Saving lives starts with a timely referral call!
Recognize the clinical triggers and when LifeShare should be notified.
Recognize the clinical triggers and when LifeShare should be notified.
TWO TYPES OF REFERRALS: ORGAN AND TISSUE
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ORGAN REFERRAL |
TISSUE REFERRAL |
What are the identifying clinical triggers? |
Intubated/Ventilated + one of these clinical triggers: • Any consideration of withdrawal of life sustaining therapies, or deceleration of care (example: palliative care consults OR • DNR for purposes to not escalate care) OR • Brain death testing discussed, planned or initiated OR • GCS < 5, not due to sedation or paralytics OR • Family initiates conversation about donation |
Any patient that has died in the hospital and has a cardiac time of death. |
ORGAN REFERRAL |
TISSUE REFERRAL |
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When do I make the referral? |
Within 60 minutes of one of these triggers being met |
Within 60 minutes of cardiac time of death |
ORGAN REFERRAL |
TISSUE REFERRAL |
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What does this type of referral evaluate for? |
Heart, Lungs, Liver, Kidneys, Small Bowel and Pancreas |
Corneas, Skin, Musculoskeletal Tissue, Nerves, Heart for Valves, Bone |
ORGAN REFERRAL |
TISSUE REFERRAL |
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Remember |
If you call your patient in for an organ referral, and LifeShare evaluation determines the patient is not a suitable candidate for organ donation, you still need to call back after cardiac time of death for the tissue referral. |
WHY DO WE MAKE REFERRALS TO LIFESHARE?
All CMS recommendations are followed and referrals are made in an effort to save lives through the gift of donation. All referrals are evaluated by LifeShare and eligibility is communicated with the hospital staff.
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ARE THERE OTHER TIMES WE SHOULD CALL LIFESHARE TO UPDATE?
Although our team will be following up on a regular basis, either in person or by phone, LifeShare should be called if any of the following become true:
Code status change to DNR. |
Significant neurological decline. |
Family decision to terminally wean or withdraw medical therapy. |
Your patient becomes unstable. |
MY PATIENT IS ON A VENTILATOR AND I HAVE MADE THE REFERRAL CALL. WHAT NOW?
LifeShare will evaluate donation potential and talk with the bedside nurse. If the patient is deemed a candidate for organ donation, LifeShare will also huddle with the provider team.
In rare cases, the patient may be eligible for organ donation. A donation conversation will be planned with the LifeShare Coordinator and healthcare team. In these cases, LifeShare will usually coordinate in person with your team.
In rare cases, the patient may be eligible for organ donation. A donation conversation will be planned with the LifeShare Coordinator and healthcare team. In these cases, LifeShare will usually coordinate in person with your team.
PLANNED DONATION CONVERSATIONS: TALKING TO FAMILIES ABOUT DONATON
Centers for Medicare & Medicaid Services (CMS) is a federal agency that has laid out regulations to define the collaborative effort between hospitals and OPOs (organ procurement organizations) in the Conditions of Participation.
In the Conditions of Participation, the person designated by the hospital to initiate the donation conversation to the family must be an organ procurement representative.
Please do not mention donation to the family without including the coordinator.
Judgment cannot be made by the hospital that certain families should not be approached about donation.
Hospitals should support the family with the belief that donation is possible and should take steps to ensure the family is treated with respect and care.
Hospital staff’s perception that a family’s grief, race, ethnicity, religion, or socioeconomic background would prevent donation should never be used as a reason not to approach a family.
All potential donor families must be approached and informed of their donation rights and give a decision to donate or decline.
If family authorizes for donation, LifeShare will work with your team on the logistics for donation to occur.
MY PATIENT HAS DIED WITH CARDIAC TIME OF DEATH AND I MADE THE REFERRAL CALL. WHAT NOW?
LifeShare will work with you on the phone to evaluate the patient for potential tissue donation.
WHAT IS THE ELIGIBILITY FOR DONATION IN THE NICU?
Regardless of eligibility, referrals must be made on clinical trigger criteria. The OPO will determine suitability based on a number of medical criteria.
Many times, NICU patients are deferred due to size and weight. Due to the ever-changing environments for transplant center acceptable, that will be determined at the time of the call.
Many times, NICU patients are deferred due to size and weight. Due to the ever-changing environments for transplant center acceptable, that will be determined at the time of the call.
LifeShare appreciates the NICU staff and will remain sensitive and compassionate in this area.
In the rare instance of organ and tissue donation, these are the tiniest heroes of our state!
