Four years ago, after their mother suffered a massive stroke with no hope of recovery, Jill Kloke and her sister knew that their mother would want to be an organ donor.
But over the two-day wait at a Texas hospital for her mother to be declared brain dead, Kloke and other family members had to find corners inside the hospital to have private, emotional conversations and to make arrangements. Kloke remembers making phone calls from a bathroom.
"We didn't have a place designated just for our family going through this trauma, and not really having a sacred place to talk," said Kloke. "We were just in this open lobby, and we couldn't be together as a family."
Kloke is a registered nurse and patient safety manager at CHI Health Creighton University Medical Center — Bergan Mercy in Omaha, Nebraska, which in November opened a special waiting room for families of organ donors.
The waiting room is within the hospital's intensive care unit. It has a seating area, a long table and counter space, a television, Bibles, a refrigerator filled with drinks, and literature to help families understand the organ donation process. Drawers and cabinets contain puzzles and activity books for people of all ages. Family members get badges to enter and exit to ensure privacy. Chaplains and other staffers stop by to ensure the needs of families are taken care of.
"This opportunity that we have in our hospital is just nothing like I could ever imagine," said Kloke, who sits on a donor committee at the hospital. "It's exactly everything that our family could have used. Numerous families have been able to take that space and make it their own during that time of grief."
A broader effort
The waiting room is part of a larger effort to streamline the organ donation process for CHI Health hospitals in Nebraska and southwest Iowa. CHI Health is a part of CommonSpirit Health.
CHI Health Creighton University Medical Center — Bergan Mercy doesn't perform transplants. But in November 2023, the hospital became the designated primary organ procurement site and opened a donor care unit for 14 CHI Health hospitals across Nebraska and southwest Iowa.
This means the process is more streamlined, with smaller hospitals sending potential donors to the larger hospital for organ procurement. The clinicians at the larger hospital have the training and resources to care for donors and their families and to coordinate the process with Live On Nebraska, a nonprofit that is one of 56 organ procurement organizations in the country.
Studies have shown that donating organs through a donor care unit is more cost effective, the potential for impactful organ donation research is greater, and donor families' satisfaction is high. Coordinating organ donations through such a unit also increases donations by 27.5%. One study showed a 71% increase in lung transplantation through a donor care unit model as compared to a standard organ care model.
Live On Nebraska maintains the donor registry for Nebraska, recovers organs and tissues for donation, educates people on the importance of registration and works to grow the donor registry.
Alison Williamson, CHI Health ICU manager and Donor Care Council chair, said Live On Nebraska approached the hospital about becoming a designated procurement site and a donor care unit.
"They brought the key stakeholders together," said Williamson. "Do we have the space? Do we have the physician buy-in? Is that something that we can support and want to move forward, not only for our patients but the community? And what does that look like?
"So that conversation started two years ago, and then everything just kind of flourished."
Raising awareness
In 2023, 21 donors provided 78 organs for transplant at CHI Health Creighton University Medical Center — Bergan Mercy. In 2024, there were 29 organ donors and 81 organs for transplant. As of late March, there have been 12 organ donors with 43 organs for transplant. Since the donor care unit opened in 2023, there have been 28 total transfers from other hospitals and 44 organs procured from the transfers.
In addition to creating the waiting room, hospital leaders established a quarterly regional donor council call to update caregivers in sister hospitals on the patients who were transferred to Omaha.
Allison Hedrick is a donation services specialist for Live On Nebraska. She describes herself as the "donor champion" for the hospital, the go-to person for creating a donation culture there.
"The partnership at CommonSpirit has been amazing, from leadership all the way down to bedside," she said.
Continuing support
Hedrick noted that while hospitals of all sizes play an important role in organ donation, centralizing the process at a larger facility with more resources and experience can be especially helpful. "Having a team of experts who deal with these situations regularly means a more seamless and supportive experience for the family, knowing their loved one is in good hands," she said.
Most donor families who have had to transfer their loved one to Omaha have been fine with the arrangement. The only hesitations have involved transportation or affordable accommodations. The hospital and Live On Nebraska have worked together to help those families with those needs, and to create the waiting area within the ICU.
The renovations for the donor care unit include a large mural of a dandelion in the main lobby of the hospital. The seeds of the dandelion, which extend down a hallway toward the front door, include the initials of the donors. The idea is to show how their lives will impact others outside the hospital.
The hospital plays soft piano music over the intercom when a donor is transported to the operating room. Caregivers and family members line the hallway during the "honor walk" and hold battery-powered candles.
Kloke tries to attend honor walks. "It shows that we care about the patient and their families," she said. "It's a way for the families to know that they're being supported. And that's what we hear about the most, is just, oh my gosh, the amount of support that the hospital gave these families is just tremendous."
Just recently, Williamson came into the waiting room to talk to a husband and wife who were on the phone with a funeral home. She, too, was grateful for the special space.
"I've had to have some difficult conversations myself in this very room where I'm very glad we had the space to come in and sit and have that conversation, because these families are going through the worst time of their life," she said. "And they are making the best decision. You know that their loved one is going to give the ultimate gift of life to someone else."