| TIME | PARTICIPANTS | CONVERSATION POINTS |
|---|
| During initial donation evaluation | - OPO coordinator
- Nurse
- Patient’s attending
- Consulting physicians
- Unit leadership
- Supportive staff actively involved with patient and family, e.g., social worker, spiritual care
| - Consider monitoring the impact the timeliness had on
- Whether the opportunity for donation was maintained clinically
- How it relates to whether the family authorized donation
- Breakdown the timeliness of calls by department, possibly by service line, by type of patient, etc.
|
| During OPO check-ins | - OPO coordinator
- Nurse
- Patient’s attending
- Consulting physicians
- Unit leadership
- Supportive staff actively involved with patient and family, e.g., social worker, spiritual care
| - Updates on the current status of the patient and plan for continued treatment.
- Any updates on the family and possible clues that they may be considering WLST.
- Reminders of suggested bridging or transition verbiage for the hospital patient care team, should there be a need to bridge time for the donation conversation.
|
| Prior to the physician’s poor prognosis discussion with the family | - OPO coordinator
- Nurse
- Patient’s attending
- Unit leadership
- Supportive staff actively involved with patient and family, e.g., social worker, spiritual care
| - Any updates on details about the family and identification of the legal next of kin / legal authorizing party (LNOK/LAP) according to the UAGA, as well as the patient’s donor registration status.
- Discuss plan for discussion of poor prognosis and plan for WLST and how to transition to the OPO for the donation conversation if the family expresses desire to pursue WLST.
- Identification for the need of an interpreter based on the family’s preferred primary language.
- Discussion of best location and time for this conversation.
|
| After the physician’s poor prognosis discussion with the family | - OPO coordinator
- Nurse
- Patient’s attending
- Unit leadership (if needed)
- Supportive staff actively involved with patient and family, e.g., social worker, spiritual care
| - Discuss the outcome of the conversation and the family’s current mindset.
- In the case of a brain death (BD) discussion, identify the family’s understanding of BD, the finality and the death of their loved one and strategize the introduction of the OPO coordinator to the family.
- In WLST situations, assess family readiness to move toward WLST.
- Was donation initiated by the family? Are they asking end of life care related questions?
- Would it be in the best interest for the OPO to be introduced to the family to be available to address donation related questions.
- Identify if a collaborative donation conversation involving the physician (or alternate hospital patient care team member) and OPO coordinator would be beneficial for the family.
- If a collaborative approach is utilized, strategize each participant’s role in the conversation, e.g., physician or alternate will address medical and hospital-related questions, the OPO coordinator will address donation-related questions.
- If the patient is a registered donor, it is vital for the OPO coordinator and hospital patient care team to strategize on how best to present donation and support the family through the next steps, while honoring the patient’s decision.
|
| After the family has made a decision for donation | - OPO coordinator
- Nurse
- Patient’s attending
- Unit leadership (if needed)
- Supportive staff actively involved with patient and family, e.g., social worker, spiritual care
| - OPO coordinator will inform the hospital patient care team of the outcome of the donation conversation and / or any further needs expressed by the family.
- If the family authorizes donation, the OPO coordinator will communicate any requests from the family and will provide a copy of the authorization form for the patient’s chart.
- The OPO coordinator should communicate to the hospital patient care team what to expect during donor management and organ recovery.
- If the family declined donation, the OPO coordinator will inform the hospital patient care team, and the nurse or social worker, should place a note in the patient’s chart that donation was offered and that the family declined donation.
|
