HUDDLES

1. HUDDLES Elizabeth Spencer, CPTC Director of Hospital Development Washington Regional Transplant Consortium

2. 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%

3. 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

4. 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

5. 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 → Continuityof 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

6. 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

7. 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

8. 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.

9. 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

10. Questions?