• Comprehensive Medical Record review

• Preliminary Determination of Medical

Suitability

– Infectious Disease Testing

• Identifying Donation wishes of the patient

• Communication and plan to return on site

– Follow by Phone

• Initiation of Gift of Life paperwork

Planning Ahead…

Family Communication And The Donation Conversation:A Process Not An Event

•Family given grave prognosis

•Team explains B/D or W/D

•Support

•Questions and answers

•Given B/D news or W/D decision is finalized

•Family given time to grasp death diagnosis

•Grief support

•Donation conversation and decision

•Plan for closure, final needs and aftercare

• Information gathering and sharing

•Team planning

Six Scenarios That Trigger A Donation Discussion

Family Mentions

Donation

Brain Death

Pronounced; Explained

to the Family / Family

understands

Decision To Limit,

Decelerate or W/D

Therapies

Pulmonary or

Hemodynamic

Instability

(On the Verge of Coding)

Donation Mentioned

Independent of

Gift of Life

Patient and Family

Family Understands Death /

Non-Survivable Nature of Injury (Prior to Formal BD Pronouncement

or Withdrawal Meeting)

Drivers’ License Registries

Donor Designation Rates In Our Region

50.4% of all license and ID holders in Delaware are registered organ donors.

33.5% of all license and ID holders in New Jersey are registered organ donors.

46.1% of all license and ID holders in Pennsylvania are registered organ donors.

0

20,000,000

40,000,000

60,000,000

80,000,000

100,000,000

120,000,000

Donor Designation in the United States

118,876,309 as of 3/31/14

25%27%

33%

28%30%

38%

33%

37%

42%

36%

42% 42%

45%

48%

43%

49%

52%

40%

0%

10%

20%

30%

40%

50%

60%

Organ Donors Tissue Donors Eye Donors

2008 2009 2010 2011 2012 2013

Impact on Donation, 2008-2013Designated Donors Among Recovered Donors

Family Communication And The Donation Conversation:A Process Not An Event

•Family given grave prognosis

•Team explains B/D or W/D

•Support

•Questions and answers

•Given B/D news or W/D decision is finalized

•Family given time to grasp death diagnosis

•Grief support

•Donation conversation and decision

•Plan for closure, final needs and aftercare

• Information gathering and sharing

•Team planning

Authorization vs. Disclosure?

Authorization Form

• used in the absence of a

gift document. Next of kin

decision of gifts to give

including research

opportunities

Disclosure Form

• used in the presence of a

gift document. Next of kin

informed of patient’s

decision. NOK still has

authority to make decision

regarding research

opportunities unless

otherwise specified by

patient.

Forms used equally for Brain Death donation and

Donation after Cardiac Death

• Gift of Life coordinator accesses secured DMV 24-hour

hotline to ascertain status of donor designation

• (+) Donor Designation communication to care team

• When Gift of Life coordinator initiates family discussion,

it is explained that “your loved one has already made this

decision”

• The entire donation process is explained to the family

– Questions/Concerns are addressed

• Any decision to act on legal gift document is made in

conjunction with care team, GLDP and hospital leadership

Gift of Life Donor Program

Clinical Practice In Presence of a Gift Document