“ Ignite The Fire”

“Ignite the Fire” Golden State Donor Services Sierra Eye and Tissue Donor Services

212 Donation Summit The EXTRA Degree May 15, 2008

 

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How To “Be” Leaders for Organ, Eye & Tissue Donation Teaming with One Another Actively Listening & Learning In Action, Making: Requests Offers Commitments  Focused on Achieving Our Goals    

 

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Net Forward Energy What We Think…and What We Say… Makes All the Difference in the world!!!!  

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Overarching Strategies For System Wide Improvement  Unrelenting Focus on Change,            Improvement, and Results  Rapid, Early Referral & Linkage  Integrated Donation Process Management  Aggressive Pursuit of Every Donation                                 Opportunity   

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Key Elements of Breakthrough Improvement  Will to do what it takes to change  to a new system  Ideas on which to base the  design of the new system  Execution of the ideas  

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Number of Organ Donors by Month Transplant Collaborative

700 650

2nd Donation Collaborative

Old System

1st Donation Collaborative

600 550 500 450

New System 2002

2003

2004

2005

1 4

1 4 7 10

2001

1 4 7 10

2000

1 4 7 10

1 4 7 10

1999

1 4 7 10

1 4 7 10

400 1 4 7 10

Number of organ donors

750

2006

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Holding the Gains…..But More Improvement is Needed Organ Donors

750 700 650 600 Collaborative Starts Here

550 500 450 400

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1999 2005

2000 2006

2001 2007

2002 2008

2003

2004 7

Donation Trends up in 4th Quarter -1.4% 2150 2100

-0.4%

3.0%

2050 2000

1.8%

2006 2007

1950 1900 1850 1800

1st Qtr

2nd Qtr

3rd Qtr

4th Qtr

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Percentage Point Gap .

Collaborative Conversion Rate Gap - by Region 80% 75% 70% 65% 60% 55% 50% 1

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3

4

5

6

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9

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OPTN Region Range: 3.2 percentage points above the goal to 12.0 Percentage points below the goal

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OT PD .

Goal OTPD by Region 4.00 3.75 3.50 3.25 3.00 2.75 2.50 2.25 2.00 1

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3

4

5

6

7

8

9

10

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OPTN Region Range: 3.52 OTPD to 3.86 OTPD

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GSDS Conversion Rate and Yield Performance by Year 2004

2005

2006

2007

Conversion Rate

60%

57%

75%

68%

Yield

3.17

3.31

2.79

2.86

 

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GSDS Donor Quality by Calendar Year 100 50 0

72% 26% 2% 2005

62%

61% 36%

31% 7% 2006

3%

SCD ECD DCD

2007

 SCD = Standard Criteria Donor  ECD = Extended Criteria Donor 

 Pt’s greater than age 55 with risk factors

 DCD = Donation After Cardiac Death    Recover Organs after heart stops

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The U.S. Opportunity: OTPD Gap = - 0.72 Organ Donors = 7985 # Additional Organs Transplanted  With Gap Closed = 7985 x 0.72  = 5579  More Transplants  (23% Increase)  

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Your DSA Opportunity Partnering with GSDS!  Conversion Rate Gap

 National Goal – 75%  2007 = 68%  Gap = 7%   OR   6 Additional Organ Donors!

 Donation After Cardiac Death 

 National Goal – 10% of total Donors  2007 = 4%  Gap = 6% or  3 Additional DCD Donors!

 Organs Transplanted per Donor Gap

 National Goal ­ 3.75  2007 = 2.86  Gap = .89   OR   58  more Organs Transplanted!  

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“Every System is perfectly designed to get exactly the results that it gets.”  

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It’s All about CHANGE!!

 Improvement requires change, but  not all change is improvement  Change should be thought of from  the standpoint of those who will  benefit from the change  The Model for Improvement provides  a framework for making effective  change  

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Integrated & Flexible Hospital/OPO Donation Team How it looks:

Administrative and clinical advocacy for  continuous process improvement  Hospital relations takes on a 24/7 mindset Willingness to switch roles to ensure best  outcomes Make requests and offers;  COLLABORATE! One size does not fit all!  

