Using Online Communication Skills Training to Increase Organ Donation Authorization

Abstract

Introduction: Family denial of organ donation from deceased donor-eligible patients is a major contributor to the deficit of transplantable organs in the United States. Research Question: Does an evidence-based communication intervention improve deceased organ donor authorization rates from family decision-makers? Design: This implementation and dissemination study used Communicating Effectively about Donation on Organ Procurement Organization professionals responsible for discussing donation and obtaining authorization from family decision-makers. A 14-month, nationwide social marketing campaign generated a sample of 682 requesters, yielding a final analyzable sample of 253 participants. Serving as their own controls, participants spent the first 3 months in a preintervention period, completed the web-based intervention, and progressed to a 3-month postintervention period. Participants completed brief online weekly surveys to assess the intervention’s impact on their communication skills. Results: Authorization rates did not improve overall between the pre- and postintervention periods. A differential effect of the intervention on 3 distinct groups of requesters was found: one group exhibited high and stable authorization rates pre–post (78%-74%); a second group had low initial authorization rates that increased after exposure to the intervention (46%-73%); the third had low and variable rates of authorization that failed to improve after the intervention (45%-36%). Conclusion: This study underscores the value of evidence-based communication training. Training targeted to requesters’ skill levels is needed to realize overall improvements in individual performance, the quality of donation discussions, and rates of family decision-maker authorization to solid organ donation.

Vascularized composite allotransplantation: Knowledge and attitudes of a national sample of organ procurement organization professionals

“…The utility of training for donation professionals has been made evident by studies that report higher rates of authorization for trained staff 27,32 . Our own past work highlights the critical importance of initial and ongoing training that provides an opportunity for skills practice 12,16,19 . Across multiple studies, interventions focused on developing and honing donation professionals’ effective communication skills when discussing donation with families led to improvements in their communication competence and comfort answering questions about donation.…”

“…Across multiple studies, interventions focused on developing and honing donation professionals’ effective communication skills when discussing donation with families led to improvements in their communication competence and comfort answering questions about donation. Training has also been associated with increased family satisfaction with the donation process, enhanced communication quality of the request, and improved authorization rates for solid organ and tissue donation 12,16,19 …”

“…27,32 Our own past work highlights the critical importance of initial and ongoing training that provides an opportunity for skills practice. 12,16,19 Across multiple studies, in- proved authorization rates for solid organ and tissue donation. 12,16,19 We also explored OPO donation professional's preferences for Thus, participants were more likely to be drawn from individuals who had at least some interest in VCA donation.…”

“…12,16,19 Across multiple studies, in- proved authorization rates for solid organ and tissue donation. 12,16,19 We also explored OPO donation professional's preferences for Thus, participants were more likely to be drawn from individuals who had at least some interest in VCA donation. Nonetheless, a total of 154 professionals from 67.2% (n = 39) OPOs were represented in the sample, and the sample's demographics are consistent with prior research involving donation professionals.…”

“…Recruitment of OPO professionals was initiated with leadership of all 58 OPOs in 2018, requesting that they encourage participation from the approximately 750 professionals who hold donation discussions with families nationwide 19 . The study was introduced to Chief Executive Officers who shared the information to staff via internal listservs.…”