The OTA delivers the national program through leadership of, and collaboration with, members of the DonateLife Network (DLN). The network comprises State/Territory Medical Directors, DonateLife Agencies (one in each state and territory), and hospital-based doctors and nurses who specialise in organ and tissue donation.

State and territory governments employ staff to implement the clinical services model consistent with the national program through the DonateLife Network. The roles and responsibilities are consistent with the model and approach of the national program in the public hospital sector and, where mutually agreed, in the private hospital sector.

Donation specialists in the DLN:

• provide professional donation services and encourage best clinical practice to increase donation rates
• participate in clinical practice review and audit
• raise awareness about organ and tissue donation
• provide care and support to families throughout the donation process
• educate health professionals about the donation process.

At 30 June 2019 the DLN comprised 267 OTA-funded staff (152.6 full-time equivalents). These fractionated roles were occupied by 180 doctors and nurses specialising in organ and tissue donation in 98 hospitals across Australia, and 116 staff in eight DonateLife Agencies (one agency in each state and territory).

DonateLife Network hospitals

The Commonwealth Government provides funding in selected public and private hospitals that have the greatest potential for organ and tissue donation, to employ trained, clinical specialists dedicated to organ donation. The 2008 funding model for state and territory funding agreements was based on population and a rurality factor. Since that date, the Budget allocation has been indexed by the Budget Wage Cost Index.

The contribution of each jurisdiction to the national program in 2018 within the context of population size and funding provided by the Australian Government is shown in the figure below.

The DonateLife Network funding model for 2018-19 and outcomes for 2018* The Australian Capital Territory population includes the population of the NSW South Eastern Region

The following section outlines the key contributions of each state and territory to the delivery of the national program in 2018–19.

Co-State Medical Directors: Associate Professor Michael O’Leary, Dr Elena Cavazzoni

General Manager: Danielle Fisher

Director of Nursing and Clinical Services: Juliana Celcer

Clinical Manager: Nicola Seifert

Volunteer program

The NSW Organ and Tissue Donation Service successfully launched its Volunteer Program in July 2018. Since the inaugural induction session there have been five training sessions in both regional and metropolitan areas, with 50 active volunteers inducted into the program. Trained DonateLife volunteers have since participated in a number of community awareness events, including BStreetsmart, National Rugby League matches, university orientation weeks and community talks.

DonateLife Week 2018

During DonateLife Week 2018 donation staff at the Royal North Shore Hospital coordinated the Royal Registration Race, a competition between the hospital departments to increase the number of registrations on the Australian Organ Donor Register. Royal North Shore Hospital donation specialists donned magenta-coloured scrubs to generate further media attention and to encourage discussion about organ and tissue donation. A variety of educational and informative hospital and community information stalls were also hosted across local health districts, run by donation specialists and volunteers.

NSW 7th Annual Clinical Symposium 2018

The NSW Organ and Tissue Donation Service held its 7th Annual Clinical Symposium in October 2018. CORE business – back to the future was the theme of the symposium, where specialists from across the sector shared their expertise and innovation in organ and tissue donation and transplantation. One of the segments incorporated an interactive medical suitability panel that included representatives from specialties such as virology, cardiology, hepatology, nephrology and tissue banking. The panel was presented with multiple case scenarios that stimulated interesting and lively discussion among the members and the audience.

State Medical Director: Dr Rohit D’Costa

Deputy State Medical Director: Dr Sam Radford

Director of Nursing and Operations: Ms Robyn Scott (to 7 December 2019), Leanne McEvoy (Acting from 8 December 2019)

Clinical Manager: Leanne McEvoy, Georgie Callaghan (Acting)

Implementing routine referral

DonateLife Victoria continued to implement routine referral across the state. With most metropolitan hospitals fairly well progressed in their practice, routine referral is now expanding to Victorian regional centres. The results are clear, with 257 families agreeing to donation in 2018 (193 actual donors and 64 intended donors). June 2018 saw the busiest single month for a state on record, with 22 actual donors.

Developing a new consent resource

DonateLife Victoria developed a series of video resources to assist staff with donor family conversations. The resources include a full mock donor family interview as well as a set of appendices that delve into more complex scenarios, such as explaining rapid retrieval or donation after circulatory death to a family. The resources are now being used nationally.

