March 20, 2018 New York Academy of Medicine Region 9 Organ Donation and Transplantation Breakthrough Collaborative Kick-Off Meeting March 20, 2018 New York Academy of Medicine

The HRSA Organ Donation and Transplantation Breakthrough Collaborative Began in 2003 at the request of the Secretary of the US Department of Health and Human Services, Tommy Thompson, housed within HRSA Division of Transplantation Formal, concerted effort of the donation and transplantation community to bring about a major change to improve the organ donation system. Included participation of OPOs and hospitals with the largest organ-donor potential. Used the “Breakthrough Series Collaborative” method originally developed by the Institute for Healthcare Improvement, as the framework for the intervention.

Institute for Healthcare Improvement Collaborative Model for Achieving Breakthrough Improvement Here is an illustration of the IHI Model that was used. The model can be applied to any topic for which major change is desired. First, the topic of increasing organ donation was identified. Then, HRSA identified faculty members from high performing hospitals and OPOs, and developed learning content based on best-practices. They then invited the OPOs and hospitals with the highest potential for donors to participate. The format was structured into 3 Learning Sessions, or large in-person meetings, Between the Learning sessions, participant teams implemented the changes identified at the learning sessions in their own hospitals and DSAs using the Plan-Do-Study-Act rapid process improvement method. At the end, results were published and shared. This entire cycle took two years.

Breakthrough Collaborative Structure Identify team leadership and members Learning Sessions 3 in person meetings over the course of 9 months Plenary sessions, work groups, coaching, problem-solving Action Period (between learning sessions) Test and implement hospital-specific organizational approaches Remain in contact with other teams through email, webinar, conference calls Summative Congress & Publications Work is summarized Teams present results and lessons learned Measurement and Evaluation All teams track measures over time and key Collaborative leaders review each team’s monthly progress to assess the overall progress of the Collaborative

The HRSA Organ Donation and Transplantation Breakthrough Collaborative Expert practitioners drawn from hospitals and OPOs that had already demonstrated their ability to achieve and sustain high organ donation rates were chosen as faculty for the collaborative and best practices were gleaned from their institutions. Between October 2003 and September 2006, the number of total US organ donors increased 22.5%, an increase 4-fold greater than the 5.5% increase measured over the same number of years in the immediate pre- Collaborative period.

Collaborative 2003-2006

Goals of the Region 9 Collaborative Committed to saving or enhancing lives by spreading known best practices to the region’s hospitals, to improve organ donation rates Measures: Increase Eligible Donor Conversion Rate: Baseline 61.6% Increase Total Donor Conversion Rate: Baseline 36% Increase Transplanted Organs per Donor: Baseline 2.77

Region 9 Commitments OPOs and hospitals must be committed to implementing rapid and sustained change within each organization in order to improve donation rates Hospitals and OPOs must support team members in actively participating throughout Collaborative Learning Sessions and Action Periods Hospitals and OPOs should define ways that successes of efforts will be spread to other hospitals in hospital system or DSA So, what are we asking of you?

Region 9 Collaborative Timeline Jul-Sept 2017: Planning committee convened, conducted conference calls, engaged support of partners Oct 2017-Feb 2018: Developed strategies, goals and content with help from best practice experts March 20, 2018: Kick-Off Meeting Summer/Fall 2018: Learning Session Winter/Spring 2019: Learning Session Spring/Summer 2019: Summative Congress/Spread of Lessons Learned

Next Steps March 30, 2018, 1:00pm: Open Web-Ex/ Conference Call to: Share progress on actions committed to at today’s meeting Get ideas or coaching from others to help address any barriers to the actions Monthly calls to keep actions progressing Monthly report of Collaborative metrics Learning Session meeting in Summer/Fall 2018