Collaborating with medical examiners and coroners to increase donation

Jim Mohr¹, Kimberly Young¹, Christina Parsons¹, Ken Lotherington ¹, Mathias Haun¹

¹Organs and Tissues , Canadian Blood Services, Ottawa , ON, Canada

Approximately 50% of deaths in Canada occur outside the hospital environment with most falling under medical examiner or coroner jurisdiction. In 80% of Canada’s tissue banks, less than 5% of donors are identified from death investigation cases, identifying a significant opportunity for improvement.

In August 2008, the federal, provincial and territorial (F/P/T) governments gave Canadian Blood Services a mandate to work with the tissue donation and transplantation communities to develop leading practices and recommendations in support of system performance improvement.

One national partner organization engaged early on by Canadian Blood Services was the Canadian Conference of Chief Coroners and Chief Medical Examiners, which led to the development of a Reference Manual for Donation for Canadian coroners and medical examiners as well as an initiative to implement practical steps to increase tissue donations from deaths outside the hospital environment.

Canadian Blood Services is facilitating collaborative workshops with medical examiners and coroners in the Provinces of Manitoba, Ontario, New Brunswick, Saskatchewan and Nova Scotia, and in each province tissue recovery and organ procurement organizations, pathologists, funeral professionals and governments officials are joining these process improvement workshops, with a goal of increasing the identification and referral of donors. A panel of Canadian and international tissue banking and death investigation experts has also been convened to support this initiative. The first provincial workshops are taking place in 2013, the others will follow in 2014.

To-date, participants in the provincial workshops have identified several local opportunities for improvement and are improving or creating new functional linkages between organizations to realize more tissue donations. Knowledge gained through these provincial collaborations will be detailed in a report and shared with the broader Canadian donation community.

Medical examiners and coroners can be engaged as key partners to support increasing tissue donation from deaths that occur outside the hospital.