BEST PRACTICES: Making Sense of Organ, Eye and Tissue Referrals (Part 2)
In our last issue of Partners, we reviewed the “who, what, why, where and how” regarding the Donor Referral Hotline. As a follow-up, let’s take a closer look at the “how” as it relates to the differences between organ, eye and tissue donation and the agencies who respond to them.
Quick review of the Donor Referral Hotline basics:
- Hospitals are required under The Conditions of Participation Act to report all “imminent” deaths as well as actual deaths that occur in the hospital.
- The same 1-800 Donor Referral Hotline phone number is used to call in all imminent and actual deaths.
- The Donor Referral Hotline is based out of Denver, Colorado. The call center staff are specially trained to screen and triage organ, eye and tissue referrals.
“How” are referrals managed after the initial call to the Hotline?
When you call the Donor Referral Hotline, the call center agent will gather information about the patient, including their age, weight, and reason for admission. Most importantly, they will ask: “Is your patient on a ventilator and does she/he have a heartbeat?”
If you answer “Yes” – the referral is identified as an “imminent” death and paged out to Finger Lakes Donor Recovery Network as an organ referral.
If you answer “No” – the referral is identified as a death and paged out to the eye and/or tissue agencies that have agreements with your hospital.
A Coordinator from the appropriate organization will then call the patient’s bedside nurse or other healthcare provider currently involved in the patient’s care to gather more information – such as known past medical history, current lab numbers, and goals of care (imminent deaths). This information is used to further evaluate donation potential and determine next steps.
- Each referral will be evaluated individually
- Organ Procurement Organizations and tissue recovery agencies use different criteria to determine if a patient can be an organ, eye and/or tissue donor
- Past medical history and age restrictions vary between organ, eye and tissue donation
- Previous and current medical conditions that might rule out for one type of donation, may not rule out for the others
FACT: A patient referred for organ donation could be an organ donor even if they have hepatitis, certain types of cancer, are septic or have some organ systems failing.
Will I need to call back the Donor Referral Hotline for any reason?
After the referral is made, it may be necessary to call the Referral Hotline back, particularly if the Coordinator has not reached the hospital yet. Have the referral number (assigned during the initial call) handy so the referral can be accessed quickly.
Call the Donor Referral Hotline back if…
- there is a change in the patient’s medical condition or status
- you feel there is additional information the organ, eye or tissue agencies should be made aware of
- the family is discussing moving to comfort care measures*
- the family asks about organ donation
- the patient dies. Even if the patient had been determined not to be medically suitable for organ donation, they may still be a candidate for eye/tissue donation and those agencies will need to know their time of death
* For organ donation, the patient must remain on the ventilator right up until recovery of organs. Call the 1-800 phone number ASAP prior to extubation.
In the next issue of Partners: We’ll look at Best Practices for addressing when the family discusses moving to comfort care or asks about organ donation.