Utilizing the Structure and Resources of a Multi-Hospital Health System to Improve Organ Donation
Health Resources and Services Administration
09/30/01 - 09/29/04, no cost extension until 9/29/05
Karl McCleary, Department of Health Policy and Administration
Linda M. Collins, The Methodology Center and Department of Human Development and Family Studies
Frank Lawrence, Department of Health and Human Development
David Wagstaff, The Methodology Center
M. Robina Josiah, Department of Health Policy and Administration
Cleveland Clinic Transplant Center, Cleveland Clinic Health System (CCHS), CCHS Quality Institute, and LifeBanc of Ohio
The purpose of this project was to evaluate the effectiveness of a comprehensive hospital development strategy for increasing organ donation within a multi-hospital system in Northeastern Ohio. Using the hospital's personnel as the primary change agents, in partnership with the local organ procurement organization, the goals of the study were as follows: (1) to increase referral rates of potential donors, (2) to increase the total number of organ donors within the health system, (3) to improve clinician attitudes regarding end-of-life management, and employee attitudes about organ donation in general, and (4) to improve organizational readiness for change across the health system regarding organ donor initiatives and CMS policies. During a pilot study across the nine participating hospitals, we determined the health system's current annual referral rate of potential donors is 86, and its actual number of organ donors is 15. Our objective was to achieve 100% compliance on our targeted outcome measures (i.e., referral rates, donation consents). The primary interventions for achieving these goals included: (a) developing a shared vision about hospital development among key stakeholders that link their efforts to existing health system resources and desired organ donor practices; (b) assessing commonly held knowledge, attitudes, and behaviors among clinicians, health care professionals, and staff that either enable/support organ donation or act as barriers in achieving key targets; (c) applying organizational change methodologies that reinforce, support, and promote the organ transplantation mission and values of the health system; and (d) developing quality indicators of the organ donor process to monitor, establish goals, and provide feedback on critical leverage points that affect donor outcomes.
Related Publications
Josiah, M.R., and McCleary, K.J. (2005) Attitudes to organ donation among critical care staff in a multi-hospital systems: 112S. Critical Care Medicine Dec 2005 33(12):Supp:A28.