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High Leverage Changes: Hospital/OPO Partnerships      

Advocate Organ Donation As the Mission Involve Senior Leadership to Get Results Deploy A Self­Organizing OPO/Hospital Team Practice Early Referral, Rapid Response Master Effective Requesting Implement Donation After Cardiac Death

 

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Building bridges between the hospital and the potential donor’s family…  

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First Things First: Hospital/OPO Partnerships        

Physician & clinical champions are known Process in place for conducting real time  death record reviews OPO “Presence": In­house coordinator Focused change agenda based on analysis of  current hospital data "Team Huddles" are the norm Clinical Triggers in use After Action Reviews are the norm "Effective Requesting" in place, in action  

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Think About the Possibilities!!  If every Level 1 Trauma Center in the  US raised their Conversion Rates to  75% there would be an additional 501  831 Additional Organ Donors! organ donors.  If every Level 2 Trauma Center in the  US raised their Conversion Rates to  75% there would be an additional 330  organ donors.  

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High Leverage Transplant Practices Efficiently plan & manage the donor  case process Involve Critical Care specialists to  maximize donor management Relentlessly advocate for the  placement of every transplantable  organ Active & progressive acceptance to  increase organ transplantation  

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Collaborative Improvement: Eye & Tissue Donation

 Collaborative work has had positive impact  on eye & tissue donation  New opportunities to engage hospitals  Eye & Tissue referrals are stable/increasing  DSAs are utilizing Collaborative  improvement methods   Implementation of state donor registries  PLENTY of room for life­enhancing  improvement!  

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Golden State Donor Services DSA Medal of Honor Winners     

*Santa Rosa Memorial Hospital Sutter Roseville Medical Center Kaiser Foundation Hospital Mercy San Juan Hospital University of California Davis Medical Center *Denotes 3X Winner   24

Our Future  75% conversion rate  3.75 organs transplanted per donor  10% DCD in each DSA  35,000 deceased donor organs  transplanted annually

 

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Sunday, September 24, 2006

Cystic Fibrosis Patient After Double Lung Transplant

“A quiet revolution in  the world of lung  transplants is saving  the lives of people  who, just two years  ago, would have  died on the waiting  list. In the past 16  months, waits have  shortened, lists have  shrunk, and the  number of lung  transplants has gone  up. Further  improvements are  expected this year.” 

Lung Patients See a New Era of   26 Transplants

Sunday, September 24, 2006 “A quiet revolution in  the world of lung  transplants is saving  the lives of people  who, just two years  ago, would have  died on the waiting  list. In the past 16  months, waits have  shortened, lists have  shrunk, and the  number of lung  transplants has gone  up. Further  improvements are  Hannah is now studying Social Work in college. expected this year.” 

Cystic Fibrosis Doublewith Lungtransplant Transplant ShePatient plansAfter to work

She plans to work with transplant patients when she graduates. Lung Patients See a New Era

Transplants

 

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No single person saved Hannah’s life. Her life was saved by many people in many places over many months, always choosing to do the right thing, the thing that was most likely to increase organ donation and transplantation.

YOU can make a difference!  

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Faces of those who wait… Brandon, age 9 YOU are their HOPE!!  

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Lifesaving Requests  Commit to reaching the national donation & transplantation goals

 Designate a key hospital leader accountable for action & results on this initiative

 Track organizational progress through quality indicators

 Implement proven best practices  BE BOLD for those who give and for those who wait!

 

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Remember…YOU are the extra degree…at 211º water is hot… at 212º it boils…

You

Are responsible for your results It’s time to turn up the heat. It’s time to Commit! 33

Putting a Face on Performance It Really Is All About the 1’s… 1 Donor at a Time 1 Donor Family at a Time 1 Transplant Candidate at a Time 1 Month at a Time 1 Day at a Time ...and each 1 of YOU!  

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