Improving quality of withdrawal of life-sustaining measures in organ donation: a framework and implementation toolkit
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Improving quality of withdrawal of life-sustaining measures in organ donation: a framework and implementation toolkit Ame´lioration de la qualite´ de l’interruption des traitements de maintien en vie lors du don d’organes : proposition d’un cadre et d’outils d’aide a` la mise en œuvre . Michael Hartwick, MD . James Downar, MD . Andrew Healey, MD . . . Sean Keenan, MD Jehan Lalani, MHA Jim Mohr, MBA Amber Appleby, RN MM . . . Jenna Spring, MD Jesse W. Delaney, MD Lindsay C. Wilson, MHA . Sam Shemie, MD . for Canadian Blood Services, the Canadian Critical Care Society, the Canadian Association of Critical Care Nurses, and the Canadian Society of Palliative Care Physicians Received: 11 September 2019 / Revised: 7 May 2020 / Accepted: 14 May 2020 The Author(s) 2020
Abstract Background Donation after circulatory determination of death (DCD) is responsible for the largest increase in deceased donation over the past decade. When the Canadian DCD guideline was published in 2006, it included recommendations to create standard policies
and procedures for withdrawal of life-sustaining measures (WLSM) as well as quality assurance frameworks for this practice. In 2016, the Canadian Critical Care Society produced a guideline for WLSM that requires modifications to facilitate implementation when DCD is part of the endof-life care plan.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12630-020-01774-6) contains supplementary material, which is available to authorized users. A. Healey, MD (&) Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada e-mail: [email protected]
J. Spring, MD Interdepartmental Division of Critical Care Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
Trillium Gift of Life Network, Toronto, ON, Canada
J. W. Delaney, MD Departments of Critical Care and Medicine, Scarborough Health Network, Scarborough, ON, Canada
M. Hartwick, MD J. Downar, MD Department of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada
Division of Palliative Care, Department of Medicine, University of Toronto, Toronto, ON, Canada
Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada
S. Shemie, MD Donation and Transplantation, Canadian Blood Services, Ottawa, ON, Canada
S. Keenan, MD Division of Critical Care Medicine, University of British Columbia, Vancouver, BC, Canada
Division of Critical Care, Montre´al Children’s Hospital, Montre´al, QC, Canada
Donation Services, BC Transplant, Vancouver, BC, Canada
McGill University Health Centre and Research Institute, Montre´al, QC, Canada
J. Lalani, MHA J. Mohr, MBA A. Appleby, RN MM L. C. Wilson, MHA Donation and Transplantation, Canadian Blood Services, Ottawa, ON, Canada
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A. Healey et al.
Methods A pan-Canadian multidisciplinary collaborative was convened to examine the existing guideline framework and to create tools to put the existing guideline into practice in
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