• R L O'Brien, M F Serbin, K D O'Brien, R V Maier, and M S Grady.
• Northwest Organ Procurement Agency, Seattle, Wash, USA.
• Arch Surg Chicago. 1996 Feb 1;131(2):153-9.

ObjectiveTo implement and then determine the efficacy of a "hospital development" (HD) plan designed to increase organ donation rates at an urban trauma center.Design/SettingRetrospective reviews of all deaths at an urban, level I trauma center for 1991 to 1994.SubjectsPotential organ donors were identified by standardized criteria, and the reasons why potential donors did not become actual organ donors ("nonproductive donors") were categorized. Actual donors were defined as individuals in whom one transplantable organ was recovered. Results also were expressed as percentages of potential donors for each year. Changes in actual donor numbers and in nonproductive donor categories were compared for the "pre-HD" (1991-1992) and "post-HD" (1993-1994) periods.InterventionThe HD plan had six components: identification of key contact individuals, development and modification of relevant hospital policies, improvement in procurement agency visibility in hospital units, education of hospital staff regarding organ donation, institution of early on-site donor evaluations, and provision of feedback to hospital staff about the disposition of potential organ donors.ResultsInstitution of the HD plan was associated with a highly significantly increase in actual donors for the post-HD period as compared with the pre-HD period (P < .001), and pre-HD and post-HD donor rates were 26.1% and 49.5%, respectively. This increase was due primarily to a marked improvement in hospital staff identification and referral of potential donors (P < .001).ConclusionsA coordinated plan incorporating continuing staff education, organ donation policy refinement, and increased visibility and availability of organ procurement agency personnel can substantially increase organ donation at an urban trauma center.

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