It is conservatively estimated that implementation of the various elements of this strategy will result

in breakthrough performance across Canada, as measured by a 50 per cent increase in the number of transplants over the next five years. To accommodate increased donation activity, frontline services will need more resources. It is recommended that governments ensure that financial resources are made available to organizations that provide ODT services—including OPOs, transplant programs, hos- pitals that support patients pre- and post-transplant (notably intensive care units and operating rooms), programs that support living donors, and ancillary functions (such as testing and medical diagnostics)— to support the increased activity generated as a result of increased donation and transplantation.

Approximately 2,100 transplants occurred in Canada in 2009. During that same year, more than 1,000 people donated organs. If the recommendations described in this strategy are adopted, within five years, it is projected that more than 1,500 people will donate organs, and the system will conduct more than 3,400 transplants. These increases will have a large impact on ODT services that will be challenged with keeping up with growth while maintaining high levels of patient care. To ensure the strategy achieves the goal of improving performance in organ donation and transplantation nationally, it is imperative that increased funding for frontline services be made available.

Offsetting the requirement for additional financial resources is the benefit the health care system will incur as a result of increased transplants. As the number of kidney increases, for example, there will be a substantial long-term benefit to the system through the reduced dependence on dialysis treatment for renal failure.

At the OTDT research roundtable, February 2011: Dr . lee ann tibbles, Associate Professor, Division of Nephrology, Departments of Medicine & Physiology and Pharmacology at the University of Calgary; Dr . lori west, Acting Scientific Director, CIHR Institute of Circulatory and Respiratory Health; and Dr . Dana Devine, Vice-President of Medical, Scientific and Research Affairs at Canadian Blood Services .

o r G a n D o n a t i o n a n D t r a n S P l a n t a t i o n i n C a n a D a | ODT System Recommendations

The savings in dialysis could be redirected to provide some of the additional resources required for ODT programs and organizations.

It is important to note that there was discussion at the Organ Expert Committee to improve the ways in which funds are delivered to programs (i.e., through a performance or activity based funding model). It is recognized that this cannot be done apart from the broader health care environment. It must be done with the support of, and in collaboration with, provincial and territorial governments. No matter the funding model, it is essential that adequate financial resources be available to support the increased volume of activity that derives from a concerted effort by all participants in the integrated inter-provincial system to drive to higher performance levels in Canada for donation and transplantation.

Figure 7-5. RecommenDations

By 2017, Canadian patients will have a trusted, integrated transplant system that performs among international leaders.

c o l l a b o R at i o n

P R i n c i P l e s , V a l U e s a n D e t H i c a l f o U n Dat i o n i n c R e a s e D o n at i o n

• Donation physicians

• National public awareness strategy • Intent-to-donate registries

• Data management and analytics • Professional awareness and education

• Financial resources for frontline ODT service providers

a c c e s s to t R a n s P l a n tat i o n

• Comprehensive, integrated, inter-provincial patient registries

i n f R a s t R U c t U R e a n D c a Pa b i l i t i e s • Leading practices

• Research and innovation a c c o U n ta b i l i t Y

• Formal accountability framework • ODT oversight committee and

sub-committees • Mandatory data reporting • Auditing

o r G a n D o n a t i o n a n D t r a n S P l a n t a t i o n i n C a n a D a | ODT Implementation and Costing

Implementation of the twelve recommendations in this strategic plan has the potential to achieve transformational change and deliver breakthrough performance across Canada: an increase of 50 per cent in the number of deceased donors, as well as transplants; a decrease in the variability of wait times among provinces; a significant drop in the number of people who die while on waitlists; and a marked increase in public and health-care professional confidence in all aspects of the ODT system.

The implementation plan presented in Figure 8-1 aims to achieve these performance improvements within five years. Alternate strategy-implementation approaches do exist, and may be required if constraints delay implementation of certain recommendations; however, the performance targets envisioned in Call to Action are directly linked to the rapid adoption of all recommendations at the specified investment. As international experience shows, performance improvements happen when multiple, interwoven initiatives, collaboration and national leadership converge.

kimberly Young, Executive Director, Organs and Tissues, Canadian Blood Services and CEO of the former CCDT

s U P P o R t i n g t H e f R o n t l i n e s o f o D t

Implementation of various elements in this strategy will deliver breakthrough performance, including a 50 per cent increase in the number of transplants over five years. This increase will directly impact frontline ODT services, such as OPOs and hospitals. For example, hospital ICU capacity may be challenged to support the additional number of donors, as well as the resulting transplants recipients who require ICU stays. Adequate ongoing funding for these services is essential so they can maintain a high level of patient care, remain compliant with new policies (such as mandatory data reporting), and contribute to reaching system performance targets. Funding may include capital investments in infrastructure—including equipment, ICU beds, and operating rooms—to support anticipated performance increases.

iMpleMentAtion