning this initiative. Timely referral and donation rates were tabulated before and after the intervention. Data were analyzed using Generalized Linear Mixed Models (SAS). Results: There was a significant increase (2.1 fold) in timely referral rates on campus 1 (p<0.05). The timely referral rate on campus 2 rose 1.3 fold but did not reach statistical significance. The tissue donation rate overall rose significantly (2.6 fold, p<0.05). In 2005, the donation rate was 21 cases/year and rose to 56 cases/year by 2008 (p<0.05). The rate has held steady since that time (2009-2011). Conclusions: Switching the responsibility from the admitting department to the providers caring for the patient when calling in tissue referrals following asystolic deaths results in higher tissue donation rates.