Introduction Normalising the discussion and practice of Corneal Donation amongst hospice inpatients has been the focus of quality improvement (QI) work at the hospice for several years. Previous successful interventions include multi-professional education, developing a referral flow chart, alerts on the electronic patient record to flag potential donors and encouraging staff to observe the retrieval process. Prior to 2018, corneal donation was not routinely discussed and there was only one donation over 3 years compared to 211 referrals and 140 donors over the last 3 years. The COVID pandemic introduced unique challenges for corneal donation in the hospice, including reduced bed capacity, redeployed staff and tissue donation contraindicated in patients with recent COVID infection.

Method(s) Routinely collected data of hospice deaths, including eligibility to be donors, evidence of discussions with patients and families and referral numbers were analysed comparing data during 2019–2020 with 2020–2021.

Results In April 2020-March 2021, 157 patients died at the hospice, which was just under half the number of deaths during April 2019-March 2020 (322), in keeping with the number of beds halved from 28 to 14. In 2020–2021 62% of patients were deemed eligible to donate, compared with 64% eligible during the preceding year. 82% of eligible patients were offered the opportunity to discuss tissue donation in 2020–2021, compared with 80% the previous year. There were 51 corneal donors at the hospice in 2019–2020 (24.6% of all considered eligible) compared to 25 donors in 2020–2021 (24.5% of those considered eligible).

Conclusion(s) These results demonstrate that despite the numerous challenges of the pandemic, previously undertaken QI work has enabled sustained change, with the relative rate of tissue donation, frequency of discussions and subsequent referrals preserved during the pandemic period. QI is a fundamental tool for recovery from the pandemic and visualising future positive and sustained change.