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Family communication coordination: a program to increase organ donation.

To improve organ donation performance, the Medical College of Virginia Hospitals implemented a comprehensive family support and communication program, consisting of a standard family communications protocol, a hospital-based team from the Department of Pastoral Care, targeted staff education, and an ongoing quality assurance measuring and monitoring system. The 3 best-demonstrated request practices, private setting, "decoupling," and collaboration in the request between the organ procurement organization and hospital staff, were incorporated into the program. Improvement in the consent and donation rate was evident in the second calendar year of the program; the consent rate was 72% and the donation rate was 50%. During the second year, there was also a positive correlation between "decoupling," appropriate requestor, and the consent rate. Implementation of a hospital-based team and a standard protocol facilitated the clarification of roles and responsibilities toward clearer and more consistent family communication and support. Data suggest that staff experience is a major contributor to a positive donation outcome.