Remarks to the Donation and Transplantation Community of Practice

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by HRSA Administrator Mary K. Wakefield

September 30, 2009
Dallas, Texas

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Good morning. I am delighted to be here this morning to speak with you – a terrific group of people and organizations that comprise the Donation and Transplantation Community of Practice.

Let me start by congratulating you for the great strides you've made in recent years through your participation in HRSA's initial Breakthrough Collaboratives.

Your presence here today demonstrates your commitment to sustain the gains you have made, to continue to build best practices into your hospital's end-of-life continuum of care, and to continue our work to increase the number of organs available for transplantation. On behalf of HRSA and HHS, I thank you for that dedication and determination.

It's a wonderful thing to look out into this audience and see the partnerships that you represent: organ procurement organizations, hospitals, transplant centers, national organizations, and federal partners – all working together toward a shared, common goal. This year, by including specialists in donor designation in our work, we'll improve our partnership and our ability to honor the wishes of Americans who want to be donors.

With the startling increases in the number of people needing organs, tissue, and corneas for transplantation, your work is such extremely important work – and it's the right work at the right time.

I'm not sure how much you know about HRSA, so I want to take just a minute to give you a sense of the broad and varied portfolio of important programs within this agency. Our health centers provide primary health care to more than 17 million patients each year, most of them poor or lacking health insurance. Our Ryan White HIV/AIDS program helps more than half a million low-income or uninsured people living with HIV get the care and prescription drugs they need to lead healthy lives. We help to support the training of health care workers, dentists, nurse practitioners and doctors, and we place them in areas where their talents are needed most. HRSA is a $7.2 billion agency and what I've just highlighted is a large part, by no means all, of what we do.

HRSA is known, officially, as “the principal federal agency charged with increasing access to health care for those who are medically underserved.” Normally that means people who are medically and geographically vulnerable, people who are poor or have no health insurance. And in the last category – having no health insurance – there are far too many people.

But in the field of donation and transplantation, the phrase “medically underserved” has a different meaning. It means the people who are waiting list candidates, the 104,000 people who need transplants to extend and improve their lives. In this case, the people on this tragically lengthening list are “medically underserved” not necessarily because they lack money or health insurance, but because we have too few donors. We have the technical capability, of course, to meet their needs – the limiting factor is the lack of donated organs and tissue.

So, we face a paradox: even while your work to boost donation rates expands and improves, so, too, does the technology able to keep ailing people alive and add them to the waiting list.

We have to find more ways to step up our game. We must do more, and do it more efficiently and effectively, if we're going to make a notable dent in the transplant waiting list.

To do that, HRSA is committed to the Community's three key goals:

• Increasing the conversion rate to 75 percent or better;
• Reaching 3.75 or more organs transplanted per donor; and
• Increasing the proportion of ‘donation after cardiac death' cases to 10 percent or more.

At HRSA, we intend to continue to do everything in our power to help you continue to achieve significant, rapid improvements in these areas.

We know that tremendous results are possible because some of our colleagues and peers have already done it. You will hear from them throughout these two days.

The practices these action teams have tested and adapted to get results show all of us the way forward.

And the speed with which these best practices can yield results is remarkable.

I urge all of us in this room to take the examples profiled here today and tomorrow, and apply them as efficiently as you can to your own work.

And I ask those of you experiencing success to take the time, to make the effort to share those gains in your designated service areas, in your region, and with your colleagues across the country.

As you know, HRSA will recognize high-performing hospitals, transplant centers, and OPOs tonight. I challenge all of you to be award winners next year.

In addition, I ask those of you in the audience to find even more ways to lead in this arena.

You are the stewards of a precious gift, given by donors and their families. And through that stewardship, you are a treasured resource for our nation.

Please be an active leader in this Community of Practice. Complete your DSA action team. Become active in your region.

And I'm going to ask one last thing of you. I'm asking you to share with us your ideas about how we at HRSA can be better partners. How we can work together more efficiently. What you think the Community's next steps should be. To make it easy for you, we have set up an online “suggestion box” that you can access and send comments directly to us. The address is: NLC5@hrsa.gov

I'm making this type of interaction a hallmark of my term as HRSA administrator. We at HRSA have the tools now to communicate more directly, to share ideas more quickly, to change course – if need be – faster than ever. I want us at HRSA to use this technology to be more responsive to our stakeholders and the public, and I encourage you to take advantage of the opportunity.

We know a lot inside HRSA, but we sure don't know everything. Working in partnership with you means opening our doors wide to your ideas, suggestions and constructive criticisms.

You've heard President Obama say the same thing to members of Congress about health care reform: If you have good ideas, share them with me, and if they're better than mine, we'll adopt them! I'm fairly sure, in this arena, that your ideas will be better than mine, so please do share them.

I came to lead HRSA from the University of North Dakota and I know that Washington is not the only source of wisdom and knowledge in this vast country of ours. HRSA has a great number of talented and intelligent people on staff, but most of us work in a single building in Rockville, Maryland. We'll get much smarter when we hear more often from the people who are in direct touch with the families and communities that federal programs are intended to help.

So please take advantage of that opportunity. We'll keep the suggestion box open throughout the conference and for some time after it ends. Joyce Somsak's staff will read the emails that come in, they'll summarize them for me, and then we'll sit down discuss what HRSA needs to do, what we need to change or improve, to be better partners with you.

Let me close by restating HRSA's commitment to your success.

We will do everything in our power to support your work with the Donation and Transplantation Community of Practice.

In turn, we need you to do everything in your power to maximize the impact of this extraordinary opportunity – the people who are on that waiting list today and those not yet there are counting on us. Thank you for being here today. And, most of all, thank you for your leadership and action.