Raising the bar on organ donation

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Whether it’s helping patients get a second chance at living a fuller life or supporting them through end-of-life care, it’s safe to say that physicians and staff at William Osler Health System (Osler) are dedicated to providing the best care possible. As one of Canada’s largest community hospitals, we serve approximately 1.3 million people living in one of the fastest growing and most culturally diverse regions in the country.

While we recognize that conversations around something like may not be the easiest for our community to engage in, Osler continues to make it a priority – offering every eligible patient the opportunity to make an informed decision about organ and tissue donation, while respecting their beliefs, values and wishes

Currently, there are approximately 1,600 Ontarians waiting for a life-saving organ transplant. We understand that in order to help these men, women and children, organ donation is becoming an integral part of end-of-life care across the province. At Osler, we are honoured to be one of the leaders in this area. In 2015, Osler had 20 organ donors – which is the highest number of donors in the Greater Toronto Area and third highest overall in Ontario, according to the Trillium Gift of Life Network (TGLN).

While this achievement can be attributed to the efforts of Osler’s tremendous clinical team, it is first and foremost a testament to the generosity of the donors who are able to give the gift of life to others. After all, a single donor can save up to eight lives and enhance as many as 75 lives through tissue donation. Through the efforts of the Osler clinical team and the compassion of the patients and families we serve, organ donations at our hospitals have steadily increased. We had 16 donations in the first three quarters of the 2015/16 fiscal year, relative to 11 donations in the 2013/14 fiscal year and five in the 2012/2013 fiscal year.

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As we remain committed to improving our organ and tissue donation performance, it is important that we also reflect on the journey that led us to where we are today. Osler was not always among the highest in the province for its organ and tissue donation performance. In fact, just a few years ago, Osler was near the bottom of the list among GTA hospitals for its performance and with that, we identified areas where we needed to improve.

In the time since, and with the help of a dedicated organ donation program involving a multi-disciplinary clinical team and support from our partners at TGLN, Osler has achieved remarkably improved performance. This includes increases to Osler’s routine notification rate – which measures our compliance in notifying TGLN of all patients who have passed away or those who are at risk of imminent death, as well as our conversion rate, which measures our performance in facilitating organ donation upon identification of potential organ donor cases.

It is important that TGLN be notified so that all potential opportunities for donation can be identified and more lives can ultimately be saved through organ and tissue donations and transplantations.

As we started on our improvement journey, we had to take a close look internally at our processes related to these two measures, identify areas where we could improve, and implement strategies to target our efforts for better results. Some of these improvements included:

  • The establishment of a Hospital Donation Physician , and alignment of work with TGLN’s Regional Medical Lead to ensure donation is integrated into end-of-life practices at the hospital;
  • The adoption of TGLN clinical triggers, which guide staff in the ICU on when to call TGLN about potential donors; and
  • The introduction of a process that prompts staff to notify TGLN when a patient has passed away.

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As a result of these actions, we have been able to remarkably improve our performance over the last few years. According to the latest data, our conversion rate increased to 67 per cent after the first three quarters of the 2015/2016 fiscal year – improving from 22 per cent in the 2012/2013 fiscal year and 42 per cent in the 2013/14 fiscal year. This is also well above the current provincial conversion rate of 54 per cent.

Osler’s routine notification rate has also improved. According to the latest data, we have increased it to 93 per cent in the first three quarters of the 2015/16 fiscal year, from 80 per cent in the 2013/2014 fiscal year.

While we recognize that we are making great strides in this area, we also understand that our work is far from over. We are grateful to our compassionate donors and we are proud of Osler’s staff and physicians who remain dedicated to this important work. We will continue building on these positive changes so that we can make a difference in the lives of patients and families, and beyond for all Ontarians.

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