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AOPO Potential Donor Study: Current OPO Practice in Identifying Potential Donors Beyond the Definition of Eligible. Rick Fowler, MBA Project Consultant Association of Organ Procurement Organizations Community of Practice Action Conference October 15, 2014. Agenda.

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Rick Fowler, MBA Project Consultant Association of Organ Procurement Organizations

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Rick fowler mba project consultant association of organ procurement organizations

AOPO Potential Donor Study: Current OPO Practice in Identifying Potential Donors Beyond the Definition of Eligible

Rick Fowler, MBA

Project Consultant

Association of Organ Procurement Organizations

Community of Practice Action Conference

October 15, 2014


Agenda

Agenda

  • Background/history on organ donor potential

  • AOPO Potential Donor Study

    • Member Survey Results

    • Early Data Collection

    • Next Steps


Challenges across the nation donors transplants and patients waiting

Challenges Across the Nation: Donors, Transplants and Patients Waiting

123,178 waiting list candidates as of 08/05/2014

Based upon OPTN year-end data provided on 08/05/2014. This work was supported in part by Health Resources and Services Administration contract 234-2005-37011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.


Early estimates of us donor potential

Early Estimates of US Donor Potential


Rick fowler mba project consultant association of organ procurement organizations

Death Record Review – AOPO Form


Early 2000s hrsa collaboratives

Early 2000s - HRSA Collaboratives


Rick fowler mba project consultant association of organ procurement organizations

Focus: More Donors & More Transplants

Collaborative

Starts Here


Imminent eligible

Imminent & Eligible

  • Eligible – Common denominator for measuring and reporting “Potential”

  • Imminent – the next layer of the onion – might become Potential or “Potential Potential”


Rick fowler mba project consultant association of organ procurement organizations

Initial Eligible Death Numbers fit within the Ranges Established by Earlier Estimates of US Donor Potential


Eligible deaths

Eligible Deaths


Donors from eligible deaths non dcd 71 years

Donors from Eligible Deaths(Non-DCD & <71 years)


Conversion rate donors non dcd 71 eligible deaths

Conversion Rate(Donors: Non-DCD & <71/Eligible Deaths)


Eligible deaths donors non dcd 71 and conversion rate

Eligible Deaths, Donors (Non-DCD, <71), and Conversion Rate


Deceased organ donors in the us

Deceased Organ Donors in the US

8268

8143

8085

8126

8017

7989

8022

7943

7593

7150

6457

6190


Additional donors from patients outside of eligible deaths

Additional Donors (From Patients Outside of Eligible Deaths)


Breakdown of additional donors

Breakdown of Additional Donors


Aopo member survey

AOPO Member Survey


Aopo member survey1

AOPO Member Survey

  • Widely recognized that the Eligible definition does not capture all “Potential” Donors

  • AOPO conducted a survey to better understand what OPOs are currently doing

    • 20 Question Survey distributed July 2014

    • Understand if OPOs are collecting data on Potential Donors Beyond Eligible,

    • And if so, what are they collecting?


Three major categories of potential

Three Major Categories of Potential


Aopo member survey results

AOPO Member Survey Results

58

(95%)


Aopo member survey results1

AOPO Member Survey Results

58

55

(95%)

(93%)


Aopo member survey results2

AOPO Member Survey Results

58

55

51

(95%)

(93%)

(92%)


Aopo member survey results3

AOPO Member Survey Results

58

55

51

51

(95%)

(93%)

(92%)

(92%)


Aopo member survey results4

AOPO Member Survey Results

58

55

51

51

51

(95%)

(93%)

(92%)

(92%)

(82%)


Three major categories of potential1

Three Major Categories of Potential


Rick fowler mba project consultant association of organ procurement organizations

OPO Upper Age Limits (in years) for the 3 Major Groups of Potential: Declared Brain Dead, Consistent with Brain Death, and DCD

Number of OPOs


Rick fowler mba project consultant association of organ procurement organizations

OPO Upper Age Limits (in years) for the 3 Major Groups of Potential: Declared Brain Dead, Consistent with Brain Death, and DCD

