“Ignite the Fire”

Golden State Donor Services

Sierra Eye and Tissue Donor Services

212 Donation Summit

The EXTRA Degree
May 15, 2008

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How To “Be”
 Leaders for Organ, Eye & Tissue Donation
 Teaming with One Another
 Actively Listening & Learning
 In Action, Making:
Requests
Offers
Commitments
 Focused on Achieving Our Goals

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 Net Forward Energy

What We Think…and

What We Say…

Makes All the Difference in

the world!!!!
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 Overarching Strategies For
System Wide Improvement

 Unrelenting Focus on Change,           
Improvement, and Results
 Rapid, Early Referral & Linkage
 Integrated Donation Process Management
 Aggressive Pursuit of Every Donation          
                      Opportunity 

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Key Elements of
Breakthrough
Improvement
 Will to do what it takes to change 
to a new system
 Ideas on which to base the 
design of the new system
 Execution of the ideas

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 Number of Organ Donors by Month
750
Transplant Collaborative
Number of organ donors

700 2nd Donation Collaborative

1st Donation Collaborative

650 Old System

600

550

500

450
New System
400
10

10

10

10

10

10

10
1
4
7

1
4
7

1
4
7

1
4
7

1
4
7

1
4
7

1
4
7

1
4
1999 2000 2001 2002 2003 2004 2005 2006

Mont h
6
 Holding the Gains…..But More
Improvement is Needed
750

700
Organ Donors

650

600
Collaborative
550 Starts Here

500

450

400
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

1999 2000 2001 2002 2003 2004

2005 2006 2007 2008
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Donation Trends up in 4th
Quarter
-1.4%
2150
2100 -0.4% 3.0%
2050
2000 1.8%
2006
1950 2007
1900

1850
1800
1st Qtr 2nd Qtr 3rd Qtr 4th Qtr

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 Collaborative Conversion Rate
Gap - by Region
80%
Percentage Point Gap .

75%

70%

65%

60%

55%

50%
1 2 3 4 5 6 7 8 9 10 11
OPTN Region
Range: 3.2 percentage points above the goal to
12.0 Percentage points below the goal 9
 Goal OTPD by Region
4.00
3.75
3.50
3.25
OT PD .

3.00
2.75
2.50
2.25
2.00
1 2 3 4 5 6 7 8 9 10 11
OPTN Region

Range: 3.52 OTPD to 3.86 OTPD 10

GSDS Conversion Rate
and Yield Performance
by Year
2004 2005 2006 2007

Conversion 60% 57% 75% 68%

Rate

Yield 3.17 3.31 2.79 2.86

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GSDS Donor Quality by
Calendar Year
100 72% 62% 61%
36% SCD
50 26% 31%
ECD
2% 7% 3%
DCD
0
2005 2006 2007

 SCD = Standard Criteria Donor
 ECD = Extended Criteria Donor 
 Pt’s greater than age 55 with risk factors
 DCD = Donation After Cardiac Death
 Recover Organs after heart stops
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The U.S. Opportunity:

OTPD Gap = - 0.72

Organ Donors = 7985

# Additional Organs Transplanted 
With Gap Closed = 7985 x 0.72 
= 5579  More Transplants  (23% Increase)

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Your DSA Opportunity -
Partnering with
GSDS!
 Conversion Rate Gap
 National Goal – 75%
 2007 = 68%
 Gap = 7%   OR   6 Additional Organ Donors!
 Donation After Cardiac Death 
 National Goal – 10% of total Donors
 2007 = 4%
 Gap = 6% or  3 Additional DCD Donors!
 Organs Transplanted per Donor Gap
 National Goal ­ 3.75
 2007 = 2.86
 Gap = .89   OR   58  more Organs Transplanted!
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“Every System is
perfectly designed
to get exactly the
results that it
gets.”
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It’s All about
CHANGE!!
 Improvement requires change, but 
not all change is improvement
 Change should be thought of from 
the standpoint of those who will 
benefit from the change
 The Model for Improvement provides 
a framework for making effective 
change

