Improving organ donation rates by modifying the family approach process.
BACKGROUND
The purpose of this study was to identify steps during family approach for organ donation that may be modified to improve consent rates of potential organ donors.


METHODS
Retrospective study of our local organ procurement organization (OPO) database of potential organ donors. Modifiable variables involved in the family approach of potential organ donors were collected and included race and sex of OPO representative, individual initiating approach discussion with family (RN or MD vs. OPO), length of donation discussion, use of a translator, and time of day of approach.


RESULTS
Of 1137 potential organ donors, 661 (58%) consented and 476 (42%) declined. Consent rates were higher with matched race of donor and OPO representative (66% vs. 52%, p < 0.001), family approach by female OPO representative (67% vs. 56%, p = 0.002), if approach was initiated by OPO representative (69% vs. 49%, p < 0.001), and if consent rate was dependent on time of day the approach occurred: 6:00 am to noon (56%), noon to 6:00 pm (67%), 6:00 pm to midnight (68%), and midnight to 6:00 am (45%), p = 0.04. Family approach that led to consent lasted longer than those declining (67 vs. 43 minutes, p < 0.001). Independent predictors of consent to donation included female OPO representative (odds ratio [OR], 1.7; p = 0.006), approach discussion initiated by OPO representative (OR, 1.9; p = 0.001), and longer approach discussions (OR, 1.02; p < 0.001). The independent predictor of declined donation was the use of a translator (OR, 0.39; p = 0.01).


CONCLUSIONS
Variables such as race and sex of OPO representative and time of day should be considered before approaching a family for organ donation. Avoiding translators during the approach process may improve donation rates. Education for health care providers should reinforce the importance of allowing OPO representatives to initiate the family approach for organ donation.


METHODS
Epidemiologic study, level IV. Therapeutic study, level IV.
From the University Medical Center Brackenridge (A.E., C.V.R.B., S.A., T.G., B.C.), University of Texas Southwestern-Austin; and Texas Organ Sharing Alliance (E.E., S.D., C.K.), San Antonio, Texas.
Aileen
A
Ebadat
Carlos V R
CV
Brown
Sadia
S
Ali
Tim
T
Guitierrez
Eric
E
Elliot
Sarah
S
Dworaczyk
Carie
C
Kadric
Ben
B
Coopwood
D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D015397:Program Evaluation; D012189:Retrospective Studies; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000592:standards / Q000706:statistics & numerical data*; D014481:United States