Georgia Hospital Improves Organ Donation Process

Improved organ donation practices and greater program visibility led to a sustained increase in referrals, donors, and transplanted organs at a Georgia hospital, thanks to a focus on enhanced staff education and family communication.

“Collaborative Approach to Organ Donation in a Level II Trauma Center“ details the steps taken at Northeast Georgia Medical Center’s hospital campus in Gainesville as part of a multidisciplinary initiative to increase its organ donation rate.

Co-author Jesse Gibson, MBA, BSN, RN, TCRN, is the trauma program director and chair of the Donation Advisory Committee at the trauma center, serving 18 counties in a predominantly rural area. Part of a five-hospital health system, the medical center serves more than 2,600 trauma patients annually, with 95% having blunt trauma. Since the initiative was conducted, the hospital has been nationally verified as a Level I trauma center by the American College of Surgeons Committee on Trauma.

“By investing in staff members and partnering with bedside providers, our facility improved the organ donation experience for nurses, physicians, donors, and families,” Gibson says. “The outcome of that investment has been a hospital culture that values and celebrates organ donation as a standard of care for patients and families and an important part of honoring end-of-life wishes.”

The performance improvement initiative began at the end of 2017 to address concerns about lower-than-expected metrics related to the medical center’s organ donation process. Initial reviews of patient care revealed deviations from best practice, including missed referrals, care team members initiating discussions about donation with families, and misconceptions about the donation process.

The Donation Advisory Committee helped clarify language and revise policies related to end-of-life care, partnering with the hospital liaison at its organ procurement organization to increase physician and staff education and provide visibility for the process. Beyond engaging staff to reinforce the expected practice, a transitional language guide was provided to physicians and advanced providers to assist them in any initial discussions that may arise with families. A series of organ donation presentations in 2018 and 2019 provided staff education. They encouraged a dialogue about the process and review of the most recent organ and tissue data, metrics, and expectations.

To improve the program’s visibility, the project team arranged for a “Donate Life” flag to be raised on the main campus each time a family authorized organ donation. The team also implemented an “honor walk” to recognize the donor and family as donors are transported from the inpatient area to the operating room for organ procurement, with staff members lining the hallway to show respect and support. In 2019, the hospital held its first donation remembrance celebration, attended by families of organ donors and the clinical staff members who cared for them.

Since the project began, the number of organ referrals, donors, and transplanted organs has increased yearly, except for a slight dip in 2020 during the early COVID-19 pandemic. The number of organ referrals doubled, from 169 in 2015 to 320 in 2021. The number of organ donors in 2021 was 31, with more than 22 donors in 2015, 2016, and 2017. Similarly, the total number of organs donated in 2021 was 102, up from 16 in 2015. The rate at which an appropriate requestor initiated the conversation about organ donation with the family increased from 52% in 2015 to 90% in 2021.