Severe Shortage of Organs Leaves 85,000 Americans on Transplant Lists: Joint Commission Panel Offers Solutions to National Crisis 6/15/2004
From: Charlene Hill of the Joint Commission on Accreditation of Healthcare Organizations, 630-792-5175 or chill(at)jcaho.org OAKBROOK TERRACE, Ill., June 15 -- The Joint Commission on Accreditation of Healthcare Organizations today issued a call to action to eliminate the expanding gap between patients awaiting organ transplantation -- especially those in racial and ethnic minority groups -- and the availability of organs to meet their needs. The call to action is set forth in the Joint Commission's newest public policy white paper, "Health Care at the Crossroads: Strategies for Narrowing the Organ Donation Gap and Protecting Patients." More than 85,000 people in the United States now await life- saving transplants and over 6,000 people die each year while waiting for organs to become available. Both of these numbers grow daily. In addition, current epidemics of morbid obesity, hypertension and diabetes have the potential to drive the need for organs to still greater levels and make this an even more critical public health issue in coming years. Despite efforts by many hospitals, the federal government, organ procurement professionals, and selfless individuals who themselves have become living organ donors, the Joint Commission report concludes that what has been tried to date has simply not been enough. "The challenge today is to make the gift of life available to all who need it," says Dennis S. O'Leary, M.D., president, Joint Commission. "All of the key players -- hospitals, physicians, other clinicians, organ donation coordinating groups, regulators, educators, public policy-makers, community leaders, researchers, and advocacy groups need to come together in a concerted effort. The time for action is now." The Joint Commission's white paper was developed in collaboration with an Expert Roundtable whose 36 members represented a wide diversity of interests relevant to organ donation. The report contains 33 specific recommendations and identifies accountabilities for each recommendation. This is intended to provide a roadmap for following through on the recommendations. The Joint Commission report also suggests approaches to creating hospital cultures in which organ donation is a priority and emphasizes the need to find alternatives to meet the growing demand for organs. Failure to aggressively address the severe shortage of organs, the Joint Commission warns, could have ominous consequences for the American population. "When it comes to organ transplantation, there are substantial disparities for ethnic and racial minorities," says Clive O. Callender, M.D., F.A.C.S., chairman, Department of Surgery, Howard University Hospital, and founder, Minority Organ and Tissue Transplant Education Program. "While ethnic minorities represent 25% of the population in the United States, they comprise 50% of the people who are waiting for organs on the kidney transplant waiting list. And African Americans wait twice as long for an organ than White Americans." In order to change existing attitudes and behaviors related to organ donation, the Expert Roundtable identified the following three strategies: -- Make organ donation a priority by focusing efforts on the hospitals having the greatest potential to identify organ donors and implement national "best practices" for organ donation, including education of hospital staff about organ donation. This focus also involves examination of the financial issues that affect or could help to facilitate donation, such as making success in organ donation a criterion in potential pay-for- performance models and encouraging Medicare reimbursement for costs related to maintaining potential organ donors prior to declaration of death. -- Bring equity, fairness and safety to the transplantation process by employing grassroots efforts to raise awareness, change behavior and increase the rate of donation among ethnic and minority groups. Research is also needed to better understand why disparities in transplantation rates exist. African Americans wait longer for organs than their Caucasian counterparts, are offered transplantation far less often, and frequently have lower survival rates than Caucasians. The legitimate transplantation needs of persons with disabilities also must be addressed. In addition, the increasing reliance on living organ donors requires that their safety be protected and underscores the need for a national living donor registry that could track complications and outcomes. -- Seek new ways to meet the demand for organ donation by emphasizing responsibility of hospital personnel to honor the prior wishes of organ donors without requiring consent from the donor's family, and developing protocols that would provide for and encourage donation after cardiac death. Other strategies include curbing demand by expanding preventive and health promotion programs aimed at preventing organ failure. The Joint Commission itself already promotes organ donation through its accreditation requirements for hospitals, and earlier this year launched a national "Speak Up" campaign for individuals who are considering becoming live organ donors. The campaign urges living donors to themselves make the process as safe as possible by becoming active, involved and informed. Consumers can download the "Speak Up" brochure that provides specific guidance to living organ donors by visiting the Joint Commission website, http://www.jcaho.org. A complete copy of the Joint Commission white paper, "Health Care at the Crossroads: Strategies for Narrowing the Organ Donation Gap and Protecting Patients" is available at http://www.jcaho.org. The report is part of a continuing series of white papers on key public policy issues that impact patient safety and health care quality. ------ Founded in 1951, the Joint Commission on Accreditation of Healthcare Organizations seeks to continuously improve the safety and quality of care provided to the public through the provision of health care accreditation and related services that support performance improvement in health care organizations. The Joint Commission evaluates and accredits nearly 16,000 health care organizations and programs in the United States, including 8,000 hospitals and home care organizations, and more than 8,000 other health care organizations that provide long term care, assisted living, behavioral health care, laboratory and ambulatory care services. The Joint Commission also accredits health plans, integrated delivery networks, and other managed care entities. An independent, not-for-profit organization, the Joint Commission is the nation's oldest and largest standards-setting and accrediting body in health care. |