culture of donation doug miller symposium 2013 gundersen lutheran medical center lacrosse, wi
TRANSCRIPT
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Culture of Donation
Doug Miller Symposium 2013Gundersen Lutheran
Medical CenterLaCrosse, WI
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Trust• When cases go smoothly, both hospital staff
and families TRUST that donation is a good thing
• Good organ donation experiences breed a hospital/staff culture that supports future investment in the donation program
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Donor Resource Team• In 2007 Gundersen trialed a donor resource team
– 10 - 12 ICU nurses– Once verbal consent obtained, resource team RN
contacted – Resource team RN dispatched to adult ICU/ER/peds
ICU
• By 2009, resource team was deemed “successful”
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2013 Gundersen Donor Resource Team
Melissa Revels, RN Donation Liaison
Julie Gollnick, RN Team Leader
Chrissy Tevis, RN Team Leader
Rita Roberts, RN
Jake Clements, RN Erica Cook, RN
Seth Barna, RN
Tracy Quackenbush, RN
Kristen Krueger, RNBecky Kiesau, RN
Kathy Hageseth, RN Angie Haugen, RN
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Resource Team Duties 1. Complete consent form
• Why? Re-do’s and have lost some donors due to the descriptions given
• How? Utilize cheat sheet 2. Prep family for med/soc interview3. Discuss the donation process in-depth4. Give family permission to leave
• “How would you like to say goodbye?”• “I promise you we will take good care of Karen – she is
comfortable, and you need not worry.”• “We will call you with any updates.”
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McDonald Room
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Resource Team Duties (cont.)5. Enlist pastoral care/social work per family needs
– Offer spiritual support/listening – Contact clergy/arrange for rituals as able– SW: Insurance/FMLA, etc.
6. Assist bedside nurse with serologies and order sets
7. Present donation mementos to family
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Forward Focus - 2012 to Present• Problem: Data showed donation potential in non-realized
DCD cases – Families were offered donation at point of withdrawal of
ventilator…TOO LATE• Plan: Get resource team members involved earlier –
huddle/approach before family is “done”• Strategy: Orange sheet communication tool for resource team
members to stay abreast of open referrals –> initiate huddles/approaches sooner
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Orange Sheet – Do/Study1. Revised for more
“free-writing,” increasing its value/use
2. Donation liaison used sheet to track where things were at on a given referral
3. Paper sheet not part of patient’s permanent medical chart
1. Decisions for resource team made by FF team
2. Paper worksheet inconsistent with GL’s paperless charting
3. Orange sheet did not fulfill goal to deploy resource team earlier on organ referrals
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What We Learned: Act/Next Steps1. Evaluate FF Team:
• Enlist resource team members to the FF committee• Create new PDSA focus with resource team ownership
2. Consistency is Needed:• New donation/bereavement liaison to actively follow all
referrals - .5 FTE position3. Ongoing Donation Awareness:
• Rapid recovery• Invite PICU RN to join resource team
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Next Steps (cont.)• Resource team / MD connections• Strengthen MD knowledge/commitment to donation program
– Resident training– GL provider/UW OTD dinner – 11 providers– Reach out to cardiology MDs
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Thank you!