Transplant Statistics: Annual Report : Appendix E

APPENDIX E

OPTN Professional Education Activities

INTRODUCTION

In an effort to increase donation, the UNOS Professional Services Department (PSD) educates health care professionals concerning their role in the donation and transplantation process. This goal is accomplished through development of educational materials, original research, participation with OPTN/UNOS constituent committees, and networking with professional organizations. The PSD also responds to requests for transplantation-related information and data from patients awaiting transplantation and from members of the general public.  This appendix will provide a brief description of these activities.

STUDIES AND PROJECTS

Over the past year, the main focus of the PSD has included the following:

• Donation after Cardiac Death (DCD) issues
• Implementation of the Critical Pathway for the Organ Donor (CPOD)
• Initiatives with new health care specialties, e.g., social workers, hospital administration personnel and pediatric donors

Donation after Cardiac Death (DCD) Issues

DCD Focus Group Study. As part of the OPTN contract, UNOS conducted focus groups with more than 200 health care professionals to assess the current status of DCD with respect to scientific knowledge, beliefs, and ethical concerns. It is estimated that there could be at least 1,000 potential DCD donors each year; approximately 142 DCD donors were recovered in 2001. The following groups participated in this study: American Academy of Neurology, American Association of Critical Care Nurses, American Association of Neuroscience Nurses, American Association of Neurological Surgeons, American College of Emergency Physicians, American College of Surgeons - Committee on Trauma, American Society of Critical Care Anesthesiologists,American Society of Transplant Surgeons (ASTS), American Society of Anesthesiology, Association of Organ Procurement Organizations (AOPO), Association of periOperative Registered Nurses (AORN), Association of Surgical Technologists, Emergency Nurses Association, National Association of Medical Examiners, National Medical Association, North American Transplant Coordinators Organization (NATCO), and Society for Neuroanesthesia and Critical Care.

The study was completed in May 2002. Manuscripts will be prepared for publication that will outline the identified barriers to DCD participation and strategies will be suggested to address these barriers. In addition, 10-15 case scenarios will be developed on DCD for utilization in professional education initiatives.

Critical Pathway for the DCD Donor. A team of procurement experts chaired by John Edwards, Gift of Life, has drafted an algorithm that standardizes DCD donor protocols. This "critical pathway" has been extensively reviewed by the transplant community. This team is also developing a packet of information to assist OPOs in implementing DCD protocols within their service area. A one-hour presentation on the DCD donor was included at the annual meeting of the American Association of Critical Care Nurses.

Medical Examiners/Coroners DCD Position Statement. The OPTN/UNOS Task Force drafted and approved a statement endorsing the concept of DCD.

Operating Room Personnel Initiative Representatives from the American Association of Nurse Anesthetists, American Society of Anesthesiologists, AORN, AOPO, Association of Surgical Technologists, Division of Transplantation, National Medical Association, and NATCO, as well as two at-large representatives, compose the OPTN/UNOS advisory council for this project. M. Susan Mandell, MD, PhD, a transplant anesthesiologist from the University of Colorado Health Sciences Center, serves as the chair. This council is working to develop guidelines and standards of practice for DCD donors, especially important as this type of donor provides special challenges to operating room personnel. The participants also plan to conduct subspecialty focus groups (e.g., anesthesiologists, scrub technicians, operating room registered nurses, etc.) and additional educational initiatives.

Implementation of the Critical Pathway for the Organ Donor

The Critical Pathway for the Organ Donor (CPOD)was developed in 1999 under the OPTN contract. The CPOD is an algorithm developed to provide a standardized donor protocol. An early pilot study demonstrated an increase of 10.3% in the number of organs recovered per donor and an 11.3% increase in the number of organs transplanted per donor. The CPOD this past year was endorsed by the following transplant professional organizations:

• American Society of Transplantation (AST)
• ASTS
• AOPO
• NATCO

Pediatric Initiative

The Pediatric Advisory Council was established to discuss the educational needs of the pediatric community regarding organ donation. Paul Colombani, MD, serves as chair of the council. Organizational representatives from the American Academy of Pediatrics, Council on Medical Student Education in Pediatrics, National Association of Pediatric Nurse Practitioners, Society of Pediatric Nurses, NATCO, AOPO, ASTS, and AST serve on the council.

The council recommended the development of a Critical Pathway for the Pediatric Donor. A pathway development team, composed of members of the advisory council, will develop a draft of the pediatric pathway.

New Specialty Initiatives

During the past year, the PSD has established Advisory councils to develop new professional educational initiatives with the following constituencies:

• Primary Care Physicians/Family Practice Nurse Practitioners
• Hospital Administration Personnel
• Social Workers

Primary Care Physicians/Family Practice Nurse Practitioners. A Primary Care Provider Advisory Council was established and met in May 2001 to discuss the development of an initiative to educate primary care providers about organ donation and transplantation issues. The council, chaired by Shirley Schlessinger, MD, includes representatives from the following organizations: the American Academy of Family Physicians, the American Academy of Nurse Practitioners, the American College of Osteopathic Family Physicians, the American College of Physicians, American Society of Internal Medicine, the American Medical Association, the AOPO, the NATCO, and the Society of General Internal Medicine.

A tri-fold brochure was developed to assist nontransplant health care professionals about organ donation and transplantation; this brochure has been widely distributed at professional exhibits and is available upon request. The development of a continuing medical education (CME) program is underway that will be available on the OPTN website for credit to nontransplant health care professionals. Discussions are currently underway with the American Academy of Family Physicians to serve as CME providers for the initiative.

Hospital Administration Personnel

A Hospital Administrators Advisory Council was established to focus on issues and challenges surrounding the implementation of the Hospital Conditions of Participation (CoP), provide networking opportunities for health care professionals responsible for CoP implementation, and enhance the motivation of hospital administrators towards organ donation and transplantation issues within their hospital. Michael Henderson, MD, and Art Thomson of the Cleveland Clinic are co-chairs of this council. The advisory council met to discuss methods of educating hospital administrators. Some ideas that the council may pursue include educating JCAHO surveyors about the donation process in hospitals and developing a resource guide to aid hospital administrators.

PATIENT INFORMATION AND DATA REQUESTS

The PSD provides patient information services to patients and the general public. Appendix Table E-1 shows the number and type of requests fulfilled within the past year. (See Appendix H for a complete description of the OPTN data request functions.) In addition to the patient information and data request system, UNOS also maintains the National Transplantation Resource Center, which offers a comprehensive collection of literature relating to transplantation.

*Note: Figures reflect 5,649 individual requestors.