Public Reporting

The purpose of public reporting is to enable Trillium Gift of Life Network (TGLN) and participating Ontario hospitals to demonstrate their commitment to honor the public’s intent to donate. Public reporting is a clear method to share donation performance to patients on transplant waiting lists and provide knowledge on donation activities to the greater Ontario public.

Background / Context

There are many different types of hospitals in Ontario and there are also a number of factors which could affect the organ and tissue donation performance of hospitals. Following are definitions of the three performance indicators being reported (Routine Notification Rate, and Conversion Rate and Eligible Approach Rate) and the influences that may impact hospital results.

Routine Notification Rate measures a hospital's compliance with notifying Trillium Gift of Life Network (TGLN) of all reportable deaths and patients at high risk of imminent death, in accordance with the Trillium Gift of Life Network Act. Contributing to the variation in hospitals’ Routine Notification Rate is the extent to which hospitals have established policies and procedures to facilitate notification and whether the notification process has been integrated into end-of-life care.

Conversion Rate measures the percentage of actualized organ donors; i.e. the number of donors from whom at least one organ was recovered and transplanted, out of all potential organ donors determined through health record review. Potential donors include those who are medically suitable, where next of kin is available to approach for consent, and for whom the coroner has provided permission to proceed with donation. Conversion Rate may be affected by a variety of factors such as those listed below:

• Type of hospital; where neurosurgical and/or trauma centres (Class A Hospitals) are more likely to have a higher number of potential organ donors;
• Size of the population serviced by a hospital and a given hospital’s referral pattern to larger regional centres;
• Frequency and presence of disease(s) and/or condition(s) which may contribute to the suitability of a person to be a donor;
• The timing of the notification of a potential donor to TGLN;
• The working relationship between TGLN and the hospital to ensure optimal approach planning when seeking consent from families for organ and tissue donation. Skill and knowledge of hospital physicians/staff in planning, with TGLN, for a sensitive and compassionate discussion about donation; and
• Patients’ and their families’ personal beliefs and practices at end-of-life.

Eligible Approach Rate measures the overall rate of approaches for organ donation from those cases considered eligible for approach. This metric is used to evaluate system performance. Eligible Approach Rate may be affected by a variety of factors such as:

• The extent to which hospitals have policies to facilitate referrals to TGLN;
• The timeliness of notification to TGLN;
• Documentation in the policy of the hospital’s commitment to mandatory approach; and
• Setting withdrawal of life-sustaining therapy times (WLST) with families, thereby allowing for time to assess for potential donation.

 

Definitions

Designated Hospital:

• Is required by Ontario law to comply with PartII.1 of the Trillium Gift of Life Network Act;

• As per Part II.1 of the Trillium Gift of Life Network Act, the hospital is required to notify Trillium Gift of Life Network when a patient has died or is at risk for imminent death.

 
Class A Hospital:

• Any hospital that provides neuro-surgical and/or trauma services to communities in Ontario;

• These hospitals are the regional providers of neuro-surgical and/or trauma services to large geographical areas.

 
Class B Hospital:

• Any hospital that doesnot provide neuro-surgical and/or trauma services, but can make a Death Determination by Neurologic Criteria (DNC).

 
Class C Hospital:

• Any hospital that is not able to make a Death Determination by Neurologic Criteria (DNC).
  
  

Potential Donor:

• A deceased patient who has been identified as having organ donation potential. This determination is made after review of the medical record.
  
  

Actual Donor:

• A deceased patient who has donated at least one organ that was recovered and transplanted.
  
  

Routine Notification Rate:

• The overall rate of compliance with the legislative requirement for notification of a patient’s death or imminent death to Trillium Gift of Life Network. This is the percentage of all referred cases to TGLN vs. all cases that should have been referred to TGLN.
  
  

Conversion Rate:

• The overall rate for deceased patients who became actual organ donors from those that appear to have organ donor potential (potential donor). This determination is made after review of the medical record.
  
  

Eligible Approach Rate:

• The overall rate of approaches to families/ substitute decision makers for organ donation of those cases considered eligible for approach.
  
  

Blank Data Field:

• A blank in the data field indicates that the hospital had no deceased organ donation potential for the time period being reported.
  
  

 

Frequently Asked Questions