Number of OPOs


Rick fowler mba project consultant association of organ procurement organizations

OPO Upper Age Limits (in years) for the 3 Major Groups of Potential: Declared Brain Dead, Consistent with Brain Death, and DCD

Number of OPOs


Rick fowler mba project consultant association of organ procurement organizations

OPO Upper Age Limits (in years) for the 3 Major Groups of Potential: Declared Brain Dead, Consistent with Brain Death, and DCD

Number of OPOs


Breakdown of opo time limits in minutes from extubation to asystole for potential dcds

Breakdown of OPO Time Limits (in minutes) from Extubation to Asystole for Potential DCDs


Three major categories of potential2

Three Major Categories of Potential


Aopo member survey results5

AOPO Member Survey Results

58

55

51

51

51

(95%)

(93%)

(92%)

(92%)

(82%)


Rick fowler mba project consultant association of organ procurement organizations

Number of OPOs Tracking these Outcomes within each of the 3 major groups of Potential: Declared Brain Dead, Consistent With Brain Death, and DCD


Aopo member survey results6

AOPO Member Survey Results

58

55

51

51

51

(95%)

(93%)

(92%)

(92%)

(82%)


Rick fowler mba project consultant association of organ procurement organizations

Number of OPOs Tracking these Outcomes within each of the 3 major groups of Potential: Declared Brain Dead, Consistent With Brain Death, and DCD


Aopo member survey results7

AOPO Member Survey Results

58

55

51

51

51

(95%)

(93%)

(92%)

(92%)

(82%)


Rick fowler mba project consultant association of organ procurement organizations

Number of OPOs Tracking these Outcomes within each of the 3 major groups of Potential: Declared Brain Dead, Consistent With Brain Death, and DCD


Rick fowler mba project consultant association of organ procurement organizations

Number of OPOs Tracking these Outcomes within each of the 3 major groups of Potential: Declared Brain Dead, Consistent With Brain Death, and DCD


Preliminary 2013 data from 11 opos

Preliminary 2013 Data from 11 OPOs


Preliminary 2013 data from 11 opos1

Preliminary 2013 Data from 11 OPOs

2227


Preliminary 2013 data from 11 opos2

Preliminary 2013 Data from 11 OPOs

2227


Preliminary 2013 data from 11 opos3

Preliminary 2013 Data from 11 OPOs

3623

(+1396)

2227


Preliminary 2013 data from 11 opos4

Preliminary 2013 Data from 11 OPOs

3623

(+1396)

2227


Preliminary 2013 data from 11 opos5

Preliminary 2013 Data from 11 OPOs

4706

(+2479)

3623

(+1396)

2227


Preliminary aggregate data from 11 opos 2013

Preliminary Aggregate Data from 11 OPOs2013


The impact of potential donor data

The Impact of Potential Donor Data

-“It has provided an excellent way to expand our hospitals perspective on donation potential besides the brain dead opportunities.”

-“It opened our eyes to what our real potential donor population was and also showed us how under performing we really were.”

-“It adds a level of accountability and consistency by giving these patients a label…it validated them and uncovered countless opportunities to study various aspects of the donation process. We have shared this new data with all of our hospitals and it is standard on our dashboards. The hospitals have subsequently increased their accountability for every opportunity, every time…it lifts the veil on how they are actually performing.”


Key points

Key Points

  • Most OPOs are collecting data on Potential Donors Beyond the Definition of Eligible

  • While there is local variation in Methodologies and Definitions, there are also a lot of similarities (good starting point)

  • Preliminary data indicates a significant number of Potential Donors Beyond Eligible


Next steps

Next Steps

  • Collect more detailed data from all participating OPOs to determine the size and nature of the donor pool beyond the definition of Eligible.

  • Examine similarities and differences in definitions and methodologies. How close are we to a common approach?

  • Help inform policy discussion around Total Potential on the local and national levels.

  • Leverage local performance improvement efforts with hospital partners based on Potential Donor data.


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