Quality Improvement Yields Quality of Life: A Palliative Care Tissue Donation Collaborative (SA508C)

Abstract

•Describe elements of a successful tissue donation collaborative program•Describe tissue donation eligibility, potential benefits, and process Although 25% of all US deaths occur in nursing homes, nursing home residents (including those enrolled in hospice care) are not routinely considered for tissue donation programs. Nursing home residents with non-cancer hospice diagnoses may be eligible post-mortem tissue donors and able to provide critical and life-enhancing donations of skin, corneas, heart valves, veins, and bone. This review demonstrates a successful collaborative tissue donation program within a Veterans Affairs (VA) nursing home. We will routinely (90%) identify potential tissue donors from a hospice/palliative/nursing home program and increase the number of tissue donors from one VA Medical Center in one year. In 2015 a VA Medical Center Interdisciplinary Organ/Tissue Donation Committee (Surgery, Palliative Care, Nursing, Ethics, Quality Management, Regional Transplant Community) created and implemented policies and procedures for organ/tissue donation and procurement, including potential donors who died in the nursing home/hospice/palliative care unit. Outcome measurements included: location and number of deaths, percent of referrals completed, potential donors, characteristics of donors, satisfaction of providers/families. Collaborative Program Year 1: 200 total deaths with 128 (64%) referrals completed to Regional Transplant Community. Seven potential donors were identified and four families consented to tissue donation. Two of the four donors died in the nursing home with hospice care, all were known to the palliative care consult team. Primary diagnoses = organ failure (organ, heart, and kidney). Nursing home/hospice/palliative care providers and families of decedents reported satisfaction with the process and opportunity to consider tissue donation. Updated measurements, quality improvement interventions, challenges, successes, and donor case studies will be presented. Post-mortem donated tissues from nursing home hospice patients can be life-saving or life-improving for people with trauma, burns, cancer, blindness, and more. Hospice and nursing home leaders may collaborate with Medical Center tissue donation programs to build successful partnerships and give families the option of the gift of tissue donation.