specialist medical and surgical services –
organ donation coordination education and information Service
(organ donation new zealand)
Tier LEVEL two
SERVICE Specification
Status:
It is compulsory to use this nationwide service specification when purchasing this service.
/MANDATORY þ
Review History
/Date
First Published on NSFL / April 2006Review of the 2006 Organ Donation Coordination Education and Information Service
Amendments: updated content, terminology and quality requirements. / April 2014
Consideration for next Service Specification Review / within five years
Note: Contact the Service Specification Programme Manager, National Health Board Business Unit, Ministry of Health to discuss proposed amendments to the service specifications and guidance in developing new or updating and revising existing service specifications.
Nationwide Service Framework Library web site http://www.nsfl.health.govt.nz
SPECIALIST MEDICAL AND SURGICAL SERVICES –
ORGAN DONATION COORDINATION, EDUCATION AND
INFORMATION SERVICE
(ORGAN DONATION NEW ZEALAND)
TIER LEVEL TWO
SERVICE SPECIFICATION
T0108
This tier two service specification for the Organ Donation Coordination, Education and Information Service (the Service) should be read in conjunction with the tier two Solid Organ Transplant Services service specification and is linked to the Tier One Specialist Medical and Surgical Services service specification.
1. Service Definition
The Service is a national service for deceased organ and tissue donation purchased by a single lead District Health Board (DHB), Auckland DHB, on behalf of all DHBs and delivered by Organ Donation New Zealand (ODNZ).
The Service:
· coordinates organ and tissue donation in New Zealand (NZ) Intensive Care Units (ICUs)
· coordinates tissue only donation in the hospital and community setting and refers as appropriate to other tissue donation / banking services
· coordinates referrals of livers and cardiothoracic organs from Australian coordinators to transplant services in NZ
· provides educational programmes to health professionals involved with organ and tissue donation
· provides information and follow-up for the families and whanau of organ and tissue deceased-donors
· provides information to the public and advice to health professionals about organ and tissue donation in NZ
· audits organ donation practices in NZ and works with health professionals in donor hospitals to ensure there are nationally consistent processes for deceased donation
· assists the Paired Kidney Exchange Programme (by packing and transporting kidneys).
2. Exclusions
The following are excluded from this Service:
· living donation of kidneys and liver[1] (ODNZ will refer the public to the most appropriate department for advice)
· blood, haemopoeitic progenitor cell donation (HPC)
· living bone donation
· tissue coordinated and retrieved by the tissue coordinators as part of Coroner’s autopsies in Auckland
· eye tissue coordinated and retrieved by the Eye Bank for eye only donors (except in the ICU environment).
· public awareness campaigns about organ donations.
3. Service Objectives
3.1 General
The key objectives of the Service are to:
· provide, within the bounds of best clinical practice, as many highest quality organs and tissues as possible for transplant recipients in NZ and Australia.
· develop, maintain and enhance nationally consistent processes for deceased donor organ and tissue donation in NZ
· work collaboratively and in cooperation with the tissue donation services for the best outcome for all New Zealanders.
2.2 Māori Health
Refer to tier one Specialist Medical and Surgical Service specification.
In addition, the Service must recognise the cultural values and beliefs that influence the effectiveness for services for Māori people and must consult and include Māori in service design and delivery.
4 Access
4.1 The Donor Coordinator
The 24 hour service for consultation for clinicians about potential organ and tissue donation is accessed through a single direct dial number (phone 09 630 0935). This call is responded to by a donor coordinator.
A medical specialist is available 24 hours (through the donor coordinator) to provide advice and support for health professionals involved in the donation process.
4.2 Other services
Outside of potential organ and tissue donation, the Service is provided during normal working hours and is accessed via telephone, email and separate websites for health professionals and the public.
5 Service Components
5.1 Processes
5.1.1 Co-ordination and retrieval services
The Service will coordinate:
· the donation, retrieval and transport of organs and tissues retrieved from patients who donate following death in intensive care units in NZ
· organs referred from Australia for transplant in NZ and referral to Australia of organs from NZ according to the terms of the reciprocal organ sharing agreement between Australia and NZ
· the donation of tissue from tissue only donors as defined in the Service Definition and Exclusion sections above.
6.1.2 Education, support and follow-up
The Service will:
· provide information and support to family and whanau of deceased donors both prior to and following organ and / or tissue donation
· provide follow-up for family and whanau of deceased organ and tissue donors where ODNZ was involved in the donation
· provide consultation, information, advice, support and follow-up to healthcare professionals caring for potential deceased-donors and their family and whanau
· provide accurate and up-to-date information to the public, media and other stakeholders about organ and tissue donation. This may require collaboration and referral to other agencies
· provide education and support for Link Teams (including senior nurses in ICUs. and operating theatres and ICU doctors). Link Teams provide a link between donating hospitals and ODNZ. Link Team members also enable improved education, further development of donation practices and ongoing monitoring and evaluation of the donation processes
· establish and maintain educational programmes for health professionals involved in organ and tissue donation. The educational programmes ensure that health professionals have the necessary expertise in all aspects of the donation process.
