HHS Secretary Tommy G. Thompson's Organ Donation Initiative

Organ Donation Breakthrough Collaborative
"From Best Practice to Common Practice": An Initiative Built on the Best Practices of High Performing Donation Service Areas

On April 25, 2003, Health and Human Services (HHS) Secretary Tommy G. Thompson launched an initiative to increase the number of organ donations in the U.S. ...fast. With this initiative, Secretary Thompson challenged the 300 hospitals with the highest number of eligible donors (potential donors) to increase the donation rate in their institutions to 75%.

In 2002, almost 60% of all eligible organ donors identified in the United States were concentrated in just 300 hospitals. Unfortunately, not all of these eligible donors became actual donors. In fact, in the U.S., eligible donors become actual donors in only 46% of cases. Most hospitals have donation rates of 30% to 55%, and some have rates below 5%. But there are hospitals that have achieved outstanding organ donation rates: 17 of these 300 hospitals have excellent programs that enable donation of transplantable organs in over 75% of cases. This initiative from HHS is aimed at rapidly spreading the proven best practices of these hospitals and their partnering Organ Procurement Organizations (OPOs) to achieve organ donation rates (also known as conversion rates) of 75% in all participating hospitals.

OPO reporting of hospital conversion rate data to the national Organ Procurement and Transplantation Network (OPTN) began in August 2001 upon the recommendation of the HHS Office of Inspector General (OIG). The OIG data collection recommendation stemmed from the underlying assumption that data measurement provides the basis for performance improvement. Although these data are self-reported by the OPOs and should not yet be considered a scientific database, they provide a very useful means by which hospitals and OPOs can measure their performance. Further research underway by the Scientific Registry of Transplant Recipients (SRTR) uses these data in conjunction with other data sources to provide additional practice measures. By understanding which hospitals and OPOs have outstanding organ donation rates, it has become possible to identify and disseminate best practices.

Using these data, HHS' Health Resources and Services Administration (HRSA) identified OPOs that were successfully collaborating with hospitals to achieve high organ donation rates. In May 2003, observers were sent to these sites to identify practices that OPO and staff believed were essential to their success.

These visits inform a breakthrough collaborative initiative, targeted to increase organ donation in the 300 hospitals with the highest number of eligible potential donors. By harnessing the collective wisdom of participants and a panel of experts, this collaboration provides the necessary technical and social support needed to help teams from participating organizations to make dramatic improvements. This cooperative program of the Health Resources Services Administration (HRSA), jointly with the Institute for Healthcare Improvement (IHI), also draws upon other HRSA-funded research and the recent "Research to Practice" consensus conference hosted by UNOS.

On April 25, Secretary Thompson set the benchmark for hospital organ donation rates at 75%. He has given each hospital a new target to reach: 46% is not good enough to meet the needs of patients waiting for transplantation. To see how the 300 hospitals with the highest number of eligible donors compare to this standard click here.