EFFECTIVE REQUEST PROCESS

1
EFFECTIVEREQUEST PROCESS

• A Collaboration Between
• Hospitals and OneLegacy
• Margie Whittaker, Nurse Manager, SICU
• Mission Hospital
• Yolanda (Yuli) Coffey, BA Family Care Coordinator
  OneLegacy

2
Order of Process

• 1. Timely Referral
• 2. Timely response by OPO
• 3. Early family support provided by hospital
• 4. Communication/Education regarding patients
  care
• 5. Early involvement of OneLegacy with family
• 6. Use of huddle
• 7. Following Approved Brain Death Policy
• 8. Provision of adequate time with family
• 9. Appropriate requestor(s) utilized

3
Timely Referral
4
Timely Response by OneLegacy

• TIMELY RESPONSE
• Is within 1 ½ hours of referral
• being made

5
Early Family Support Provided

• Initial impression begins in the ER and sets the
  tone for the entire hospital experience.
• Families replay their hospital experience for
  months and years to come
• It is a day in our life.a lifetime of
  memories in theirs.

6
When families have been well informed by Hospital
Staff about their loved ones care and condition
Communication/Education Regarding Patients Care

• The better prepared they are to accept the
  outcome and make end of life decisions.

7
Early Involvement of OneLegacy with Families

• OneLegacy early involvement is key to ongoing
  assessment of donation readiness
• Prior to first documentation of Brain Death
• End of life discussions
• -DNR
• -Final Religious Rituals
• -Funeral Planning
• Withdrawal of care mentioned

8
Use of Huddle

• Ideal Huddle
• OneLegacy Staff, Physician, Nurse, Chaplain,
  Social Worker, etc.
• Family assessment
• Review ideas generated to continue to meet needs
  from initial brain death exam to approach for
  donation

9
Brain Death Policy

• Current copy in the Organ Donation Manual
• Staff familiar with policy
• Dont have one, working on one - Let your
  Hospital Services Coordinator help you formalize
  one.

10
Adequate Time with Family

• Trust
• Emotional level of family
• Acceptance of Death
• Family power dynamic (who is in charge)
• Timing/Pacing
• The Grief of family (rituals, normalizing
  feelings)

11
Appropriate Requestor

• Identified during the HUDDLE
• TEAM HUDDLE helps identify not only the
  requestor but the most appropriate time and place
  for approach.
• INFORMED decision can only be made if timing is
  appropriate and the most effective requestor
  makes the approach
• Each family deserves the opportunity to make an
  informed decision about donation-IF the patient
  is suitable candidate for donation

12
If Family Declines Donation

• Offer support to family as they gather relatives
  and friends to say good-bye
• Often stay until ventilator is removed
• Provide packet of information
• Offer help with funeral arrangements, grief
  support, and referrals

13
If Family Consents to Donation

• Offer family a Memory Box, Handprint, Angel
• Support family friends as management of the
  donor continues
• Provide grief packet
• Including information on organ and tissue
  donation
• Family Services support
• Call family after recovery of organs to provide
  information about what organs were recovered

14
Aftercare Program

• Sympathy Card
• Organ Placement/Tissue Disposition Letter
• General information about recipients who received
  transplants and what tissue was recovered with
  possible uses of tissue

15
Aftercare Program

• Letters of Support
• at 6 weeks, 3 months, 6 months, 18 months, 24
  months
• Include grief literature, information on writing
  to transplant recipients, our volunteer program,
  etc.
• Phone call to assess coping, offer referrals and
  support
• Anniversary Card on One Year Anniversary of
  Loved Ones Death

16
Donor Remembrance Ceremonies
White doves are released at the end of the
ceremony
Each family receives a Life Bridges Donor Pin
Pendant set
Terry Harrington, heart recipient and the voice
of Lisas sax on the Simpsons, performs
Families personalize balloons before the balloons
are released
17
Donor Family and Recipient Meetings
A lung recipient holds a picture of his donor
during the meeting with his donors mother.
A donor mother listens to her sons heart beating
in the recipient
Liver recipient Jeff Hedrick meets his donors
parents for the first time on the one-year
anniversary of his transplant.
18
Donate Life Run Walk
Participants walked through the Circle of Life
Garden and donor families found this to be a
place of reflection.
Donor families formed teams of all sizes and
walked in honor of their loved ones.
Tshirts were personalized with each donors
picture