Moderator Cristian Nunez OneLegacy Presenters Marcia Penido LCSW Huntington Hospital Robert Coppel OneLegacy Michelle Post LMFT OneLegacy Breakout Session B The Donation Process The Continuum of Care ID: 765252
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Moderator:Cristian Nunez, OneLegacy Presenters:Marcia Penido, LCSW, Huntington HospitalRobert Coppel, OneLegacyMichelle Post, LMFT, OneLegacy Breakout Session B: The Donation Process – The Continuum of Care
Questions to Run On How can the hospital’s family support staff help guide the donation process?How can you help ensure a family is approached effectively and appropriately?What happens with a donor family AFTER an organ or tissue donation?
But How Does this Relate to My Job? A Guide for the Hospital Social Worker & Chaplain Marcia Penido, LCSW, MPHCo-Chair, Organ & Tissue Donation CommitteeHuntington Hospital
Objectives At the end of this presentation, the participant will be able to:Understand their hospital’s donation policy (timely referrals, diligent search, administrative consent).Understand how they can impact the momentum of a referral/donor case.
Prompt the Referral Know the clinical triggers for referring patients:Loss of >1 brainstem reflex &/orDNR & terminal extubation being consideredEnsure referral is on the radar of the MD/RNFollow-up until referral is made
Trigger Card
Identify Patient/N.O.K. Do you have a diligent search protocol?Have you thought of everything?Do you have a time limit set?Legally-recognized decision-maker vs N.O.K.Does your hospital allow administrative consent?
Support the Support System Prepare them for MD’s dx/pxAttend care conference(s) if possibleValidate their griefReinforce medical info, if neededAssist with concrete issues/answersGet spiritual care provider, if neededOffset anger directed at hospital/healthcare teamRun interference vs. withdraw into the background
Follow the Referral Is the patient ruled in or out?What did OL write?What does the MD/RN know?Does OL’s understanding match the MD’s?DCD vs BD?Map out the process for what will happenEnsure unit staff understand & communicate in shift report
Pave the Way for Approach N.O.K.Decision-maker(s) InfluencersSaboteursMIAsCareful responses if donation questions are askedObserve/listen for family dynamicsAsk about documents/listen for clues as to patient’s wishes
Huddle with the Team Have a Team Huddle Worksheet on which to document collaboration/plan Part of Medical RecordHuddle upon OL’s arrivalHuddle upon FCS’s arrivalHuddle prior to approachHuddle whenever helpful(Did I mention you should huddle?)
Follow after the Approach Support family regardless of decisionEnsure they know their decision is not judged or rewardedAnswer questionsProvide referralsRun interference with potential saboteursObserve/listen for information helpful to After Action Review & pass it onto Donor Council
Learn, Learn, Learn Review every caseCelebrate perfect collaborationLearn from challenges & declinesSuccess is an effective request what the patient would have wanted or the N.O.K. needed to do
Wait! There’s More for You to Do!Do you have a Donor Council/Donation Committee?Is your discipline/department represented?Is the nursing unit where donors are referred represented?Do you have a method for giving feedback after cases are identified?Do you receive recognition when there’s a success or challenging case?Do you celebrate donor families?
Maximizing Outcomes… Support….the family/support systemDiffuse…any distrust, misunderstandings, misperceptions, dissatisfactionFollow closely…the process so that all policies are followed & opportunity for donation is being protectedLiaison…between medical staff & OL, ensuring collaboration
What Factors Can Affect an Approach?Robert CoppelFamily Care SpecialistOneLegacy
ObjectivesAt the end of this presentation, the participant will be able to:Understand what constitutes an effective or ineffective approach.Understand of what a OneLegacy family approach consists.
Why Huddle?CollaborationFact findingFirst Person Consent / Advance DirectivesIdentify LNOK, Family Support SystemUnderstanding family dynamics, key decision-makersSpiritual and Cultural needs of each familyEstablishing Hospital family support system: SW, Pastoral, etc.
