In 1998, the Multi Organ Transplant Program embarked on an ambitious project: to develop a multidisciplinary Philosophy of Care. Representatives from all disciplines involved with the program took part in formulating the values and belief statements that have culminated in this important and foundational document. In 1999, the final draft of the Philosophy of Care was presented to patients throughout the program for their evaluation. After our patients' endorsement, this document was unanimously approved by the Multi Organ Transplant Program's Quality Management Committee and Senior Executive Team. The Philosophy of Care reflects our beliefs about health, patient care, the environment, and the health care team. It outlines our expectations of patients and defines what patients should expect from their health care team. The Philosophy of Care is incorporated into our patient resources, our teaching materials for health care professionals, and is posted throughout the program for patients and staff members.

Philosophy of Care

We believe that our work is only possible through the generous act of organ donation and our efforts must honour these remarkable gifts from organ donors and their families.

We believe that respect, dignity, integrity and empathy drive all care and support all relationships, that courtesy and consideration are basic to every interaction.

We believe that the goal of the MOT Program is to work in partnership with individuals, families and the community to promote optimal health and quality of life for patients through all phases of transplantation and/or circumstances in their lives.

We believe that the field of transplantation is a unique and complex body of knowledge and is most comprehensive and best delivered with the participation and partnership of a multi-disciplinary health care team.

We believe that all members of the health care team make an important and valuable contribution to the plan of care. Each member of the team is a dedicated professional who continually maintains a current knowledge base and consistently strives to advance the science and art of transplantation.

We believe that all people are unique with their own needs, goals, and abilities.

We believe that people achieve their optimal state of health in collaboration with the health care team.

We believe that information and education provide patients with knowledge to exercise their rights and responsibilities to make informed decisions about their health care.

We believe that the best possible care is based on patient needs, available resources and ethical principles.

We believe that all services must be provided in a safe environment which supports health goals and enables care to be delivered with comfort and efficiency.

Patients' Expectations of the Multi Organ Transplant Program

All staff of the Multi Organ Transplant Program are committed to client-centered care and support the rights and responsibilities of patients and families.

Throughout your transplantation experience at The Toronto Hospital Multi Organ Transplant Program, can expect:

• to be treated with dignity, respect and courtesy;
• confidentiality;
• the most appropriate, planned and coordinated care that can be provided;
• to receive planned and coordinated care that encompasses your physiological, emotional, psychosocial, educational, physical and spiritual needs in a timely fashion;
• to receive care in a culturally sensitive environment;
• to receive clear, honest answers to your questions and the necessary information necessary to make informed choices;
• to be provided care in a safe environment;
• to consider participating in research because of its contribution to the provision of health care and the future of transplantation.

The Multi Organ Transplant Program's Expectations of Patients

Throughout your transplantation experience at the Multi Organ Transplant Program, you have the responsibility:

• for your own health;
• to work in partnership with the health care team to ensure the best possible treatment, rehabilitation, discharge planning and follow up care;
• to provide accurate information and to share any concerns with all members of the health care team;
• to inform the team if you do not understand or cannot follow the health care instructions;
• to understand and respect that the needs of other patients and families may be more urgent than your own needs;
• to treat staff, other patients and their families in a considerate, courteous, confidential and cooperative manner;
• to understand The Toronto Hospital's role as a teaching and research hospital and to cooperate with health care professionals in training;
• to take appropriate health and safety precautions both in hospital and out in the community;
• to take care of your personal property and valuables and to respect the Hospital property and regulations;
• to take appropriate measures to ensure that financial obligations are met surrounding your current and future health care needs.

Toronto General Hospital Multi Organ Transplant Program - Core Concept Definitions

Health: The state of physical, mental and social well-being and not merely the absence of disease.

Patient: The individual who receives physiological, psychosocial and spiritual care from the multidisciplinary team. The multidisciplinary team recognizes that the patient is an integral part of a family unit, where family is defined by the patient.

Team: The team is comprised of multidisciplinary practitioners who work in collaboration with patients and their families and each other, to achieve optimal health for patients in all phases of transplant care. Team members are committed to excellence in practice, teaching and research.

Environment: Physical, collegial and social conditions and processes which exist internally and externally to facilitate patient care and professional development.

The Multi Organ Transplant Program Ethics Committee

Since 1996, the MOT program's Ethics Committee has been meeting to address clinical and programmatic issues in need of ethical consideration. The committee consists of representatives from all areas of the transplant program, as well as the Bioethicist for the University Health Network. Over the past few years, the committee has formulated several policies for the program, including:

1. Donor Family & Transplant Recipient Information Sharing Guidelines
2. Recording of Donor Information
3. Donor/Recipient Information Disclosure

The Ethics Committee meets monthly to assess issues in all departments of the program and will meet on an ad hoc basis to consider clinical issues involving specific patient situations. The committee has reviewed issues relating to transplantation of foreign nationals, living donors, retransplantation, and confidentiality, as well as exploring emerging issues in the field of transplantation.