Referral Process…
Organ & Tissue Donation
Tami R. Dewell,
CTBS
Manager, Family Care Center
Cell: 213.760.7336
Direct office: 213.989.2425
Fax: 213.977.1075
1001 Wilshire Blvd. Suite 200
Los Angeles, CA 90017
tdewell@onelegacy.org
"The Heart that Gives..........Gathers"
Objectives ~ Ensure Participants understand the
referral process for Organ and Tissue
Donation
~ Participants take a pro-active role in
identifying improvement areas within
their current donor referral practice
Run with It !!...
~ What can you identify within
OneLegacy’s current referral process
that presents an opportunity for
improvement?
~ What do you see within YOUR current
internal referral process that presents
an opportunity for improvement?
THE BASICS….
800-338-6112

WHY do you make the referral call??
~ CMS Conditions of participation
~ It’s the Right Thing To Do
WHEN do you make the referral ??
Organ?
~ Clinical Triggers
Tissue?
~ Cardiac Death
Potential Organ Donor ~
800-338-6112
 “First” Call – Press 1 when prompted.
~ Direct routing to OL Care Center
~ Initial Intake evaluation:
Hospital Name / Unit Phone Number
Referring person’s name / Unit / Floor / Bed #
Patient Name / DOB / Race / Gender / Medical Record #
Confirm Vent dependency status / Confirm + Heartbeat
Medical HX: Active Cancer, Infectious Disease?
Current GCS / Brain Death notes?
Admission date / time / Admitting Diagnosis
Current Sedation?
Blood Pressure / Creatinine / Total Bili / AST / ALT
Plans to Extubate? If yes, When?
Organ Referral – Deferral…
• Your Patient does not meet organ criteria…
What now??
~ The Family Care Coordinator will inform you the patient does not meet
the criteria and inform you of one of the following:
~ Please call at the time of cardiac death
~ Please call the Referral line if any change in neuro status
~ Please call if plans are to extubate (as soon as possible)
Organ Referral – Evaluation…
•
Your Patient does meet initial organ criteria…
What now??
~ The Family Care Coordinator will inform you the patient potentially
does meet the criteria and inform of the following:
~ We will call the Organ Team Lead (OTL) to inform him/her of the
referral and a decision will be made about a site visit.
~ We will call you back with the decision.
~If we conduct a site visit, a Procurement Transplant Coordinator (PTC)
will arrive in approx. 1 hour.
~If we continue to follow (no site visit), the PTC will make a follow-up
phone call.
~If we defer, we will inform you of one of the previously mentioned
during the “deferral” discussion
Summary… Organ Referral
800-338-6112
• One Call to the Referral Line
• Initial Intake call should take approx. 5 – 8 min.
• Informed of deferral or further evaluation
• Family Care Coord will call back re: further eval
• PTC will follow-up with callback or site visit
~ HOW HAS THE PROCESS CHANGED ???
Potential Tissue Donor ~
800-338-6112
 “First” Call – Press 2 when prompted.
~ Routing to central Triage Group
~ Initial Intake evaluation:
Hospital Name / Unit Phone Number
Referring person’s name / Unit / Floor
Patient Name / DOB / Race / Gender / Weight / Medical Record #
Date / Time of Death / Cause of Death (if known)
Admission date / time
NOK information, including contact #’s
This call should be less than 5 minutes
Tissue Donor - Deferral
• Your Patient does not meet tissue criteria…
What now??
The Triage Coordinator will inform you of the
deferral, no further follow-up necessary and
decedent may be released to the Funeral Home
You will receive the referral #
Tissue Referral… Evaluation
• Your Patient does meet initial tissue criteria…
What now??
~ Triage will forward the referral to OneLegacy Care Center for further evaluation
~ OL Family Care Coord (FCC) will call you to ask for additional information to
determine eligibility of offering the family donation options
~ Circumstances that brought patient to the hospital
~ Course of treatment, including WBC x3, Temp x3, X-Rays, CTs,
Cultures, Antibiotics (start/stop), Blood Product / Fluids given
~ Medical History listed on the H & P in chart / Height
~ Date / Time of Extubation (if applicable)
~ Physician info: Attending / Primary / Who is signing DC?
~ CME Status / NOK Status / Funeral Home chosen?
Evaluation Outcome…
• Following further evaluation, if decedent does not
meet tissue criteria, the FCC will inform you and
you can release the decedent to the Funeral Home
the Family has Chosen.
• If decedent meets tissue criteria, the FCC will
inform you and ask that you not release the
decedent to the Funeral Home until we are able to
provide donation options to the family and followup with the hospital with consent outcome.
Secondary evaluation call will take approx. 10 – 25 min
Potential Tissue Donor…
The “Inside Scoop” … what we want you to know…
•
“Sepsis” is an automatic ruleout ??…
•
We have a contact # for the NOK, that should be enough…
•
Under no circumstances are you to release the body to the Funeral
Home when OL has requested that you not…
•
ER Deaths: Pronounced time of death should be all you need, why do
you ask about LKA or status upon arrival
•
Lab Results, the importance of getting the info = eligibility
•
Previous organ referral, OL no longer following and now the patient
has died,
calling back at time of cardiac death…why?
•
Pre-Transfusion blood samples…what’s the big deal???
•
Time metrics…why the rush???
•
HIPPA
A New Perspective on Life
Spinal curvature
After bone grafts
Corneas
• 35,000 corneal surgeries performed annually in the states
• Restore or improve impaired or lost sight
• 90% of all corneal transplants successfully restore vision
• Recipients range from 2 days to 103 years old
 Over 1000 recipients have received the gift of sight through cornea provided
by OneLegacy
QUESTIONS ????