Building Expertise and Compassion into the Health System | The Clinical Compass

Providing care for a patient at the end of life is not easy, and in some cases, clinicians may also find themselves facing another difficult responsibility: speaking with grieving families about the possibility of organ and tissue donation.

These conversations require a careful balance of compassion and clarity – answering complex questions, addressing uncertainty and honouring the wishes of patients and their loved ones.

In moments like these, access to clear, evidence-based guidelines for organ and tissue donation is important. They help clinicians navigate difficult discussions with confidence and care, while reducing the risk of missed donation opportunities.

After all, behind every conversation is a complex system that must be ready to respond when a family makes the decision to say “yes.”

Meet Dr. Andrew Healey

Dr. Andrew Healey is the Chief of Critical Care and Chief of Emergency Medicine at St. Joseph’s Healthcare Hamilton and a clinical professor at McMaster University. In addition to his role, he also acts as the provincial medical director for organ and tissue donation with Ontario Health (Trillium Gift of Life Network).

His dual role allows him to act as a bridge. At Ontario Health, he helps ensure the realities faced by hospitals and front-line workers are reflected in how donation policies and hospital readiness are shaped in practice.  His work helps build systems designed to support families through an experience that is equal parts difficult and generous.

How This Clinical Lead is Applying Policy to Practice

The role of a clinical lead sits at the intersection of system planning and front-line care. When it comes to organ and tissue donation, it’s the nurses who do the front-line clinical work with families. “They have specialized training; they understand how to navigate the system and they’re critical to organ and tissue donation in Ontario,” says Dr. Healey.

While Dr. Healey isn’t the one at the bedside having these conversations, his role is to help make sure the system is prepared to support those moments when they arise. “I really wanted to be a clinical lead in this space because I wanted to ensure that the system was ready for the donor family to make that decision,” he adds.

Just as importantly, readiness has to work across different hospital settings. As Dr. Healey notes, “We hear lots of stories about how we can better support the system through the implementation of policies. While a policy might work in principle, in practice it might not work in every hospital.”

That’s where partnerships become essential. Dr. Healey brings practical experience and a hospital lens, while administrative partners help implement improvements consistently across the health system. Together, they help ensure policy, planning and front-line delivery align so that the system can respond seamlessly when donation becomes a possibility.

The Future of Donation and Transplant in Ontario

Looking ahead to the future of donation and transplant in Ontario, Dr. Healey reflected on innovations that allow the system to meet families where they are. “Some families want more time, others want a very rapid experience. Our system is evolving so we can respond to both.”

From supporting donation following Medical Assistance in Dying outside a medical setting, to advanced preservation technologies that help organs remain viable for transplant, medical innovations are expanding what is possible.

Drawing on his personal experience as part of both donor and recipient families, Dr. Healey believes the next phase of progress should ensure families feel confident, supported and free of regret about their decisions, while also improving organ quality and outcomes for recipients.

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