Mercy at a Glance

1
Mercy at a Glance

• Founded by the Sisters of Mercy in 1893
• Tertiary referral center
• Three hospitals on three campuses
• Total licensed beds 917

• Total admissions 35,882
• Outpatient Visits 220,527
• Total employees 6,300
• Physicians on staff 720

2
Clinical Expertise

• Multi-organ Transplant Center since 1985
• Level II Trauma Center 61,758 patient visits
  busiest in
  Iowa
• Pediatric trauma room and Childrens ED
• Mercy One Air Ambulance -- 800 flights
• Leading cardiology program in state
• Leading team of regional neurologists
• Committed team of hospitalists
• Consistent focus on advanced education and
  credentialing for nursing professionals

3
Collaborative Participation

• Led by committed and respected nurses from ICU,
  transplant program and trauma
• Championed by well-respected transplant surgeon
  and internal medicine physicians
• Collaborative initiative presented to
  Administration and Physician Leaders
• Education continued on a departmental level with
  all crucial parties
• Neurology
• Trauma Team
• OR staff
• Anesthesia
• Critical Care Nursing

4
Engaging Physician Champions

• Iowa Donor Network and Collaborative Team worked
  together to identify key players as well as
  potential barriers
• Initial groundwork was established with
  intensivists, neurologists and critical care
  nurses
• Peer to peer influence has been most successful
• At the request of physician leaders, joint
  presentation regarding the Collaborative was made
  to entire medical staff at annual meeting. Strong
  support was generated in this setting!

5
Initial Positive Outcomes

• First DCD Donor occurred in December 04
• Community awareness has increased as evidenced
  by family response
• Enhanced internal communication and
  understanding between staff, especially
  physicians
• Collaborative has facilitated multi-disciplinary
  approach in relation to organ donation
• Implementation of clinical trigger cards, team
  huddles, rotating educational bulletin boards and
  development of family support team

6
Key Learning

• Remain focused, even in face of conflict
• Reinforce communication methods and messages
• Team work isnt just helpful, its essential
• Dont be afraid to say this isnt working
• Leave all egos at the door do whats right

7
Family Support Team in Critical Care and ER

• The Team
• Patient Care Manager
• Trauma Coordinator
• Bedside Nurse
• Chaplains
• Social Workers
• Physicians

8
Family Support Team Roles

• Crisis intervention, support, facilitation, and
  advocacy. Assess family dynamics
• Perceptions of patient condition and prognosis
• Be aware of spiritual needs as well as physical
  and emotional needs of the family
• Documentation on the Care Coordination Progress
  Notes in the Discharge section of chart good
  communication between shifts

9
Family Support Team

• Huddles
• Family support team members often serve as
  liaison between family and Iowa Donor Network
• Family Support Teams can be beneficial in any
  family crisis situation, not just organ donation.

10
2006 Benchmarking Data on Hospital Compliance
with Conditions of Participation Regarding Organ
Donation  January December, 2006  
Mercy - 2006 Success

• Timely Referral Rate 100
• Approach Rate 100
• Consent Rate 81
• Conversion Rate 81 (13/16)

Iowa Donor Network