Reaching new sectors of the community

Corporate partnerships with organisations such as Victoria Police helped to spread the word about organ and tissue donation in 2018–19. These partnerships saw a staggering increase in registrations which – combined with other media and community engagement activities – saw Victoria being the first state to record more than 50,000 new registrations in a calendar year.

State Medical Director: Dr Leo Nunnink

Deputy State Medical Director: Dr Angus Carter

State Manager: Tina Coco AO

Focus on donation specialists

After several years of increases, donation rates in Queensland slowed in the early months of 2019 compared to the same period in 2018. For reasons that are not yet clear, there was a 32% reduction in the number of possible donors in audited hospitals in quarter one of 2019. Despite a fall in the number of opportunities, DonateLife Queensland has maintained its focus on ensuring that donation can occur in every situation where it is possible. There has been a renewed focus on involving a donation specialist in every family donation conversation.

Improving clinical practices

A new model for assessment of medical suitability began a pilot phase on 1 May 2019. The new process establishes a set of exclusion criteria agreed with transplant physicians. In the absence of any obvious clinical exclusions, the consent process proceeds, followed by a detailed assessment of medical suitability. This improved system should increase donation opportunities by providing more detailed information to support clinicians identifying suitable recipients earlier in the allocation process.

Engaging our Community Champions

Since the inception of our Community Champions program in 2017, DonateLife Queensland has trained around 70 champions, helping to extend our reach into the community. Our champions help by manning stalls, speaking with media outlets and assisting with talks at schools, workplaces and various clubs. The assistance of our Community Champions contributed to a 20% increase in Australian Organ Donor Registration numbers in Queensland across 2018.

State Medical Director: Dr Stewart Moodie

Nursing Service Director: Heylen Laver

Routine notification and bereavement follow-up

Throughout 2018–19 DonateLife South Australia and the Royal Adelaide Hospital ICU team collaborated to implement routine notification of planned end-of-life and deliver bereavement follow-up to relatives of patients who died in ICU. The project aims to determine the feasibility of bereavement follow-up as a means to achieve routine notification and to evaluate feedback on the quality of end-of-life care and the donation conversation experience. As a result of the project, the timely exploration of organ and tissue donation and the referral rate to DonateLife South Australia has increased and the service has been expanded to include the Royal Adelaide Hospital Emergency Department.

Enhanced donor database

A review of the DonateLife South Australia Donor Database (known as ERIN) began in 2017 to assist the agency in recording the referral of potential donors, tracking follow-up with donor families, and collating data on referral activity and outcomes. The functionality of this database was updated in 2018 to collect information on routine notification of all patients at planned end-of-life. This has allowed the data collected to assist with the ICU and ED mortality review process and has provided a template for the bereavement follow-up of all families.

Community awareness and young adult education

DonateLife South Australia actively participated in DonateLife Week 2018. Activities included an Adelaide Oval roof climb for donor family members and transplant recipients. There was also a reception to honour donor families and acknowledge the work of volunteers and staff at Government House, hosted by the South Australian Governor, Hieu Van Le. In addition, raising awareness among young adults was a key focus throughout 2018–19. DonateLife South Australia participated in the Royal Automobile Association’s Street Smart High program attended by 8,000 senior high school students. We also participated in the Prevent Alcohol and Risk-related Trauma in Youth (P.A.R.T.Y) program delivered within metropolitan hospitals to approximately 800 secondary seniors.

State Medical Director: Dr Bruce Powell (to 30 June 2019), Dr Simon Towler (from May 2019)

Clinical Nurse Manager: Melissa Smith

Hospital education

In May 2019 DonateLife Western Australia conducted a Perioperative Workshop in the state-of-the-art Education Centre at Perth Children’s Hospital. This facility allowed us to give presentations, set up hands-on instrument and equipment workstations, and conduct theatre simulations in the one area. This workshop complements the ongoing Introductory Donation Awareness Training and Family Donation Conversation workshops offered throughout the year.

Community education and awareness

DonateLife Western Australia held a display and registration stand at the Australian Student Medical Association Conference in 2018 where medical students debated opt-in versus opt-out registration systems. We also undertook promotional activities during DonateLife Week 2018, when the Hon Ken Wyatt AM MP launched the Tonic Health Media partnership at the Mount Hospital’s pharmacy.

