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Editor's Notes

• #2: Good Morning! My name is AJ Johnson, Senior Organ Recovery Coordinator from Sierra Donor Services located in Sacramento California. I am both honored and humbled to address you all today.
• #3: I spent 13 years in the United States Army, and I’d like to share with you all something that was taught to me while I was there. The B.L.U.F.F.!!!! (BOTTOM LINE UP FRONT FIRST!) This is a way of speaking that we use in the Army! It’s a type of speak, that gets to the ROOT of the matter quickly without any added fillers or fluff. It’s efficient. It’s HONEST. And most of all, it’s effective. The BLUFF here AS it pertains to this PRESENTATION and more importantly the NEED, is simple! YES! As you all can see on the screen, “The need of ALL has been ACKNOWLEDGE!” But this STATEMENT is incomplete! YES! THERE IS A PROBLEM THAT WE HAVE ALL ACKNOWLEDGED! THIS is EVIDENT by your presence here at AMAT this week! The BOTTOM LINE UP FRONT FIRST as it pertains to what faces us, is a SIMPLE SOLUTION that has been made far too COMPLEX! By institutional and organization apathy, and unwillingness to fully engage this problem head on, we ALL are culpable. Sure! We have studied, probed, poked, and postulated for years! But what have we DONE? Time is wasted and with this stagnancy comes with it the unnecessary loss of lives. Lives WE are committed to saving.
• #4: Dr. David Acosta is not only the Vice Chancellor of Diversity and Inclusion for UC Davis Health System, but I’m honored to call him a friend, a teacher, and further our Principal Investigator in a pending grant proposal our OPO and UC Medical Center are co-authoring. This statement serves not only as the framework of the intent of this effort, but highlights the CHALLENGES we faced and continue to WORK to overcome. In HOSPITALS in our small DSA in Sacramento, California I have personally witnessed the inequities in CARE and treatment of racial/ethnic population groups first hand. In one case, a physician caring for an African American family expressed his explicit bias openly regarding African Americans. “Stating why should I stay late to help you with this patient? Black People don’t donate any way” And this hostile rhetoric is just the tip of the iceberg. Over the last three years WE began to notice a pattern in the way African American families were served by the hospitals in our region. This first hand observation coupled with the testimonials from community members about the way they are treated prior to the ASK from the OPO, and further how the OPO was perceived by the community, made us realize that we needed to address not only the ethnic discrimination occurring in health care in our DSA, but the OPO Brand in our community. Creating this PDSA would be an avenue for a FEW of us to bring change and hopes of equitable care and treatment to the MANY.
• #5: Beans and Bullets-the weapons, munitions, equipment, and supplies of a military needed to accomplish a mission. We all know this information, right? SO I won’t bore you with the details. THE FOLLOWING SLIDES ARE HERE ONLY TO HIGHLIGHT THE DISPARITY. Thousands of people are awaiting kidney transplantation in this country: A large proportion of those are AA awaiting kidney transplantation .
• #6: Racial/ Ethnic groups make up almost 60% of national waiting list.
• #7: The U.S statistics on deceased donor rates point to a drastic shortage of AA Donors.
• #8: I know you all have seen and are quite familiar with these national numbers. I believe showing them to you can give you perspective on what we are up against in California. The U.S statistics on deceased donor rates point to a drastic shortage of AA Donors. NOTE CONTRAST OF DECEASED DONOR RATES NATIONALLY VERSES CALIFORNIA. WAIT TIMES ARE ON AVERAGE 10 YEARS!!! In California, total population of 33,871,648. 34% are registered donors. California Active OPOs 4 Active TXCs22 OPO��: Organ Procurement Org.��TXC��: Transplant Center
• #9: African Americans only account for appx 6.9% of the California Population. However, African Americans more than double that in SDS DSA and is more in line with the National Population rates.
• #12: And from the CHALLENGE grew a relationship! Dr. Brown would invite SDS to join him and his church in the Church’s first annual Community engagement event called the Capitol City Block Party!
• #13: It was clear we NEEDED a plan! For the “in box thinking” one size fits all approach we had was a complete and utter failure as it pertained to communities of color.
• #15: CHARLES MINGUS-One of the most important figures in twentieth century American music, Charles Mingus was a virtuoso bass player, accomplished pianist,��bandleader and composer. Born on a military base in Nogales, Arizona in 1922 and raised in Watts, California, his earliest musical influences came from the church– choir and group singing– and from “hearing Duke Ellington over the radio when [he] was eight years old.” He studied double bass and composition in a formal way (five years with H. Rheinshagen, principal bassist of the New York Philharmonic, and compositional techniques with the legendary Lloyd Reese) while absorbing vernacular music from the great jazz masters, first-hand. His early professional experience, in the 40′s, found him touring with bands like Louis Armstrong, Kid Ory and Lionel Hampton. In my OPINION if there were a “Mount Rushmore” of Jazz musicians, Charles Mingus would occupy the first three HEADS!
