title: In-house coordinator programs improve conversion rates for organ donation.
abstract: BACKGROUND
  The organ supply shortage continues to be a public health care crisis, with nearly 20 people dying each day awaiting transplantation. Inability to obtain consent remains one of the major obstacles to converting potential donors into organ donors. We hypothesize that the presence of in-house coordinators (IHCs) from organ procurement organizations (OPOs) will improve organ donor conversion rates.
  
  
  METHODS
  This retrospective review analyzed the effect of an IHC program on organ donation outcome. Referrals for possible organ donation from three IHC programs to regional organ procurement organizations were included. Data regarding organ donation demographics and outcomes were compared before (Pre-IHC) and after (Post-IHC) the establishment of an IHC program. The main outcome measures were conversion and family decline rates. The conversion rate was calculated as the number of actual donors divided by the number of eligible deaths and is represented as a percentage. The IHC functioned to assess for potential donors, ensure timely referrals, provide hospital staff education, assist with family consent and donor management, and provide family support.
  
  
  RESULTS
  Post-IHC was associated with a significantly lower family decline rate (6% vs. 18%, p < 0.001), a significantly higher consent for research rate (8% vs. 0.4%, p < 0.001), and a significantly higher conversion rate (77% vs. 63%, p = 0.007) compared with Pre-IHC. In addition, a significant increase in referrals per day (0.35 vs. 0.27, p < 0.05) and organs transplanted per eligible death were noted Post-IHC.
  
  
  CONCLUSIONS
  The presence of an IHC program significantly improves conversion rates for organ donation as well as organ yield. An IHC program should be considered as a viable option to bridge the gap between organ supply and organ demand.
authors.affiliation: Division of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA. ali.salim@cshs.org
authors.forename: Ali
authors.initials: A
authors.lastname: Salim
authors.forename: Cherisse
authors.initials: C
authors.lastname: Berry
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Ley
authors.forename: Danielle
authors.initials: D
authors.lastname: Schulman
authors.forename: Chirag
authors.initials: C
authors.lastname: Desai
authors.forename: Sonia
authors.initials: S
authors.lastname: Navarro
authors.forename: Darren
authors.initials: D
authors.lastname: Malinoski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D007258:Informed Consent; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011368:Professional-Family Relations; D015397:Program Evaluation; D012017:Referral and Consultation / Q000458:organization & administration*; D012189:Retrospective Studies; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D055815:Young Adult