1. Let’s Start at the Beginning: It Starts with a Call Nancy Biagioni Director of Donor Development & Education

2. The Family Service Department  Who we are: The San Diego Eye Bank Family Services Department was established in 2006 and is dedicated to providing the best customer service possible to each hospital, hospiceand family. We believe each family is unique and our goal is to ensure that every family is given the option of donation. By being available 24 hours a day we serve as a source of information and support, regardless of whether they donate.

3. Who are We?  Highly trained group of individuals focused on presenting families the opportunity of donation with respect, empathy and kindness  Currently all members of the team have a background in social services and extensive knowledge in serving the community at large  All coordinators know how to approach sensitive subjects and different situations  Experienced in tailoring services based on the needs of the next of kin’s needs

4. A Family Services Coordinator (FSC) will call RN and request the following:  Suspected Cause of Death  Medical Examiner’s Office status  Past medical history  Recent labs, treatment and temperatures  Next of kin contact information and information on how the family is coping  Funeral Home arrangements, if known

5. Why is This Much Information Necessary?  Based on all the information that the FSC just gathered they will decide what the patient is possibly suitable to donate and begin preparing to have this conversation with the family. Because the quality of the tissue begins to decrease immediately after the patient expires the family must be approached fairly quickly so the information the nurse provides on how the family is coping is very important.

6. Additional Information  Were they a registered donor?

7. How is the Legal Next of Kin Presented with the Opportunity of Donation?  Once donation suitability is established, the legal next of kin is contacted and a professional approach is made after assessing the donor and family situation or the legal next of kin is notified of their loved ones intent to be a donor  We assess if the family has any questions or immediate needs that we can help address  If the family is ready we reinforce the understanding and begin the conversation with “ I know this is a very difficult time for you”

8. How is the Family Presented with the Opportunity of Donation  The subject of donation is introduced. For example: “We understand you are going to have to make several decisions. At this time you have the opportunity to make a decisions about donating corneas and other tissues for transplant or research. I would like to give you some information about that. And I want you to ask me any questions you have. After I have answered your questions and given you the information, please tell me what you want to do and I will see that it is done. The first thing you should know is that tissue transplants enhance the quality of other peoples’ lives. For instance you could donate your husband’s corneas so that two other people have the possibility of re-gaining their sight.”

9. How is the Family Presented with the Opportunity of Donation  Family is informed that the decision to donate is completely voluntary and they do not have to donate  FSC support all families decision

10. Additional Help from You  Please don’t bring up the subject of donation  Call within one hour of the death  Obtain a telephone number of where we can reach the legal next of kin over the next few hours

11. Statistics  Conversion rate for SDEB FSC – 53%

12. Case Study #1  69 year old male  COD: Lung cancer with meets to liver and bone  Informed by RN that the wife left the hospital and was coping well and family was with her. RN only had the home telephone number – no other number was requested.  Unable to contact LNOK. RN called to request case status, since no contact made the funeral home was called  6 hrs. after death the LNOK, calls the SDEB. FSC offers her the opportunity of donation

13. Case Study #1  NOK declines because RN had informed her that due to cancer, her husband is not eligible for donation  Coordinator explains that eye donation for transplant is still possible.  NOK consents and said if she had known he was eligible, she would have called sooner because this would have made her husband happy.  Patient’s body had been transported to the funeral home, access for recovery was not granted until the following morning  Transplant case turned to research because of time

14. Case Study #2  58 year old male, found down, then hospitalized for 2 days  COD: Cardiac Arrest  RN notified LNOK (Daughter) who lived in Texas and was 31 weeks pregnant  RN notified EB, confirmed medical history and provided LNOK contact information  FSC contacted LNOK  Coordinator began conversation by asking how she was doing and if there was anything she needed assistance with since we were aware she was out of state

15. Case Study #2  LNOK began crying and needed someone to talk to and expressed the need for help with certain things because she was an only child. Her mother had passed away a year prior and her husband was deployed in Afghanistan  Family Services Coordinator helped her by providing her with an emailed list of funeral homes. She asked that we look up possible flights online for her while she packed and finally asked that we call her back once she secured a flight to discuss donation.  Before the coordinator was able to call back LNOK called while she waited for her flight to talk about donation and to express her appreciation for the coordinators help.