Efforts to develop a mechanism that improves donation rates and provides better service to patients and staff are presented in this article. The University of Nebraska Medical Center has incorporated a routine referral process into its acute bereavement services requiring representatives to respond to each in-house death to provide consistent support and management for the decedent's family and the hospital staff. Every family was offered bereavement support and the opportunity to consent to autopsy as well as to organ and tissue donation if medically appropriate. Key data related to death and consent discussions were documented, routinely reviewed, and reported to a central location. Appropriate and timely access of these data helped to modify the program and assess its need for additional education or intervention.