Leigh Anne Dageforde1, William Muren2, Su-Hsin Chang3, Neeta Vachharajani4, Diane Brockmeier2, Jennifer Yu4, Blaire Anderson5, Surendra Shenoy4, Yiing Lin4, Adeel Khan4, Jason Wellen4, William Chapman4, Majella Doyle4. 1. Department of Surgery, Division of Transplantation, Massachusetts General Hospital, Boston, MA. 2. Mid-America Transplant Services, Saint Louis, MO. 3. Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, Saint Louis, MO. 4. Department of Surgery, Division of Abdominal Organ Transplantation, Washington University in St. Louis School of Medicine, Saint Louis, MO. 5. Department of Surgery, Division of Transplant, Nebraska Medicine, Omaha, NE.
Abstract
BACKGROUND: More people who have personally consented to organ donation via first person authorization (FPA) registration before death become organ donors than those not personally consenting. The majority of registrations occur at state-specific department of motor vehicle (DMV) and licensing offices, where people register their vehicles and obtain driver's licenses. METHODS: One organ procurement organization (OPO) ran 3 DMV offices and implemented an intervention: a donor-centric approach, including employee education, office decoration with donation materials, and customer experience improvements. Data about registry enrollment was collected before and during the 4-year OPO licensing office contract. A linear mixed model and interrupted time series analyses were performed to evaluate whether the intervention improved rates of registration. RESULTS: Preintervention registry enrollment rates per month were 10%-50%. Having the offices run by an OPO was associated with more enrollments independent of the increasing trend of enrollment (P < 0.001). Also, the DMV office with the lowest preimplementation registration rates had an immediate increase in enrollments after the intervention leading to higher registration rates (P < 0.001). CONCLUSIONS: A donor-centric OPO-managed DMV experience increases FPA registration, especially at offices with low initial registration rates. However, even at the office with the highest percentage of FPA registrations, rates were only 65% at intervention conclusion. The transplant community should consider other opportunities for FPA registration.
BACKGROUND: More people who have personally consented to organ donation via first person authorization (FPA) registration before death become organ donors than those not personally consenting. The majority of registrations occur at state-specific department of motor vehicle (DMV) and licensing offices, where people register their vehicles and obtain driver's licenses. METHODS: One organ procurement organization (OPO) ran 3 DMV offices and implemented an intervention: a donor-centric approach, including employee education, office decoration with donation materials, and customer experience improvements. Data about registry enrollment was collected before and during the 4-year OPO licensing office contract. A linear mixed model and interrupted time series analyses were performed to evaluate whether the intervention improved rates of registration. RESULTS: Preintervention registry enrollment rates per month were 10%-50%. Having the offices run by an OPO was associated with more enrollments independent of the increasing trend of enrollment (P < 0.001). Also, the DMV office with the lowest preimplementation registration rates had an immediate increase in enrollments after the intervention leading to higher registration rates (P < 0.001). CONCLUSIONS: A donor-centric OPO-managed DMV experience increases FPA registration, especially at offices with low initial registration rates. However, even at the office with the highest percentage of FPA registrations, rates were only 65% at intervention conclusion. The transplant community should consider other opportunities for FPA registration.