Bridging Language Effectiveness for Organ Donation
Thursday, September 19, 2024
9:15 AM – 10:15 AM CT
Location: Midway 10 (First Floor)
Abstract:
Background: Specialized training for individuals approaching surrogate decision-makers of potential organ donors enhances donation rates. Excluding physicians from these conversations, as is typical of the current process for approaching surrogates, risks fracturing the therapeutic relationship between the physician and family.
Objectives: To evaluate the feasibility and impact of a quality improvement (QI) project in a pediatric intensive care unit (PICU), training physicians in the utilization of “Bridging Language” to introduce the concept of organ donation to pediatric surrogate decision makers of children eligible for organ donation at end of life.
Methods: Prospective quality improvement project in the PICU at a quaternary pediatric hospital over 12 months. Physicians trained in “Bridging Language” approached surrogates of patients determined to be eligible for organ donation, less than 18 years of age, and undergoing neurologic death testing and/or at end of life. Historical donation authorization rates averaged over the previous seven years were compared with authorization rates during the project.
Results: 80% (8 of 10) of the eligible surrogates exposed to Bridging Language during the QI project authorized organ donation compared with 62% (56 of 91) of surrogates for eligible donors historically.
Conclusion: Bridging Language was feasible to implement, was associated with increased donation authorization rates, and honors the humanizing therapeutic relationship between intensivist(s) and patient family. With trust in the medical community at all-time lows and absolute scarcity of procured organs worsening, the Bridging Language model deserves further consideration as a high quality, ethically sound, effective approach to the donation authorization process.
Learning Objectives:
After participating in this conference, attendees should be able to:
Upon completion, participants will garner an appreciation for the progressive scarcity of donor organs and process limitations of organ donation authorization models that exclude providers from involvement.
Upon completion, participants will be able to describe the value of empowering providers to utilize Bridging Language to introduce the concept of organ donation to surrogates of pediatric patients.
Alyson Baker – Children's Nebraska; Michael Hobson – PICU Medical Director, Indiana University School of Medicine