• #17: We chose to use the PDSA CHANGE MODEL given it allows for fluidity, and expansiveness in a real time and real world environment. Our strategy was a multidiscipline two prong approach. IHI uses the Model for Improvement as the framework to guide improvement work. The Model for Improvement, developed by Associates in Process Improvement, is a simple, yet powerful tool for accelerating improvement. This model is not meant to replace change models that organizations may already be using, but rather to accelerate improvement.
• #18: To say Sierra Donor Services (SDS) otherwise known as the DONOR BRAND was didn’t have a large presence in the AA community is an understatement. The truth was SDS was either alien or unknown at best, and vehemently despised at worst by the targeted community. So we had to go about fixing our BRAND! Strengthening the BRAND and creating a new BRAND EXPERIENCE! What is a BRAND? A collection of images and ideas representing a producers; it refers to the descriptive verbal attributes and concrete symbols such as name, logo, slogan, and or design that conveys the essence of a company. It is a symbolic embodiment of al information connected to a company, product, or service. Marketers��distinguish��the��psychological��aspect��of��a��brand from the experimental aspect.��The��experiential��aspect��consists��of the sum of all points of contact with the��brand��and��is��known��as the BRAND EXPERIENCE!��The psychological aspect sometimes referred to as the BRAND IMAGE,��is a symbolic construct created within the minds of people and consists of the information and expectations associated with a product or service. Marketers��engaged��in��branding��seek��to��develop��or��align��the expectations behind��the��BRAND��EXPERIENCE,��creating��the��impressions��that��a��brand associated��with��a product or service has certain qualities or characteristics that make it unique or special. ��A��BRAND��is��therefore��one��of��the��most VALUABLE ��elements��in��an ADVERTISING��theme,��as��it��demonstrates what��the��brand��owner��is��able��to��offer��in��the CONSUMER! BRAND RECOGNITION when a widely known and trusted in the marketplace, when BRAND RECOGNITION builds up to a point where a brand enjoys critical mass of POSITIVE SENTIMENT in the marketplace, it is achieves BRAND FRANCHISE!
• #19: Partnered the DONOR BRAND with BRANDS the targeted community trust, such as Churches, and other organizations with long standing historical tactile involvement in the community with proven service resulting in community trust. Received invitations and endorsements from organizations at their sponsored functions. Organizations such as the National Council of Negro Women, NAACP, ACTS, and many, many others. These events led to AA Churches actually REACHING OUT TO US!!! Stating that “SDS is Big Time!”
• #20: We hand picked our team of ambassadors who had shown the propensity for this type of “guerilla style” engagement. Most received training that was not “one size fits all” that was offered by our organization. We tailored there training in respects to their individual needs, strengths, and weaknesses.
• #24: LIKE REQUESTOR, RIGHT REQUESTOR BLUFF? One clinician on call everyday for all African American referrals and approaches. BEANS and BULLETS? Philosophical differences in approach can make a huge difference. In our OPO we identified problems with consent/conversion approaches! Consent not tracked. No ongoing organized training for those who consent. This was seen as an assumed “skill” that new ORC’s would have just on the virtue of working as a bedside RN, or a paramedic. As you all know, this is NOT true! The SKILLS needed for APPROACH should never be ASSUMED, they should be TAUGHT! And the organization should have a continued INVESTMENT in the CONTINUAL TRAINING OF Without the “YES” lives are not saved. BOTTOM LINE UP FRONT FIRST! What’s the BLUFF?!
• #25: Our data collection was not limited to just that of demographic and clinical details, we also collected testimonials from family members, deviations of standards of care practices, observations of staff cultural competency as it relates to this population.
• #28: Always keeping the NEEDS of THOSE WE SERVE and their families at the forefront of what we do. Engaging organizational and senior leadership support to help reduce barriers and obstacles that may occur. Focusing on strategies to facilitate the spread and sustainability of this EFFORT.
• #29: I’d like to SHARE the same challenge given to me to you!
• #31: In order that we SAVE lives tomorrow and in the days to come, we must leave here today committed to the level of courage and selflessness that our DONOR family exemplifies. When given the hard choice, THESE FAMILIES chose to GIVE, they chose to SERVE! They chose a path that certainly at the very least IS uncomfortable. But look at what that BRINGS--- LIFE! We MUST put aside ourselves, for the better of all, for ALL are whom we serve. IMAGINE If every person in this room, including myself and OPO staff, ICU nurses and physicians, Hospital Administrators and ancillary staff commit to this example of selflessness and service now, over the next year many lives will be impacted? Bodies will be healed; families will be comforted, because lives will be saved. SO I ask you, what choice will you make when you leave here today? Will you let the ordinary and the familiar routines as you return to your respective places of employment lead you away from what WE shared here today? As the echoes of the words spoken become mere whispers, and the emotions WE have shared become faded recollections of a whimsical day, will the routines of your comforts paralyze you to inaction and apathy? Or will you take what WE have been given here today and let this newfound SPIRIT of COOPERATION and TEAMWORK guide US to selflessly serve ALL who we are in NEED? The CHOICE is yours---Unite as ONE team across this GREAT NATION with ONE mission and the COMPLEX will become SIMPLE and the impossible becomes POSSIBLE. This is my BLUFF!!!