Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34377
Title: The impact of organ donation specialists on consent rate in challenging organ donation conversations.
Austin Authors: Radford, Samuel T ;D'Costa, Rohit;Opdam, Helen I ;McDonald, Mark;Jones, Daryl A ;Bailey, Michael;Bellomo, Rinaldo 
Affiliation: DonateLife Victoria, Melbourne, VIC, Australia.
DonateLife Victoria, Melbourne, VIC, Australia.;Melbourne Health, Melbourne, VIC, Australia.
Austin Health
Organ and Tissue Authority, Melbourne, VIC, Australia.
Austin Health, Melbourne, VIC, Australia.;Monash University, Melbourne, VIC, Australia.;Australian New Zealand Intensive Care Research Centre (ANZIC-RC), Melbourne, VIC, Australia.
Monash University, Melbourne, VIC, Australia.;Australian New Zealand Intensive Care Research Centre (ANZIC-RC), Melbourne, VIC, Australia.
Melbourne Health, Melbourne, VIC, Australia.;Monash University, Melbourne, VIC, Australia.;Australian New Zealand Intensive Care Research Centre (ANZIC-RC), Melbourne, VIC, Australia.
Issue Date: Dec-2020
Date: 2023
Publication information: Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine 2020-12; 22(4)
Abstract: Background: Consent rates for organ donation conversations (ODCs) vary. We hypothesised that a simple grading system could identify challenging ODCs. We further hypothesised that challenging ODCs would have higher consent rates when conducted by ODC specialists. Objectives: We aimed to study the utility of a grading system for ODCs and test the hypothesis that any training effect would be associated with improved consent rates in ODCs graded as most challenging. Methods: We stratified 2017 Australian DonateLife Audit aggregate consent and donation discussion data into four ODC grades based on Australian Organ Donor Register (AODR) status and person first raising the topic of organ donation. Grade I: "yes" present on AODR and family-raised organ donation; Grade II: "yes" present on AODR, and clinician-raised organ donation; Grade III: no registration on AODR but family-raised organ donation; and Grade IV: no registration on AODR, and clinician-raised organ donation. Results: Grade I ODCs were uncommon 7.7% (109/1420), with a consent rate of 95.4% (104/109). Grade IV ODCs were frequent (60.4%, 857/1420), with a consent rate of 41.4% (355/857). However, in Grade IV ODCs, organ donation specialist consent rate was 53.5% (189/353), significantly greater than for other trained staff at 33.1% (88/266) (P < 0.005; odds ratio [OR], 2.33; 95% CI, 1.68-3.24) or untrained requestors at 32.8% (78/238; P < 0.005; OR, 2.36; 95% CI. 1.68-3.33). Conclusion: The likelihood of consent can be predicted using readily available variables. This allows prospective identification of Grade IV ODCs, which carry low but potentially modifiable likelihood of consent. Involving donation specialists was associated with more consents for organ donation when applied retrospectively to Australian audit data.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34377
DOI: 10.51893/2020.4.OA1
ORCID: 
Journal: Critical Care and Resuscitation : Journal of the Australasian Academy of Critical Care Medicine
Start page: 297
End page: 302
PubMed URL: 38046873
Type: Journal Article
Appears in Collections:Journal articles

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