• Laura A Siminoff and Heather M Traino.
• Virginia Commonwealth University, School of Medicine, Department of Social and Behavioral Health, PO Box 980149, 1112 E. Clay St., Richmond, VA 23298, USA. lasiminoff@vcu.edu
• Prog Transplant. 2009 Jun 1; 19 (2): 180-7.

ContextDeficiencies in the donation process continue to contribute to the shortage of organs available for transplant. Continuous quality improvement of hospitals' donation processes is needed to identify and correct the problems.ObjectiveTo test the Rapid Assessment of Hospital Procurement Barriers in Donation (RAPiD), a direct observation technique with a focused ethnographic strategy, for assessing hospitals' donation processes and identifying areas in need of continuous quality improvement interventions.DesignA pre-post assessment of hospitals' barriers to patient identification and referral, and family consent to donation.Setting And ParticipantsSeventeen hospitals within the catchment area of a Northeastern organ procurement organization were assessed by using the RAPiD method. Hospital administrators, health care providers, and staff (N = 537) were interviewed as part of the assessments.InterventionInterventions, including on-site training and education, and the use of in-house coordinators, were specifically tailored to each hospital's unique set of barriers to donation. The interventions were delivered to the hospitals in the form of recommendations. The participating organ procurement organization was responsible for implementation of the interventions.ResultsThe RAPiD hospital evaluations revealed gaps in respondents' knowledge of organ donation, brain death, and referral criteria; a reluctance to declare brain death; and a rocky relationship between the hospitals and the organ procurement organization. As a result of the interventions, 9 hospitals' environments for organ donation improved, 7 showed no change, and 1 was worse.

24 keywords...

hide…