PC & OPO Collaboration Ensures Patient-Centered EOL Care

Topic: Screening for Palliative Care Patients

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Background: Inpatient hospice services within hospitals serve as an effective care option for patients in critical condition who no longer benefit from critical care interventions, and in whom the goals support a transition to comfort. Without effective collaboration, patients may be removed from life-sustaining interventions prior to considering an opportunity for organ donation. Palliative care (PC) provides an essential bridge between organ procurement organizations (OPO), primary medical teams, and the patient-family unit in assuring optimal end-of-life (EOL) care.  

Objective: To determine the influence of a PC and OPO collaboration on organ donation and inpatient hospice services.

Methods: In April 2015, our institution began inpatient hospice services for physiologically unstable patients. In August 2015, our PC team established a collaboration with our OPO to ensure that goals for end-of-life care include the possibility of organ donation. The OPO notified the PC team of all new referrals and provided updates at key process points. The PC team screened new consults meeting OPO triggers to ensure referral. A flowchart was used to outline and assure bilateral communication.

Results:

                                 Nov 2014-Apr 2015         May 2015-Oct 2015       Nov 2015-Apr 2016

Organ Referrals                          132                                    140                            148

 

Organ Donors                              10                                      10                              16

 

PC Referrals                               450                                    635                             779

 

Hospice Admissions                      18                                     160                            194

 

Conclusion: We demonstrate that a PC and OPO partnership created synergistic improvements in all services during a growth phase of the program development of PC and hospice at our institution. Through a cooperative protocol, we were able to assure that the values and needs of the patient and family were properly explored and honored.

Our results support an important leadership role for PC in establishing policies and practices that encourage collaboration with the OPOs to assure optimal end-of-life care.

Author

  • Paul DeSandre, DO
  • Director
  • Grady Health System
  • 80 Jesse Hill Jr Dr SE
  • Atlanta, GA 30303
  • 770-225-5465

Co-authors

  • Kimberly Kottemann, MBA, LifeLink of Georgia
  • Paul DeSandre, DO

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