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The Quarterly 2012

A World's Best Practice Approach to Organ and Tissue Donation for Transplantation
The Role of the State Medical Director: DonateLife SA

On 2 July 2008, the Australian Government announced a National Reform Agenda entitled A World's Best Practice Approach to Organ and Tissue Donation for Transplantation.

The Government committed $151 million over four years to establish a nationally coordinated approach to organ and tissue donation processes. The work is being driven by the Organ and Tissue Authority (OTA), in partnership with states and territories, to improve access to life-saving and life-transforming transplants for all Australians in need through a sustained increase in the donation of organs and tissues.

The twin objectives of the National Reform Agenda are to:

  • Increase the capability and capacity within the health system to maximize donation rates; and
  • Increase community awareness and stakeholder engagement across Australia to promote organ and tissue donation.

The Organ and Tissue Authority (the Authority) was established on 1 January 2009. The Authority was established under the Australian Organ and Tissue Donation and Transplantation Authority Act 2008 (The Act), as part of the Australian Government's new National reform package, A World's Best Practice Approach to Organ and Tissue Donation for Transplantation.

The Authority is an independent statutory authority within the Australian Government's Health and Ageing portfolio. The purpose of the Authority is to establish - in partnership with states, territories, clinicians, consumers and the community - a nationally coordinated approach to organ and tissue donation for transplantation. The Authority is also responsible for administering funds to non-government organisations who apply through a grants process to manage events and forums for raising awareness.

Australia is recognised as a world leader in transplantation medicine but the number of organ and tissue donations in Australia is low by international standards (Refer to Figure 1).

Figure 1

Source AOTA http://www.donatelife.gov.au accessed 18th February 2012 (3)
Note: 2011 Australia 14.9 dpmp

Since the National Reform Agenda was announced in 2008, the number of organ donations in Australasia has risen by 64% (Refer to Figure 2). The implementation of the national reform program provides an opportunity to heal, transform and save more Australian lives.

Figure 2

Note SA 2011 21.1 dpmp (Australia 14.9 dpmp)
Source ANZOD http://www.anzdata.org.au/anzod/v1/indexanzod.html

The National Reform Agenda is being implemented through nine measures:

  • Measure 1 - A new national approach and system – a national authority and network of organ procurement organisations
  • Measure 2 - Specialist hospital staff and systems dedicated to organ donation
  • Measure 3 - New funding for hospitals
  • Measure 4 - National professional awareness and education
  • Measure 5 - Coordinated ongoing community awareness and education
  • Measure 6 - Support for donor families
  • Measure 7 - Safe, equitable and transparent national transplantation process
  • Measure 8 - National eye and tissue donation and transplantation
  • Measure 9 - Additional national initiatives, including living donation programs

OTA manages implementation of the measures of the National Reform Agenda through leadership and collaboration with the DonateLife Network comprising: state and territory Medical Directors, organ and tissue donation agencies, hospital-based doctors and nurses dedicated to organ and tissue donation and organ and tissue donor coordinators.

The South Australian Experience 2009 to current

The Reform Agenda and funding enabled the SA Health Department (now SA Department for Health and Ageing) appointment of a State Medical Director of DonateLife SA in May 2009. SA is unique in appointing a FRACMA to the position and unique in making it a full time role. The other states and territories have appointed (fractional) ICU/ED and Palliative Care clinician managers.

Competencies of the Professional Medical Manager (Communicator, Collaborator, Health Advocate, Manager, Scholar and Professional) are called upon in the role that demands local, state and national coordination of complex systems (Plsek, PE 2001) and management of change and then transition through a Reform Agenda. As the State Medical Director for South Australia, I will be soon moving into my third year in the role. Consideration and reflection enables me to conclude that the training and competencies gained on the Fellowship Training Program (along with subsequent acute sector Director of Medical Services experience) have been invaluable in enabling sustained and strong leadership of this program in South Australia.

South Australia continues to be the National leader with a donation rate of 21.1 donors per million population (dpmp) 2011, while the National average in 2011 was 14.9 dpmp (Refer to Figure 3).

Figure 3

Source AOTA http://www.racma.edu.au/www.donatelife.gov.au accessed 18th February 2012

South Australia continues to consolidate 14 years of excellence in the field whilst negotiating and implementing the policy in SA, whilst the governance and practice change has been driven from Canberra.

There are a number of variables that over time have assisted SA in driving and achieving high organ and tissue donation rates. Many of the variables are being explored in an Oral History currently being researched for DonateLife SA by Dr Joanna Kijas, from Kijas Histories. With the implementation of the World's Best Practice Approach to Organ and Tissue Donation for Transplantation; professional medical leadership underpinned by a sound understanding of the principles of organisational change, development and transition continues to be a hallmark of the South Australian structure and program guiding the organ and tissue donation for transplantation sector.

The role of the professional medical manager in a leadership position within National Reform and specifically the South Australian experience will be explored in depth at both national and international Forums in the first quarter of 2012:

Forum 1
The DonateLife Network National Scientific Forum Brisbane March 28th-30th Title: Communication within the DonateLife Network: not leaving it to chance
Presenter: Dr Sally Tideman

Forum 2
The first meeting of the World Federation of Medical Managers in San Francisco April 28th-30th
Title: Reform in Progress: DonateLife SA - A Case Study: Australia's Nationwide Reform to improve access to life-saving and life-transforming transplants for all Australians
Presenter: Dr Sally Tideman

Dr Sally Tideman
State Medical Director DonateLife SA
Chair, RACMA SA Committee

Last Updated on Friday, 17 July 2015 14:14