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Creating A Culture Of Organ And Tissue Donation Saves Lives

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Written by Dr. Andrew Healey, Medical Director of Critical Care, William Osler Health System and Chief Medical Officer, Trillium Gift of Life Network

In Ontario alone there are 1,600 people waiting for a life-saving organ transplant, and the need does not discriminate. People of all ages, faiths and cultural backgrounds can find themselves in need of a transplant.

It may come as a surprise to learn that while we all have the potential to be an organ and/or tissue donor, the reality is that the opportunity is quite rare. Only two to three per cent of hospital deaths happen in a way that is conducive to organ donation.

At William Osler Health System (Osler) we have made it a priority to ensure that when donation is a possibility, every family is provided the opportunity and the information to make the choice that is right for them. Osler prides itself on quality end of life care, and that has to include the opportunity for organ and tissue donation.

Families can find hope in knowing that there is the potential to save eight lives through organ donation and up to 75 more through tissue donation.

Trillium Gift of Life Network, the Ontario agency that manages and coordinates organ and tissue donation, has been looking to international examples of successful donation programs and applying learnings here in Canada. One key change has been to engage physicians in the process, adding hospital donation physicians at nearly 60 hospitals across the province as well as six regional medical leads.

The work of Osler's Hospital Donation Physician Dr. Alex McMillan and two full-time organ and tissue donation coordinators, Susan Lavery and Michele Scott, has meant that an integrated support network is available to the donation teams -- offering education and expertise. Highly skilled donation coordinators are there to support families through every step of the process.

When TGLN began publicly reporting the donation performance of Ontario's hospitals, Osler was not considered a leader. Over the last three years, a true culture of donation has been developed and as a result, more families have been offered the opportunity to choose donation. Osler's conversion rate -- the measure of how many referred donors actually go on to save lives through donation -- rose from 22 per cent in 2012/2013 to 67 per cent after the first three quarters of the 2015/2016 fiscal year.

Routine notification also jumped from 80 per cent in 2013/2014 (when first publicly reported) to 97 per cent at the end of 2015. Routine notification measures the average rate at which TGLN is notified by hospitals when a patient has died and there may be potential for donation. Public reporting on hospital donation performance is one way TGLN has enhanced accountability and monitored progress of 70 designated hospitals in Ontario.

In 2015, Osler cared for 20 organ donors -- the most of any hospital in the Greater Toronto Area and the third highest number in Ontario. Organ donation is a complex process, and this impressive year reflects how well the team at Osler works together to make donation possible. The patient population hasn't changed, but the shift in the culture has meant that every department at Osler -- from the ER to the OR -- now see it as a priority that all families are given the opportunity to choose donation.

Nothing will ever take away from the tragedy of losing a loved one, but families can find hope in knowing that there is the potential to save eight lives through organ donation and up to 75 more through tissue donation. The strength we see in the donor families at Osler is special. Their ability to work through their grief and provide consent for donation is truly something to behold.

By registering your wishes, you relieve your family of the burden of making that decision. We also know first-hand that registration saves lives. When a family is presented with proof that their loved one registered consent, they almost always move forward with donation. Without this knowledge, families choose donation just half of the time. As BeADonor month comes to a close, let's all register at and talk to our family about our wishes.

One day, this act could help save a life.

Dr. Andrew Healey is the Medical Director of Critical Care at William Osler Health System and Chief Medical Officer for Trillium Gift of Life Network. Originally from Newfoundland, Dr. Healey has completed fellowship training in emergency medicine, critical care medicine, and echocardiography at McMaster University. He also completed a Masters in the donation of organs, tissues, and cells for transplantation at the University of Barcelona, Spain. His main academic and research interests are in ultrasound, end of life care, non-perfused organ donation, and optimization of the process of organ donation for families.

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