The outcomes model: Co-operation between business leaders, transplant specialists and the community to lead changes in the organ donation system in Australia

Introduction: Proven leading practice in organ donation for transplantation has been defined following extensive analysis of the original Spanish model. This model has been applied successfully by many nations embarking on a national reform programme. However some developed countries still have deceased organ donor rates < 25 donors per million population (DPMP).While many scientific issues related to organ donation have been resolved, logistics challenges remain. The application of business management skills could provide a solution to a supply problem where there is no scientific impediment. A low organ donation rate has a high community impact on lives lost and unfavorable impact on health economy. Methods: The Outcomes Model was created to lead a transformational and problem orientated solution for the benefit of the community by working outside usual systems. The Model used multidisciplinary teams of business executives, experienced medical practitioners, politicians, community leaders, and media personalities all working pro-bono. Business principles were used to define the parameters needed to bring social change and improved outcomes for organ donation. The Outcomes Model commences with understanding the problem and is driven by a comprehensive factual analysis that leads to a definition of World Best Practice. Practical solutions including resources, project planning and defined targets are then provided. The development of the model is therefore not constrained by any formal structure. Results: Australia had 9.8 DPMP in 2006 and despite many initiatives over the previous 15 years the rate had remained constant. As a consequence, Australians were disadvantaged. Following the Outcomes Australia intervention, the Australian Prime Minister, in 2008, approved a National Reform Package with more than AU$150 million to create the Australia Organ and Tissue Donation Authority to apply leading practice in organ donation. Although the organ donation rate in Australia in 2014 has improved to 16.1 DPMP, it has not yet achieved rates of leading performance countries. Outcomes Australia, therefore, continues to advocate for the complete implementation of leading practice in organ donation in Australia. Conclusions: Health, disability support and welfare are the three main areas of community concern today. Engaging business and community leaders and applying business principles to organ donation will guide a successful change process for organ donation systems.