A Continuous Quality Improvement Process to Increase Organ and Tissue Donation

Burris, Gary W.; Jacobs, Arlene J

doi:10.1177/090591999600600210

Journal of Transplant Coordination

1996

DOI: 10.1177/090591999600600210

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A Continuous Quality Improvement Process to Increase Organ and Tissue Donation

Gary W. Burris

Arlene J Jacobs

Abstract: The Omnibus Budget Reconciliation Act of 1987 mandated that hospitals must identify potential organ and tissue donors, notify an organ procurement organization of the potential donor, and inform family members regarding the opportunity to donate organs and tissues. Although the Joint Commission on Accreditation of Healthcare Organizations requires that hospitals comply with this statute, no standard for documenting compliance exists. A continuous quality improvement process was developed at one institution to … Show more

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Program Development and Routine Notification in a Large, Independent OPO: A 12-Year Review

Shafer¹,

Buren²,

Andrews³

1999

Journal of Transplant Coordination

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Since its inception 12 years ago, a large, independent OPO experienced a 631% growth in the number of organ donors. These increases in organ recovery were achieved initially through successful mergers, and later, following the mergers, through focused management, OPO organizational development, and hospital marketing and system development. The cumulative percentage increases beginning in 1987 resulted in the OPO achieving 27.2 donors per million population. In 1996 a system of routine notification of all hospital deaths was implemented and a 24-hour communications center was operated. After 3 full years of routine notification, 73% of all deaths were called to the OPO, resulting in the following increases: total referrals, 691%; organ referrals, 41%; organ donors, 16%; bone donors, 149%; skin donors, 123%; and heart valve donors, 78%. The 16% increase in organ donors was twice the national growth rate and significantly more than the 2% growth experienced by the OPO in the year preceding the implementation of routine notification. The OPO has demonstrated sustained growth over the past decade in a time when erosion of donor recovery levels is always a possibility and frequently a reality for many OPOs.

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Program Development and Routine Notification in a Large, Independent OPO: A 12-Year Review

Shafer¹,

Buren²,

Andrews³

1999

Journal of Transplant Coordination

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Ethical Analysis of Organ Recovery Denials by Medical Examiners, Coroners, and Justices of the Peace

Shafer

Schkade

Siminoff

et al. 1999

Journal of Transplant Coordination

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Context Despite its pivotal nature, until the early 1990s the role of medical examiners, coroners, and justices of the peace was largely ignored in discussions of the critical shortage of organs for transplantation in the United States. These officials have the right to determine, from a medico-legal perspective, whether a deceased person can be an organ donor. Thus, they play an important role in the donation process. Using a principles-based ethical framework, this article examines the problem of nonrecovery of life-saving organs for transplantation in the United States because a medical examiner or other official denies recovery. Objective The goals of organ donation and the collection of forensic evidence are not mutually exclusive. An analysis of the ethical principles and obligations of beneficence, respect for autonomy, and justice reveals that medical examiners and other officials could probably, after appropriate review, release all cases under their jurisdiction for organ donation. Conclusion Medical examiners, coroners, and justices of the peace could assume a leadership role, working together on public policy with medical, social, and legal groups, spearheading efforts to stop the loss of organs due to official denials, up to and including state and federal regulation and legislation. Beyond their professional obligations, as agents of a social institution, medical examiners and other officials have the more general ethical responsibility of promoting the public health and welfare and of reinforcing societal consensus that transplantation is a social good which should be optimized through formal and informal activities.

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Utility and Usability of the Rapid Assessment of Hospital Procurement Barriers in Donation (RAPiD) as a Tool for OPO Hospital Development Staff

2016

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More HCPs interviewed in the autonomous condition were positive toward the concept of organ donation. However, HCPs in the assisted condition were more candid about and critical of the OPO. As for knowledge, fewer HCPs in the autonomous condition reported familiarity with the donation process, need for donors, and generally accepted timely referral criteria. With respect to behaviors, more respondents in the autonomous condition reported frequent or occasional contact with the OPO and routine or occasional referral criteria use. Due to issues of bias, inadequate research experience, conflicts of interest, and ongoing OPO hospital development initiatives, the RAPiD's usability by OPO-based hospital development staff is questionable and not recommended in its current form. A next generation of the RAPiD is described for future consideration.

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A Continuous Quality Improvement Process to Increase Organ and Tissue Donation

Cited by 3 publications

References 3 publications

Program Development and Routine Notification in a Large, Independent OPO: A 12-Year Review

Program Development and Routine Notification in a Large, Independent OPO: A 12-Year Review

Ethical Analysis of Organ Recovery Denials by Medical Examiners, Coroners, and Justices of the Peace

Utility and Usability of the Rapid Assessment of Hospital Procurement Barriers in Donation (RAPiD) as a Tool for OPO Hospital Development Staff

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