Improved Organ Donation Rates in Patients with Brain Death After Adopting a Comprehensive Program at the Hamilton Health Sciences Corporation

In 2007, Hamilton Health Sciences (HHS) was recognized as a center of excellence, leading Ontario in the numberofmultipleorgandonors.Toovercomebarriersplaguingsuccessfuldonation,HHShaddevelopeda comprehensive donation program. No standardized approach to donation existed before the creation of Ontario’sTrilliumGiftofLifeNetwork(TGLN)in2000.Thispaperisanexplanatorypolicyanalysistodescribe howthischangecameabout.HHShasmadeorgan/tissuedonationapriority.Adoptedstrategiesinclude:a dedicated organ/tissue committee with participating intensive care unit physicians, chiefs of practice, nurses and senior administration; clinical triggers; a “pre-approach plan” to ensure timely discussion; public and healthcareteameducation;andstandardizedprotocols.TGLNhasbeenoperationalatHHSsince2002,with full-time,on-sitenursessince2003.ThenumberoftraumapatientsadmittedtotheHHSincreasedfrom398 patientsin2001/02to526in2006/07.Between2001/02and2006/07,therewasalsoanincreaseinthe numberofcorneadonations(48vs.145),andmultiplesolidorgandonors(12vs.32).In2007,HHSreported high rates of referral (100%), approach (86%) and consent (61%). The experience for HHS has been rewarding,yetwecontinuetofacechallengesrelatedtoresources,educationandculturaldiversity.