Transcript PPT w/Tim Sullivan to HCMC leadership

HONORING THE DONOR’S WISHES
Susan Mau Larson
Public Affairs Director, LifeSource
April 28, 2011
HONORING THE DONOR’S WISHES
Goal: to enhance and strengthen our ability to
uphold a patient’s designated wishes and the
law.
1. What is donor designation?
2. What does it mean when someone has
designated him/herself to be a donor?
3. What is our responsibility in honoring donor
designation?
Donor Designation
Honoring an individual’s
documented wishes to be
an organ and tissue donor.
Legal Framework
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1968 – Uniform Anatomical Gift Act adopted by
every state “Donation is a gift”
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1987, 2001 (SD), 2002 (MN) Revisions
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2007 – MN, ND, SD adopt revised UAGA
reinforcing donor designation (To date 39 states
and territories have adopted)
Implementation
In May 2003 LifeSource began honoring an individual’s
documented wishes to donate
Preparation for implementation included:
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Gathered stakeholder input
Established policies and procedures
Gained Board of Directors approval
Conducted training with staff and hospital partners
Shared progress with media
Incorporated donor designation into public messaging
Law of Donation:
Uniform Anatomical Gift Act
ESTATES OF DECEDENTS; GUARDIANSHIPS
MN CHAPTER 525A
Preclusive Effect of Anatomical Gift, Amendment, Or
Revocation.
(a) ... 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... An anatomical gift made in a will, a
designation on a driver's license or identification card, or
a health care directive . . ., and not revoked, establishes
the intent of the person making the designation and may
not be overridden by any other person.
Who Owns the Decision
Decision belonged to decedent when she was
alive;...
Only if she decided “not to decide”
does the decision belongs to the living.
Legal Status of Donation
Decision
• A Testamentary Decision--Cannot be Revoked
except for Public Policy Reasons in a Court of
Law
• A Statutory Right
• A Charitable Gift
Testamentary Decision
ESTATES OF DECEDENTS; GUARDIANSHIPS
• Document of Gift is like a Will, but acted on prior to
probate
• The Organ Procurement Organization is the Executor,
Both Empowered and Required to Carry Out the
Wish
• The Intent of the Decedent is the Core Question
Factors in Legal Noncompliance
Compassion
– We identify with the Living
– We want to help the Living
Fear
– We fear the Living, and their lawyers
– We want to maintain strong relationships with
hospital
– We fear the media
Immunity
Complete statutory immunity for persons
who facilitate anatomical gifts pursuant to
Anatomical Gift Act
Statutory Obligation
This obligation is shared by donation agencies
and the hospital
• Its Your Risk, Too
• Nowhere Does it say We Can Ignore this Gift
• Statutory Immunity Covers This
Organ Donors with
Donor Designation
Experience
• From May 2003 through December 2009 LifeSource
managed 1068 organ donation cases
• 14 potential cases (5/03-12/09) had
some conflict or confusion
• 9 of these 14 situations resulted in organ donation
Experience:
Factors in Conflict Situations
How We Proceed
• Huddles with care team to discuss situation and
plan
• Engagement of LifeSource and donor hospital
leadership
• Adequate on-site resources from LifeSource
Family Interactions
– Consistent messaging for hospital and LifeSource.
– Avoid language which gives perception of choice.
– Stay engaged with the family during and after the
donation.
– Provide document of donor designation and
brochure
Honoring the Donor’s Wishes…
Bringing life to an individuals’ gift
relies on the support of all involved –
procurement organizations and donor
hospitals.
We must do this in partnership.
HONORING THE DONOR’S WISHES
KARE-11
March 11, 2011
A lasting gift: Forest Lake boxer helps others in his death
LINO LAKES, Minn. -- A Forest Lake High School senior who
collapsed in the boxing ring and later died continues to give
to others.
"He was a giver. He was a giver. He wanted people to be
taken care of," said Susan Smith about her son, Charlie, who
has helped dozens of people by becoming an organ donor.
Questions/Discussion
THANK YOU
Who We Are
Honoring Donor Designation
Sheila Elledge, RN, BS
Nurse Manager Burn Unit
Hennepin County Medical Center
Sue Weese, RN, BSN, CPTC
Lifesource In-house Coordinator
Hennepin County Medical Center
Who We Are
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465 Staffed beds
22,937 Inpatients per year
101,658 ER visits per year
3,000 1st time trauma admissions of which 31%
were referred to us by other hospitals
• 327,165 Clinic visits per year
Why We Are Here
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2006 – 2010 YTD Averages
Authorization and Conversion = 78%
% of Total LifeSource Donors = 12%
% of Total LifeSource DCD Donors = 34%
Organs transplanted per donor = 3.77
Number of Tissue Donors = 32
Donor Designation Cases = 48%
Medals of Honor Won = 4
2009 Gold Medal Winner
We Are Also Here
Because…
DSA Leadership Position
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First to adopt DCD and Resident Road Show
Media Stories and Promotion of Donation
Donate Life Month/Flag
MHA and CEO Summit
DD Letter in Family Folder
Experience w/ Donor Designation
and Conflict (4 cases)
We Are Trying To…
Excellent end of life care
Honor the patient’s Gift
Follow Donor Designation Law
Minimize Fear of Family
Maximize the gift
Who We Are
Family considers taking brain-dead son off life support
A Story…
• May 6, 2008; 56 White M; SIGSW; + DD was
transferred from a small rural hospital to HCMC
Story Continued
Story Continued
Story Continued
Story Continued
• Day 3
– Follow-up call to donor wife from LifeSource.
• Interested in donation outcome and what organs were transplanted.
• Day 15
– Family called LifeSource to request additional Surgeon
General certificates for each family member.
Conflict resolution
Conflicts
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Ages: 20-51
Race: Two white, Two Black
Injury: 2 GSW, 2 aneurysms
All timely referrals
Mention of donation: Two by family
LNOK: Two-wife, Grandmother, parents
Leadership involved-both LS and HCMC
Organs recovered
• Ensure OPO and hospital leadership have a
complete understanding of donor designation.
• Connect early with donor family.
• Conflict resolution process.
• Involve everyone in the Huddle – stops the
rumor mill.
• Adequate resources available
• When you uphold the law, you are doing the
right thing for the patient.
Challenge
• Donation process built on confidence of doing
the right thing
• Clear and consistent communication-HUDDLE
• Deep rooted commitment to move forward with
donation…Regardless
• Support until the end…acceptance by donor
family
4 Donors =
19 Lives Saved