HUDDLES

Elizabeth Spencer, CPTC

Director of Hospital Development

Washington Regional Transplant Consortium

Why did WRTC begin to “Huddle?” To build partnerships

Joint accountability for donation outcomes

To develop & utilize hospital-based champions to create a better donation process Possible barriers in any potential case fixed by an “insider”

To reach the goals of the Collaborative Increase Conversion Rates to 75%

Benefits of Huddling to OPO…Fostering vested interest in outcome/ joint accountability among

hospital partners

OPO team in the loop on hospital’s care plan

More focused pre- brain death care Putting donation on the radar of caregivers

Medical “preservation of the donation option” (NMS/PC) Grave prognosis preparation (Coordinator jam)

Internal help in problem-solving Appropriate co-requestors Timeliness of testing, suitability info, OR scheduling, etc.

Creating an “All-About-the-Ones” attitude

Benefits of Huddling to the Hospital… Sharing our assessment of potential options, & developing a joint

game plan, increases their comfort level with donation approach Helps them medically preserve those potential options Provides them with tools (i.e. resources, language, etc.)

Results in increased comfort with OPO Coordinators & our good intentions Further solidifies the OPO access & partnership

Leadership roles within their institution

Hospital partners become participants in the donation process Witness & assist in something positive from something otherwise

only negative

Benefits of Huddling to the Family…

The Old Days: Hospital to OPO “Pass Off” Did the family really benefit from this strict separation? Donation as a scary thing from which the hospital

caregivers must be disassociated

Huddles → Unified Game Plan → Continuity of Care for the grieving family Donation as a positive part of the care continuum Consistency in information discussed

We know what the hospital knows & can reinforce message

Learning from Huddles…

Refining the donation process within each institution’s unique system Improve process to set up for success with

the very next potential case Examples:

Specific pediatric between-testing needs Addition of add’l department rep to Donation Cmte. Gaps in case preparation Real-time & post-case educational opportunities

Powerful Example: The Huddle Helped Make It Happen INOVA Fairfax Hospital last week

18/M/B s/p GSWH (alleged homicide) → BD Very large family from Ghana Minister responsible for “raising several people from the dead” Withdrawal planned; Family in denial; Lawsuit threatened Described as physically hostile towards hospital staff “You can not approach this family about donation”

Huddle: Meeting of the minds Unique family support → donation approach plan

Outcome: 6 Organs Transplanted Total family transformation: at peace with death & interactions Hospital grateful for assistance with the family

Why You Should Huddle…

Increase the ability of your approach team to work effectively with families.

Create an atmosphere of teamwork to fix problems/dissolve barriers.

Foster partnership with both hospital leadership & frontline hospital colleagues.

Develop sense of joint accountability.

Some cases, that wouldn’t have converted, will.

Interested? First Steps: Identify potential Huddle participants

Attending MD, Intensivist, Resident, Bedside RN, Charge RN, etc. Add’l hospital specific based on structure & needs

Soc work, chaplaincy, Donation Cmte members: PI, OR administration, Clin Spec, etc.

OPO: Coordinator, HD, AOC, Medical Director

Make “user friendly” for Coordinators & hospital participants Develop & distribute hospital-specific contact plans Utilize a resource on Huddle discussion topics to follow

Preparation & maintenance: Educate key players beforehand & in real-time

Purpose Process Benefits

Keep huddles brief & to-the-point Maintain consistency: Expectation of a Huddle every time

Questions?