Negative Factors Affecting ConsentInappropriate mention of donation registered or otherwiseInadequate explanation of grave prognosisInaccurate assessment of familyTiming
Hospital supports organ donationTeam huddlesAppropriate requestorFamily satisfied with quality of care and communicationPositive Factors Affecting Consent
Reasonable time allowed with loved oneUnderstanding of brain deathMD coordinates end-of-life discussionPositive Factors Affecting Consent
Has the doctor talked with you?What did he/she tell you?What does that mean to you?What Happens Behind Closed Doors?
Explain brain death, even if family understands. Keep in simple terms.Discuss funeral arrangements.Discuss coroner’s case and possible autopsy.What Happens Behind Closed Doors?
Thank You
AFTERcareContinuum of Care….What Happens Next? Michelle Post, MA, LMFT OneLegacy Clinical Aftercare Specialist Chair of AOPO Donor Family Service Council mpost@onelegacy.org
Objectives At the end of this presentation, the participant will be able to:Recognize how OneLegacy’s Aftercare Department supports donor families.Verbalize which aftercare programs, events, and correspondence is available to donor families.
Our PhilosophyAFTERcare = “Companioning” a bereaved family (Alan Wolfelt, Ph.D.)Not experts on grief; take cues & offer support… Do not lead~ Walk WITH
Our PhilosophyAFTERcare = ConsistencyAfter a family consents to donation, regardless of medically closing the case and not transplant…Minimum of 2 years of support from OneLegacy Aftercare Department
Who Supports the Family?OneLegacy Aftercare Staff & Interns =Interdisciplinary team: RN, LCSW, LMFT, MSW, Chaplain
Aftercare Program ~ 2 yrs Sympathy Card
Aftercare Program ~ 2 yrs Anniversary Card on One Year Anniversary of Loved One’s Death
Aftercare Program ~ 2 yrsLetters of Support Grief literature Timed intervals from the death through 2 yrs
“The Companion”, a Donor Family Newsletter3 times a year for as long as they want to continue to be on our mailing list
Aftercare ProgramPhone calls of support
Monthly Grief GroupsSaturday Mornings ~Downtown LA – Kids, Teens, Adults (Span & Eng)Redlands (Spanish – hope to start Eng)O.C. (Hope to start Eng, Fall) Building Hope Through Companioning
Day of the Dead Craft Day & Cultural Diversity in Grief Wrkshp
Surviving the Holidays WorkshopFrames, Ornaments, Plates in memory of donors
Aftercare Intern ProgramShort-Term Grief Support Services
ON-LINEPrivate Facebook Group for Donor Families
“Fields of Gold” Donor Remembrance Ceremonies Each family receives a Life Bridges Donor Pin & Pendant set Hundreds of donor family members gather at three annual events Terry Harrington, heart recipient and the ‘voice’ of Lisa’s sax on the “Simpsons,” performs
Donate Life Rose Parade Float Decorating Days & Family Circle Rose Dedication A donor family gathers to decorate in honor of their loved one Donor parents dedicating a rose Donor Sister works on the Donate Life Float
Donate Life Run/Walk Donor families formed teams of all sizes and walked in honor of their loved ones. T-shirts personalized with each donor’s picture & Family Circle Garden Posters
Bridging Lives QuiltDonor families can create a quilt block which becomes a community based quilt Kern County Bridging Lives Quilt with project leader Becky Pitre
Organ Recipient Medical UpdatesTissue Disposition updatesDonor Family and Recipient Meetings Other Aftercare Services
Long after the donation is complete...AFTERcare is available Michelle Post, MA, LMFT OneLegacy Clinical Aftercare Specialist Chair of AOPO Donor Family Service Council mpost@onelegacy.org
Questions to Run On How can the hospital’s family support staff help guide the donation process?How can you help ensure a family is approached effectively and appropriately?What happens with a donor family AFTER an organ or tissue donation?