Project
Tissue Donation Coordinator (TDC) Pilot
The NTS conducted a pilot study on the deployment of tissue donation coordinators to assist doctors in the donation procedure. What was the result?
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Tissue donation is a complex procedure. With the introduction of the new donor law (July 1, 2020) and the Quality Standard for Donation, the need for specialized support in hospitals increased.
Doctors only deal with tissue donation occasionally and therefore have little opportunity to build routine. They experience the procedure as time-consuming and combine it with other patient care. This can lead to lower quality of aftercare and fewer consents for donation.
What was the goal?
In this pilot, we tested whether a central role as a tissue donation coordinator can help doctors. All responsibilities surrounding tissue donation were assigned to one specialized professional in the pilot: the tissue donation coordinator (TDC).
We wanted to know if this relieves the burden on doctors, improves care for surviving relatives, and makes the procedure more efficient.
Collaboration
The NTS coordinated the pilot in collaboration with project leaders from the pilot hospitals. The pilot was carried out in:
- Medisch Centrum Leeuwarden (MCL)
- University Medical Center Groningen (UMCG)
- Haaglanden Medisch Centrum (HMC)
For this, we requested the deployment of specially trained hospital doctors, donation coordinators, and TDCs.
Approach
The WDC could take over tasks throughout the entire procedure: identifying donors, consulting the Donor Register, conducting the donation conversation, registering the tissue donor, and providing aftercare to the next of kin.
The implementation of this role differed per pilot hospital:
- MCL & HMC: WDC took over all tasks.
- UMCG: WDC only handled the registration.
Experiences of project leaders
The project leaders advocate for the structural deployment of WDCs:
- HMC (Jacqueline Blok): Identification of tissue donors improved and the consent rate rose significantly. Telephone conversations with families worked well, but physical presence with the deceased was sometimes lacking.
- UMCG (Jan Niesing): WDCs provided valuable aftercare and ensured feedback to the next of kin. This requires regional deployment of donation coordinators as WDCs.
- MCL (Renée Porta): The 24/7 availability worked well. WDCs were better prepared and trained in communication, which made conversations and aftercare more professional.
Results
The pilot showed that the deployment of a WDC increases the quality of the process and is experienced positively by both next of kin and professionals.
- Next of kin especially appreciate the time and attention they received from the WDC. It does not matter whether the donation conversation was conducted face-to-face or by telephone.
- The involved doctors appreciate being able to hand over the procedure to someone who is trained in it and has more time to support the next of kin.
- WDCs notice that as they guide more procedures, they are able to provide increasingly better care.
The identification of potential donors and the number of consultations of the Donor Register have also increased. The NTS concludes that the deployment of the WDC increases the quality of the tissue donation process and that it would therefore be good to deploy WDCs more broadly.
Practical and logistical challenges
The WDC pilot was successful, but national implementation still faces logistical and practical challenges. A dedicated team of WDCs with specific training and a healthcare background is needed. The following questions remain open:
- Must a WDC be available 24/7, and can this be done within the current budget?
- What does limited availability mean for retrieval teams and tissue banks?
- How will a nationally operating WDC gain access to local electronic patient records?
The NTS and the Ministry of Health, Welfare and Sport are investigating these questions to determine whether national implementation is feasible in terms of capacity and budget.