Introducing the clinical pathway to present options for organ/tissue donation

Abstract

Background: The importance of presenting options for organ/tissue donation to families of patients with irreversible brain damage has been recognized by medical staff; however, it remains difficult for attending doctors and medical teams because it is very distressful for them both physically and emotionally. Objective: To develope and introduce a clinical pathway (CP) to make it easier to present options for organ/tissue donation. Method: CP to present options for donation consisted of a cover letter (page 1), medical history and neurological evaluations (page 2), summary (page 3), and questionnaires about donation for the family (page 4, submission optional). We established it not to recommend donation, but to provide information about the patients' status and option of organ/tissue donation as an outcome of CP. Results: There were 10 cases in which CP was appropriately applied from December 2008 to July 2010. It took about 30 minutes for each case. The presentation of options for organ/tissue donation was improved. CP was applied in 4.9 ± 2.0 (2-9) hospital days. Page 4, the questionnaires about donation for the family, was returned to us in 7 of 10 cases in 0-2 days after applying CP. Families met coordinators for organ/tissue donation in 5 cases, and, finally, organ and/or tissue donation was conducted in 4 cases. Discussion: Medical teams mostly make efforts to be respectful when presenting the limits of treatment, followed by medical organ donation options. Our developed CP seemed to be helpful to remain on the side of the family, and to provide information about the patients' status and options for organ/tissue donation for the family members.