title: Effects of an in-house coordinator and practitioner referral rather than proxy referral on tissue donation rates.
abstract: BACKGROUND
  Timely referral of patients following asystolic death to an organ procurement organization (OPO) may increase tissue donation rates. Lack of education of health care providers and nonphysicians (admitting department) about timely referral to the OPO following asystolic death may adversely affect tissue donation rates. We hypothesized that using an in-house donation coordinator for provider education and changing the responsibility for calling the OPO from the admitting department to the licensed independent practitioner (LIP) declaring death would increase timely referral and tissue donation rates.
  
  
  METHODS
  An education program was developed in 2005 by a newly hired in-house coordinator to highlight the importance of tissue donation. In addition, to improve timely referrals to the OPO after death, the instructions accompanying the working copy of the death certificate were altered to require the patient's LIP to call the OPO within 1 hour of death (early 2007). Rates for both timely referrals and tissue donors were modeled by a Poisson regression model with a log link function.
  
  
  RESULTS
  Timely referral rates rose from 48% before the interventions to 72% after the intervention (P < .0001). The number of tissue donors per number of referrals also increased significantly (P = .025) over that period.
  
  
  CONCLUSIONS
  An in-house donation coordinator initiated education program and LIP referral rather than referral by other parties following asystolic death results in higher tissue donation rates.
authors.affiliation: Department of Anesthesiology, University of Massachusetts Medical School, Worcester, Massachusetts.
authors.forename: J A
authors.initials: JA
authors.lastname: Caramiciu
authors.affiliation: Department of Anesthesiology, University of Massachusetts Medical School, Worcester, Massachusetts; The New England Organ Bank, Waltham, Massachusetts.
authors.forename: J P
authors.initials: JP
authors.lastname: Adams
authors.affiliation: The New England Organ Bank, Waltham, Massachusetts.
authors.forename: B T
authors.initials: BT
authors.lastname: McKown
authors.affiliation: The New England Organ Bank, Waltham, Massachusetts.
authors.forename: C D
authors.initials: CD
authors.lastname: French
authors.affiliation: Department of Mathematics, College of the Holy Cross, Worcester, Massachusetts.
authors.forename: E R
authors.initials: ER
authors.lastname: Ruggieri
authors.affiliation: Department of Anesthesiology, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Surgery, University of Massachusetts Medical School, Worcester, Massachusetts. Electronic address: Stephen.heard@umassmed.edu.
authors.forename: S O
authors.initials: SO
authors.lastname: Heard
mesh_terms: D000288:Administrative Personnel; D006801:Humans; D012017:Referral and Consultation; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*