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 Integrated & Flexible
Hospital/OPO Donation Team
How it looks:
Administrative and clinical advocacy for 
continuous process improvement 
Hospital relations takes on a 24/7 mindset
Willingness to switch roles to ensure best 
outcomes
Make requests and offers; 
COLLABORATE!
One size does not fit all!
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 High Leverage Changes:
Hospital/OPO Partnerships
 Advocate Organ Donation As the Mission
 Involve Senior Leadership to Get Results
 Deploy A Self­Organizing OPO/Hospital Team
 Practice Early Referral, Rapid Response
 Master Effective Requesting
 Implement Donation After Cardiac Death

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 Building bridges
between the hospital
and the potential
donor’s family…

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First Things First:
Hospital/OPO
Partnerships
 Physician & clinical champions are known
 Process in place for conducting real time 
death record reviews
 OPO “Presence": In­house coordinator
 Focused change agenda based on analysis of 
current hospital data
 "Team Huddles" are the norm
 Clinical Triggers in use
 After Action Reviews are the norm
 "Effective Requesting" in place, in action

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Think About the
Possibilities!!
 If every Level 1 Trauma Center in the 
US raised their Conversion Rates to 
83175% there would be an additional 501 
Additional Organ Donors!
organ donors.
 If every Level 2 Trauma Center in the 
US raised their Conversion Rates to 
75% there would be an additional 330 
organ donors.
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High Leverage Transplant
Practices
Efficiently plan & manage the donor 
case process
Involve Critical Care specialists to 
maximize donor management
Relentlessly advocate for the 
placement of every transplantable 
organ
Active & progressive acceptance to 
increase organ transplantation
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Collaborative
Improvement:
Eye & Tissue Donation
 Collaborative work has had positive impact 
on eye & tissue donation
 New opportunities to engage hospitals
 Eye & Tissue referrals are stable/increasing
 DSAs are utilizing Collaborative 
improvement methods 
 Implementation of state donor registries
 PLENTY of room for life­enhancing 
improvement!
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 Golden State Donor
Services DSA Medal of
Honor Winners
 *Santa Rosa Memorial Hospital
 Sutter Roseville Medical Center
 Kaiser Foundation Hospital
 Mercy San Juan Hospital
 University of California Davis
Medical Center

*Denotes
 
3X Winner
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 Our Future
 75% conversion rate
 3.75 organs transplanted per donor
 10% DCD in each DSA

 35,000 deceased donor organs 
transplanted annually

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 Sunday, September 24, 2006

“A quiet revolution in 
the world of lung 
transplants is saving 
the lives of people 
who, just two years 
ago, would have 
died on the waiting 
list. In the past 16 
months, waits have 
shortened, lists have 
shrunk, and the 
number of lung 
transplants has gone 
up. Further 
improvements are 
expected this year.” 
Cystic Fibrosis Patient After Double Lung Transplant

Lung Patients See a New Era of

Transplants   26
 Sunday, September 24, 2006

“A quiet revolution in 
the world of lung 
transplants is saving 
the lives of people 
who, just two years 
ago, would have 
died on the waiting 
list. In the past 16 
months, waits have 
shortened, lists have 
shrunk, and the 
number of lung 
transplants has gone 
up. Further 
improvements are 
Hannah is now studying Social Work in college.
expected this year.” 
Cystic Fibrosis
ShePatient
plansAfter Doublewith
Lungtransplant
Transplant
She plans to work with transplant patients
to work
when she graduates.
Lung Patients See a New Era of
Transplants   27
 No single person saved Hannah’s life.
Her life was saved by many people in
many places over many months,
always choosing to do the right thing,
the thing that was most likely
to increase organ donation
and transplantation.

YOU can make a difference!

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Faces of those
who wait…
Brandon, age 9

YOU
are their
HOPE!!

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 Lifesaving Requests
 Commit to reaching the national donation &
transplantation goals
 Designate a key hospital leader accountable
for action & results on this initiative
 Track organizational progress through
quality indicators
 Implement proven best practices
 BE BOLD for those who give and for those
who wait!   32
 Remember…YOU are the extra
degree…at 211º water is hot…
at 212º it boils…

You
Are responsible for your results
It’s time to turn up the heat.
It’s time to Commit!

33
Putting a Face on Performance
It Really Is All About
the 1’s…
1 Donor at a Time
1 Donor Family at a Time
1 Transplant Candidate at
a Time
1 Month at a Time
1 Day at a Time
...and each 1 of
YOU!

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