INCREASING CONSENT BY PROVIDING ACCURATE INFORMATION

Abstract

133 Purpose: In order to determine whether giving families accurate donation information positively influences consent rates, a study was designed to determine if the donation options that families are presented with are appropriate and if this directly impacts their decision to donate. Methods: Referral calls for a particular organ and tissue procurement region were tracked over a seven month period (11/1/97-6/30/97) by a centralized call center staffed by transplant professionals. All cases where the next-of-kin (NOK) was approached for donation by the hospital staff were tracked. Using a custom referral database, the call staff immediately determined if appropriate or inappropriate donation options were presented to the NOK by the hospital based on the available patient's medical and social history. The results were then compared to the overall consent rates for each group. Results: Out of 2778 total referrals, inappropriate options were given for organs 757 times, bone 653 times, skin 575 times, heart valves 717 times, and eyes 258 times. When NOK was given inappropriate options, consent for recovery was obtained 22% of the time for organs, 21% for bone, 20% for skin, 21% for valves, and 17% for eyes. However, when NOK was given appropriate options, consent was obtained 60% of the time for organs (+38%), 40% for bone (+20%), 37% for skin (+16%), 45% for heart valves (+24%), and 41% for eyes (+24%). Conclusions: There is a significantly higher rate of consent for organ and tissue donation by NOK, when given accurate options than when not. There could be at least two plausible explanations for this. If the caller receives appropriate information before talking to the family, he or she may feel more confident with the approach, helping to elevate the sense of comfort felt by the NOK. Another explanation is that the difference in consent rates is due to two types of approach people-those who do not care and just want to get it over with, and those who care and want to provide the NOK with correct information. Consequently, the development of a system that encourages appropriate hospital staff to have appropriate donation options available before approaching the NOK could result in much higher consent rates.