Writing for Life

DonateLife Western Australia held its third Writing for Life micro-fiction competition for middle and senior school students across the state. Students were asked to write a short story about organ and tissue donation and/or transplantation. The Western Australian Health Minister, the Hon Roger Cook MLA, opened the competition during DonateLife Week 2018.

State Medical Director: Associate Professor Andrew Turner

State Manager: Susan Towns

Clinical Manager: Alexandra Goward (from February 2019)

Tree of Hope

This year DonateLife Tasmania hosted the Tree of Hope, a project sponsored by Herd of Hope, a community organisation promoting organ and tissue donation. This program enjoyed the support of the Royal Hobart, Launceston General and North West Regional Hospitals. The Tree of Hope travelled around Australia and provided the opportunity for everyone in the community to pause and reflect on the generosity of organ and tissue donors and their families, and inspire others in the community to register as an organ and tissue donor. The tree has a growing collection of personally engraved leaves contributed by donor families in honour of their deceased loved ones who gave the ultimate gift of donation. DonateLife Tasmania invited their network of donor families and recipients to contribute by engraving a message for inclusion on the tree.

Go Transit Metro buses promote awareness of donation

DonateLife Tasmania partnered with Metro Tasmania to host a state-wide community awareness campaign during DonateLife Week 2018. Buses travelled across the state for several months aiming to increase awareness of organ and tissue donation.

Community awareness

In 2018–19 DonateLife Tasmania continued with strong growth in community awareness activity with events such as AGFEST which saw record donor registrations and patron engagement across the three-day event. DonateLife Tasmania took advantage of numerous other opportunities to promote awareness of organ and tissue donation, including health and wellbeing expos, state-wide university orientation week events and the Salamanca markets. We broadened our network of community and sector stakeholders, expanding the available case studies to support extensive media and promotional opportunities.

State Medical Director: Dr Sarah Jones

Program Manager: Lee Wood

Community engagement

DonateLife Northern Territory (NT) engaged with many cultural groups, including Aboriginal Territorians and the Nepalese community. We were invited to set up a display at the Tiwi Islands Australian Rules grand final and to participate in a community consultation event at the Multicultural Council of the Northern Territory. Continued community engagement is planned for 2019–20.

P.A.R.T.Y program

DonateLife NT is part of the Prevention of Alcohol and Risk-related Trauma in Youth (P.A.R.T.Y) program held fortnightly at the Royal Darwin Hospital. The program educates senior high school students about the dangers of alcohol and risk-taking behaviour. DonateLife NT conducts a mock donation conversation and provides donation information.

Raising awareness

Raising awareness about donation in the Northern Territory is vital, with only 12% of Territorians registered on the Australian Organ Donor Register. DonateLife NT engaged with the general community at the Defence Community Expo, the Rockabilly Car Show, the Mitchell Street Mile, the Police, Fire and Emergency Services Open Day, as well as at events throughout DonateLife Week 2018.

State Medical Director: Professor Frank Van Haren

Agency Manager: Nadia Burkolter

Tissue retrieval program

DonateLife Australian Capital Territory (ACT) has expanded its tissue donation program to include retrieval of all tissue types for transplantation. We continue to build our capability in this area. Several DonateLife ACT staff were trained to retrieve eye tissue, with ongoing support provided by the NSW Organ and Tissue Donation Service. Staff have sought other opportunities to enhance their skills and capabilities, with one staff member becoming a Certified Tissue Banking Specialist through the American Association of Tissue Banking.

Gift of Life – DonateLife Walk

In February 2019 DonateLife ACT continued to support Gift of Life Incorporated with their annual Gift of Life – DonateLife Walk. This year’s walk attracted approximately 5,000 participants, many of whom were high school students. The walk is the biggest of its kind in Australia and provides an invaluable opportunity to engage with the Canberra community on the importance of donation.

Supporting staff involved in donation

Just as families are supported through the donation process, DonateLife ACT also recognises the need to support staff who connect with families at this difficult time. In 2018–19 DonateLife ACT made a concerted effort to maintain the mental and emotional wellbeing of our staff with the establishment of a more formal approach to mentoring new coordinators. Information was incorporated into the orientation manual and a half-day training session was tailored to staff needs. This was well-received by the participants.