1. HONORING THE DONOR’S WISHES
Susan Mau Larson
Public Affairs Director, LifeSource
April 28, 2011

2. Honoring the Donor’s Wishes
Goal: to enhance and strengthen our ability to uphold a patient’s designated wishes and the law.
What is donor designation?
What does it mean when someone has designated him/herself to be a donor?
What is our responsibility in honoring donor designation?

3. Donor Designation
Honoring an individual’s documented wishes to be an organ and tissue donor.

4. Legal Framework
1968 – Uniform Anatomical Gift Act adopted by every state “Donation is a gift”
1987, 2001 (SD), 2002 (MN) Revisions
2007 – MN, ND, SD adopt revised UAGA reinforcing donor designation (To date 39 states and territories have adopted)

5. Implementation
In May 2003 LifeSource began honoring an individual’s documented wishes to donate
Preparation for implementation included:
Gathered stakeholder input
Established policies and procedures
Gained Board of Directors approval
Conducted training with staff and hospital partners
Shared progress with media
Incorporated donor designation into public messaging

6. Law of Donation: Uniform Anatomical Gift Act
ESTATES OF DECEDENTS; GUARDIANSHIPS MN CHAPTER 525A Preclusive Effect of Anatomical Gift, Amendment, Or Revocation. (a) ... in the absence of an express, contrary indication by the donor, a person other than the donor is barred from making, amending, or revoking an anatomical gift of a donor's body or part if the donor made an anatomical gift of the donor's body... An anatomical gift made in a will, a designation on a driver's license or identification card, or a health care directive . . ., and not revoked, establishes the intent of the person making the designation and may not be overridden by any other person.
Tim Sullivan

7. Who Owns the Decision
Decision belonged to decedent when she was alive;... Only if she decided “not to decide” does the decision belongs to the living.
Tim Sullivan

8. Legal Status of Donation Decision
A Testamentary Decision--Cannot be Revoked except for Public Policy Reasons in a Court of Law
A Statutory Right
A Charitable Gift
Tim Sullivan

9. Testamentary Decision
ESTATES OF DECEDENTS; GUARDIANSHIPS
Document of Gift is like a Will, but acted on prior to probate
The Organ Procurement Organization is the Executor, Both Empowered and Required to Carry Out the Wish
The Intent of the Decedent is the Core Question
Tim Sullivan

10. Factors in Legal Noncompliance
Compassion
We identify with the Living
We want to help the Living
Fear
We fear the Living, and their lawyers
We want to maintain strong relationships with hospital
We fear the media
Tim Sullivan

11. Immunity
Complete statutory immunity for persons who facilitate anatomical gifts pursuant to Anatomical Gift Act
Tim Sullivan

12. Statutory Obligation
This obligation is shared by donation agencies and the hospital
Its Your Risk, Too
Nowhere Does it say We Can Ignore this Gift
Statutory Immunity Covers This
Tim Sullivan

13. Organ Donors with
Donor Designation

14. Experience
From May 2003 through December 2009 LifeSource managed 1068 organ donation cases
14 potential cases (5/03-12/09) had some conflict or confusion
9 of these 14 situations resulted in organ donation
Susan Mau Larson

15. Experience: Factors in Conflict Situations
Susan Mau Larson

16. How We Proceed Huddles with care team to discuss situation and plan
Engagement of LifeSource and donor hospital leadership
Adequate on-site resources from LifeSource
Susan Mau Larson

17. Family Interactions Consistent messaging for hospital and LifeSource.
Avoid language which gives perception of choice.
Stay engaged with the family during and after the donation.
Provide document of donor designation and brochure
Susan Mau Larson

18. Honoring the Donor’s Wishes…
Bringing life to an individuals’ gift relies on the support of all involved – procurement organizations and donor hospitals. We must do this in partnership.

19. Honoring the Donor’s Wishes
KARE-11
March 11, 2011
A lasting gift: Forest Lake boxer helps others in his death
LINO LAKES, Minn. -- A Forest Lake High School senior who collapsed in the boxing ring and later died continues to give to others.
"He was a giver.  He was a giver.  He wanted people to be taken care of," said Susan Smith about her son, Charlie, who has helped dozens of people by becoming an organ donor.
Susan Mau Larson

20. Questions/Discussion
Susan Mau Larson
THANK YOU

21. Honoring Donor Designation
Who We Are
Honoring Donor Designation
Sheila Elledge, RN, BS
Nurse Manager Burn Unit
Hennepin County Medical Center
Sue Weese, RN, BSN, CPTC
Lifesource In-house Coordinator

22. Who We Are 465 Staffed beds 22,937 Inpatients per year
101,658 ER visits per year
3,000 1st time trauma admissions of which 31% were referred to us by other hospitals
327,165 Clinic visits per year 22

23. Why We Are Here 2006 – 2010 YTD Averages
Authorization and Conversion = 78%
% of Total LifeSource Donors = 12%
% of Total LifeSource DCD Donors = 34%
Organs transplanted per donor = 3.77
Number of Tissue Donors = 32
Donor Designation Cases = 48%
Medals of Honor Won = 4
2009 Gold Medal Winner 23

24. We Are Also Here Because… DSA Leadership Position
First to adopt DCD and Resident Road Show
Media Stories and Promotion of Donation
Donate Life Month/Flag
MHA and CEO Summit
DD Letter in Family Folder
Experience w/ Donor Designation and Conflict (4 cases) 24

25. Honor the patient’s Gift Follow Donor Designation Law
We Are Trying To…
Excellent end of life care
Honor the patient’s Gift
Follow Donor Designation Law
Minimize Fear of Family
Maximize the gift 25

26. Who We Are
Family considers taking brain-dead son off life support 26

27. A Story…
May 6, 2008; 56 White M; SIGSW; + DD was transferred from a small rural hospital to HCMC

28. Story Continued 28

29. Story Continued

30. Story Continued 30

31. Story Continued Day 3 Day 15
Follow-up call to donor wife from LifeSource.
Interested in donation outcome and what organs were transplanted.
Day 15
Family called LifeSource to request additional Surgeon General certificates for each family member. 31

32. Conflict resolution

33. Conflicts Ages: 20-51 Race: Two white, Two Black
Injury: 2 GSW, 2 aneurysms
All timely referrals
Mention of donation: Two by family
LNOK: Two-wife, Grandmother, parents
Leadership involved-both LS and HCMC
Organs recovered 33

34. Connect early with donor family. Conflict resolution process.
Ensure OPO and hospital leadership have a complete understanding of donor designation.
Connect early with donor family.
Conflict resolution process.
Involve everyone in the Huddle – stops the rumor mill.
Adequate resources available
When you uphold the law, you are doing the right thing for the patient. 34

35. Challenge
Donation process built on confidence of doing the right thing
Clear and consistent communication-HUDDLE
Deep rooted commitment to move forward with donation…Regardless
Support until the end…acceptance by donor family 35

36. 4 Donors = Lives Saved