Process Improvement in Thoracic Donor Organ Procurement: Implementation of a Donor Assessment Checklist

Abstract

Implementation of a simple checklist for use during thoracic organ procurement uncovered a substantial number of near miss events. A preprocedural checklist for all thoracic organ transplants in the United States and abroad is feasible and would likely reduce adverse events.

Cardioprotective Effect of Remote Ischemic Preconditioning with Postconditioning on Donor Hearts in Patients Undergoing Heart Transplantation: a single-center, double-blind, randomized controlled trial

“…In patients undergoing orthotopic heart transplantation, RIPC combined with RIPostC reduced myocardial injury at 6h after aortic declamping,while we found no evidence of this function provided by RIPC+RIPostC could improve clinical outcomes Background The myocardium is susceptible to ischemia reperfusion injury (IRI) during cardiac surgery and known to be associated with adverse outcomes [1,2]. The number of patients requiring heart transplantation will increase, and IRI is an inevitable consequence of heart transplantation [3,4]. Although the longterm survival and quality of life of transplant recipients have improved significantly, strategies for improving myocardial protection and perioperative mortality rates have not substantially changed [5].…”

Defining Issues in the Study of Process or Quality Improvement Versus Implementation Science

“…These include the implementation outcomes (eg, acceptability, adoption, feasibility, penetration or uptake and sustainability), the service outcomes (eg, efficacy, safety, effectiveness), and the client outcomes (eg, satisfaction, quality of life, mortality) [11]. In the study presented by Loor and colleagues [1], a variety of implementation outcomes stand upstream of the client outcomes (ie, near-miss events), and each holds significance in considering the next steps of the project. Will the checklist be acceptable to stakeholders at other institutions?…”

“…I n this issue, Loor and colleagues [1] describe the design and application of a preprocedure cardiothoracic transplant checklist to standardize organ procurement processes at two academic institutions [1]. Arising from a quality improvement initiative, use of the checklist was found to assist in identifying more than 3 times the number of near-miss events than before the checklist was implemented.…”

Cardioprotective Effect of Remote Ischemic Preconditioning with Postconditioning on Donor Hearts in Patients Undergoing Heart Transplantation: a single-center, double-blind, randomized controlled trial

“…The myocardium is susceptible to ischemia reperfusion injury (IRI) during cardiac surgery and known to be associated with adverse outcomes [1,2]. The number of patients requiring heart transplantation will increase, and IRI is an inevitable consequence of heart transplantation [3,4]. Although the longterm survival and quality of life of transplant recipients have improved significantly, strategies for improving myocardial protection and perioperative mortality rates have not substantially changed [5].…”