PPF5 Education isn’t enough: challenges to increasing discussions on organ donation

<h3>Background</h3> Despite the introduction of an ‘opt-out’ system in 2020, 8,132 patients in the UK are awaiting organ transplants.^{1 2} NICE advises organ donation should be a routine consideration in end-of-life care planning, however at Moya Cole Hospice discussions were observed to be infrequent.³ This cross-site project evaluated the effect of three educational interventions on the frequency of organ donation discussions. <h3>Methods</h3> A target compliance of discussions with 70% of patients was set, allowing clinician discretion to avoid distress.⁴ Case notes for admissions to both Moya Cole Hospice sites, Heald Green (HG) and Little Hulton (LH), were reviewed at baseline and after each intervention. Interventions included a teaching session for medical staff, an educational poster and introduction of organ donation advocates. <h3>Results</h3> At baseline, organ donation discussions were held with 4.08% of patients at HG and 11.4% at the LH site. Following the first intervention, compliance at both sites improved, to 12.9% at HG and 24% at LH. Following the second intervention, compliance increased to 15.1% at HG but decreased to 2.22% at LH. Following the third intervention, compliance increased to 25.9% at HG and 12.5% at LH. <h3>Conclusion</h3> Available literature suggests education of staff is key to increasing organ donation discussions in end-of-life care planning.^{4 5} This project suggests a more inconsistent picture; despite three educational interventions, sustained improvements were not achieved. Challenges included the rotational resident doctor workforce, demonstrated by a marked decrease in compliance at the LH site after rotation. Coordinating interventions across both sites also presented difficulties; delays and staffing differences led to inconsistent results. Future plans to mitigate these issues include incorporating teaching sessions into all inpatient unit staff inductions and inclusion of organ donation discussion prompts in standardised advance care planning documents.. <h3>References</h3> NHS Blood and Transplant (2020) ‘Date announced for Max and Keira’s Law to come into effect’. [Online] Available at: https://www.organdonation.nhs.uk/get-involved/news/date-announced-for-max-and-keira-s-law-to-come-into-effect/[Accessed 04/10/25] NHS Blood and Transplant (2025) ‘Statistics about organ donation’. [Online] Available at: https://www.organdonation.nhs.uk/helping-you-to-decide/about-organ-donation/statistics-about-organ-donation/[Accessed 04/10/25] National Institute for Health and Care Excellence (2016) ‘Organ donation for transplantation: improving donor identification and consent rates for deceased organ donation’. [Online] Available at: https://www.nice.org.uk/guidance/cg135 [Accessed 04/10/25] Madi-Segwagwe BC, Bracher M, Myall M, Long-Sutehall T. Barriers and facilitators to eye donation in hospice and palliative care settings: a scoping review. <i>Palliative Medicine Reports</i> 2021;<b>2</b>(1):175–187. Wale J, Arthur A, Faull C. An analysis of knowledge and attitudes of hospice staff towards organ and tissue donation. <i>BMJ Supportive &amp; Palliative Care</i> 2014;<b>4</b>:98–103.