Background Eye donations do not meet demand in the UK (RNIB. The state of the nation eye health 2016.) NHS Blood and Transplant identified hospices as a potential source of referrals and invited selected hospices to be pilot sites for the use of an evidence-based intervention (Long-Sutehall, Bracher, Mollart, et al. Health Soc Care Deliv Res. 2023;11(20). Weston Hospicecare and St Clare Hospice will share experiences of implementing a service improvement initiative into a busy clinical setting.

Aims 1) Implement and assess whether the resources provided to sites aided in increasing discussions with patients about the option of eye donation and increased subsequent referrals. 2) Determine the feasibility of embedding eye donation discussions into routine end of life care planning conversations. 3) Identify effective ways of working between NHSBT and the pilot sites to inform future wider rollout of the intervention.

Methods Resources provided to pilot sites included: educational materials with role-modelling and patient experience videos, and online eye donation eligibility checker tool. Regional Tissue Donation Specialist Nurses were assigned to pilot sites and provided regular support with culture change. Monthly data was collected at baseline and subsequently for 6 months from retrospective inpatient case note reviews regarding eligibility, discussion rates and referrals.

Results Challenges: the resources provided required different implementation in sites. Personalised support and time investment from senior individuals were necessary as improvements depended on the actions of a few key, highly motivated individuals.

Opportunities: Discussions between staff and with patients and referral rates increased over six months and feedback from pilot sites regarding optimisation of the educational resources have been provided to NHSBT.

Conclusion Implementation of eye donation service improvement in hospices is feasible, effective, rewarding, and in line with national guidance and advance care planning principles. The evidence-based resources can be implemented flexibly in settings and are invaluable for overcoming challenges associated with culture change. We encourage more hospices to engage in eye donation work.