Donation and Transplantation Community of Practice / DTCP

A. Foundation: Organ Donation Breakthrough Collaborative Series

A major component of efforts to increase organ donation in the new millenium was a series of Breakthrough Collaboratives that began in 2003 to rapidly increase the number of deceased donors and number of donor organs made available for transplant through the sharing of best practices. The Organ Donation Breakthrough Collaborative became fully operationally in 2004.

The focus of the Breakthrough Collaboratives have changed over time to include efforts to improve: 1) the number of organs made available; 2) the capacity of organ procurement organizations (OPOs) and transplant centers to effectively manage more organ donors and perform more organ transplants; and 3) efforts to expand the use of other types of organ donors such as cardiac-death donors and expanded criteria donors. The donation and transplantation community coalesced around these Collaboratives and benefited by the rapid sharing of 'best practices' that were identified by the Lewin Group in its review of high performing OPOs and donor hospitals. The Breakthrough Collaborative methodology has proven to be a highly effective way of rapidly disseminating best practices supported by research to broad practice.

B. Evolution: The Donation and Transplantation Community of Practice

The Collaborative model of promoting rapid change through a series of frequent and intense sharing and learning experiences was effective. As best practices became embedded in organizational process, the movement evolved. The Collaborative effort continues through the Donation and Transplantation Community of Practice (DTCP), the focus of which is to sustain and increase the achievements of the Collaboratives and institutionalize ("hard wire") identified best practices. The DTCP continues the "all teach, all learn" knowledge-sharing model through local and regional networks and interaction known as the Donation Service Area (DSA) Action Teams and Regional Collaborative Teams. The DSAs are the areas served by each OPO. The DSA Action Teams champion local efforts to improve organ and tissue donation rates and processes. The Action Team consists of representatives of the OPO, donor hospitals, transplant centers, and in best cases, other partners in the donation process (e.g., eye and tissue banks, state hospital association members, donor designation professionals). Successful strategies at the DSA level are shared at the regional level—there are 11 regions designated by the OPTN in the United States. These local (DSA) and regional efforts culminate in an annual event, the National Learning Congress (NLC).

C. Operationalization: DTCP Activities

1. Partnerships

HRSA partners with professional and community entities to create an effective synergy to meet the needs of individuals in need of organ transplantation. Through these partnerships, HRSA is better able to reach the public and healthcare professionals involved in the donation and transplantation process. A key partner, the Organ Donation and Transplantation Alliance, co-sponsors many DTCP events for healthcare professionals as part of its mission to expand and accelerate the work of the Breakthrough Collaborative series. Donate Life America is an important partner in encouraging the public to register intentions to donate.

2. Meetings and Conferences

The NLC is HRSA's major annual event educating and recognizing organizations that have met national goals in increasing organ and tissue donation: 75 percent conversion rate, 3.75 organs transplanted per donor, and 10 percent of donors being donation after cardiac death. Through the NLC, best practices identified and refined through DSA action and regional strategies are shared nationally. Attendees include professionals from OPOs, hospitals, transplant centers, eye and tissue banks, hospital associations, donor designation entities, and others. In addition, several topic-specific sharing and educational experiences are convened during the year.

An annual DSA Action and Regional Strategy meeting is held each year. This meeting enhances the effectiveness of DSA Action Teams in reaching and sustaining national goals for donation and in creating and sustaining action teams in each DSA. In addition to team building activities, meeting sessions will address innovative strategies and use of national data in quality improvement. Meeting attendees also include Regional Collaborative Leaders. The teams will work in conjunction with Regional Leaders across the Nation to refine and implement regional and national strategies.

The Organ Donation and Transplantation Alliance partners with HRSA in convening hospital executive leaders, OPO directors, state hospital association leaders, and others in the CEO Summit. Attendees at this conference examine leadership roles in integrating organ and tissue donation into today's hospital environment and improving the process for staff and donor families. This meeting will encourage attendees to identify representatives to the DSA Action Team from selected donor hospitals and all transplant hospitals within the DSA.

Other meetings and task forces address special issues related to and focusing on quality improvement, donor management, pediatric issues, and transplant center issues. These meetings have been developed in response to the needs of the donation and transplantation community. The DTCP will develop additional educational and practice offerings as additional needs are identified.

3. Web-Based Education

The DTCP conducts several series of webinars each year. "Foundations" focuses on foundational knowledge and is suitable for professionals new to the field or those who want a "refresher course" in basic topics. "Get Connected" provides education on more advanced topics as requested by the community. "Transplant Webinar Series" addresses issues of particular interest to transplant centers. These webinars are recorded for access by the community. As a way of optimizing the sharing of best practices beyond the DTCP's in-person meetings and small webinars, HRSA is in the early stages of implementing a more advanced web-based educational program as a key component on the DTCP's efforts to continue the gains in attaining National goals. This will meet the needs of the community in several ways: 1) cost effectiveness, 2) access, 3) utilization of staff time, 4) timely sharing of knowledge, 5) utility in training, and 6) capability of online storage. The curriculum will be based on known best practices identified through the DTCP and the HRSA's organ donation grant programs and will be refreshed periodically as additional best practices are identified.