6.1.3 Advisory Committee
ODNZ maintains and provide secretariat support to an Advisory Committee (which provides ODNZ with a mechanism for obtaining input from health professionals involved in organ and tissue transplantation, and in intensive care medicine and nursing, as well as from Māori and Pacific peoples and the ‘consumer’).
The functions of the Advisory Committee include, but are not limited to:
· contributing to a strategic direction which ensures that initiatives to increase organ and tissue donation in NZ are evidenced-based and coordinated, and
· responding to safety concerns in organ and tissue donation.
6.2 Audit and Monitoring
The Service will:
· quantitatively and qualitatively monitor organ donation in NZ
· collect information on key measures of donation practice including consultation with ODNZ, determination of death, formal discussion with families of potential organ donors and the number of actual organ and tissue donors
· support the ‘ICU Link Nurses’ in all NZ hospitals to provided ODNZ the above information.
6.4 Budget management
The Service will manage the budget for the National Kidney Allocation System.
6.5 Key Inputs
ODNZ Staff
The Service is comprised of a part time clinical director, part time medical specialist, four donor coordinators, a communications advisor and team support.
Link Team Members
The Link Team members play a key role as local leaders, experts and liaison persons for organ and tissue donation in all donor hospitals in New Zealand. They consist of:
· Intensive Care Unit (ICU) Link Nurse(s)
· Operating Theatre Link Nurse(s), and an
· ICU Link Doctor.
6.6 Settings
The Service is located at the Greenlane Clinical Centre in Auckland, NZ.
7. Service Linkages
This section specifies services that are linked to the Service but are not purchased as a direct, integral component of the Service. The Service is multi-faceted, requiring linkages to provide liaison, information, education and effective working relationships as required with:
Linked Providers
/ Accountabilities associated with linkages /NZ ICUs / To provide a responsive co-ordination service, expert clinical advice and education
Other NZ hospitals’ staff / To provide a responsive co-ordination service, expert clinical advice and education
Transplant Units in New Zealand and Australia / To provide maximum number of organs in optimum condition for transplant services
NZ Tissue Banks, including:
• New Zealand National Eye Bank
• Heart Valve Laboratory
• New Zealand Blood Service Skin Bank / To maintain effective working relationship, including to refer all ‘eye-only donors’ (except in the ICU) to the New Zealand National Eye Bank
The NZ Blood Service and Laboratories in NZ / To maintain effective working relationship
Commercial transport operators / To maintain effective working relationship
Donor co-ordinators in Australia / Provide responsive co-ordination service and maintain effective working relationship
Medical Director, National Kidney Allocation System / To maintain effective working relationship
NZ Donor Families / To maintain appropriate communication
Health agencies, media and the public / To provide information, maintain effective working relationship
8. Quality Requirements
The Service must comply with the Provider Quality Standards described in the Operational Policy Framework or, as applicable, Crown Funding Agreement Variations, contracts or service level agreements.
The Service must comply with:
· the accepted Australasian clinical best practice guidelines, currently Australia and New Zealand Intensive Care Society (ANZICS) Recommendations concerning Brain Death and Organ Donation (Version 3.2, 2013) or, as amended in the future
· Transplantation Society of Australia and NZ (TSANZ) and Australasian Transplant Coordinators Association (ATCA) standard operating procedures
· quality standards as directed by the Ministry of Health
· legislation and NZ Government policy statements, as communicated.
9 Purchase Unit and reporting requirements
9.1 Purchase Units are defined in the joint DHB and Ministry’s Nationwide Service Framework Purchase Unit Data Dictionary. The following purchase unit code applies to this Service.
PU Code / PU Description / PU Definition / Unit of Measure / Payment systemsT0108 / Organ donation co-ordination / Facilitation of supply of donor organs and tissue for the NZ population and organ sharing with Australia / Programme / Sector Services Contract Management System
9.2 Reporting requirements
An annual narrative report and budget reports (as required) is to be provided to the Funder Auckland DHB.
Reporting RequirementsFrequency / Reporting Unit
Annual / Narrative report as outlined below, and:
• number of educational programmes delivered and to whom
• the number of families of potential deceased organ donors who had formal discussion of donation
• the number of actual organ /tissue donors
As required / Budget reports to Auckland DHB.
Narrative report
The narrative report must identify issues and trends in service provision and other matters of interest to DHBs, the Ministry of Health and tissue banks, including:
· the terms of reference of the Advisory Committee
· the membership, including duration of members of the Advisory Committee
· outline of the material and issues considered by the ODNZ Advisory Committee
Annual trends in service provision of:
· the numbers of educational programmes delivered, and to whom
· the number of families of potential deceased organ donors who had formal discussion of donation
· the number of actual organ / tissue donors.
6
Specialist Medical and Surgical Services - Organ Donation Coordination Education and Information Service (Organ Donation New Zealand Services), Tier Two service specification. April 2014
Nationwide Service Framework
[1] Living organ donation services are provided by kidney transplant services in Auckland, Wellington and Christchurch and by the NZ Liver Transplant Unit in Auckland.