1. HUDDLES Elizabeth Spencer, CPTC Director of Hospital Development Washington Regional Transplant Consortium

2. Why did WRTC begin to “Huddle?” To build partnerships  Joint accountability for donation outcomes To develop & utilize hospital-based champions to create a better donation process  Possible barriers in any potential case fixed by an “insider” To reach the goals of the Collaborative  Increase Conversion Rates to 75%

3. Benefits of Huddling to OPO… Fostering vested interest in outcome/ joint accountability among hospital partners OPO team in the loop on hospital’s care plan More focused pre- brain death care Putting donation on the radar of caregivers  Medical “preservation of the donation option” (NMS/PC)  Grave prognosis preparation (Coordinator jam) Internal help in problem-solving Appropriate co-requestors Timeliness of testing, suitability info, OR scheduling, etc. Creating an “All-About-the-Ones” attitude

4. Benefits of Huddling to the Hospital… Sharing our assessment of potential options, & developing a joint game plan, increases their comfort level with donation approach  Helps them medically preserve those potential options  Provides them with tools (i.e. resources, language, etc.) Results in increased comfort with OPO Coordinators & our good intentions  Further solidifies the OPO access & partnership Leadership roles within their institution Hospital partners become participants in the donation process  Witness & assist in something positive from something otherwise only negative

5. Benefits of Huddling to the Family… The Old Days: Hospital to OPO “Pass Off”  Did the family really benefit from this strict separation?  Donation as a scary thing from which the hospital caregivers must be disassociated Huddles → Unified Game Plan → Continuity of Care for the grieving family  Donation as a positive part of the care continuum  Consistency in information discussed We know what the hospital knows & can reinforce message

6. Learning from Huddles… Refining the donation process within each institution’s unique system  Improve process to set up for success with the very next potential case  Examples: Specific pediatric between-testing needs Addition of add’l department rep to Donation Cmte. Gaps in case preparation Real-time & post-case educational opportunities

7. Powerful Example: The Huddle Helped Make It Happen INOVA Fairfax Hospital last week  18/M/B s/p GSWH (alleged homicide) → BD  Very large family from Ghana  Minister responsible for “raising several people from the dead”  Withdrawal planned; Family in denial; Lawsuit threatened  Described as physically hostile towards hospital staff  “You can not approach this family about donation” Huddle: Meeting of the minds  Unique family support → donation approach plan Outcome:  6 Organs Transplanted  Total family transformation: at peace with death & interactions  Hospital grateful for assistance with the family

8. Why You Should Huddle… Increase the ability of your approach team to work effectively with families. Create an atmosphere of teamwork to fix problems/dissolve barriers. Foster partnership with both hospital leadership & frontline hospital colleagues. Develop sense of joint accountability. Some cases, that wouldn’t have converted, will.

9. Interested? First Steps: Identify potential Huddle participants  Attending MD, Intensivist, Resident, Bedside RN, Charge RN, etc.  Add’l hospital specific based on structure & needs Soc work, chaplaincy, Donation Cmte members: PI, OR administration, Clin Spec, etc.  OPO: Coordinator, HD, AOC, Medical Director Make “user friendly” for Coordinators & hospital participants  Develop & distribute hospital-specific contact plans  Utilize a resource on Huddle discussion topics to follow Preparation & maintenance:  Educate key players beforehand & in real-time Purpose Process Benefits  Keep huddles brief & to-the-point  Maintain consistency: Expectation of a Huddle every time

10. Questions?