Defining Quality Criteria for Success in Organ Donation Programs: A Scoping Review

Abstract

Background: Well-established performance measures for organ donation programs do not fully address the complexity and multifactorial nature of organ donation programs such as the influence of relationships and organizational attributes. Objective: To synthesize the current evidence on key organizational attributes and processes of international organ donation programs associated with successful outcomes and to generate a framework to categorize those attributes. Design: Scoping Review using a mixed methods approach for data extraction. Setting: Databases included PubMed, CINAHL, Embase, LILACS, ABI Business ProQuest, Business Source Premier, and gray literature (organ donation association websites, Google Scholar—first 8 pages), and searches for gray literature were performed, and relevant websites were perused. Sample: Organ donation programs or processes. Methods: We systematically searched the literature to identify any research design, including text and opinion papers and unpublished material (research data, reports, institutional protocols, government documents, etc). Searches were completed on January 2018, updated it in May 2019, and lastly in March 2020. Title, abstracts, and full texts were screened independently by 2 reviewers with disagreements resolved by a third. Data extraction followed a mixed method approach in which we extracted specific details about study characteristics such as type of research, year of publication, origin/country of study, type of journal published, and key findings. Studies included considered definitions and descriptions of success in organ donation programs in any country by considering studies that described (1) attributes associated with success or effectiveness, (2) organ donation processes, (3) quality improvement initiatives, (4) definitions of organ donation program effectiveness, (5) evidence-based practices in organ donation, and (6) improvements or success in such programs. We tabulated the type and frequency of the presence or absence of reported improvement quality indicators and used a qualitative thematic analysis approach to synthesize results. Results: A total of 84 articles were included. Quantitative analysis identified that most of the included articles originated from the United States (n = 32, 38%), used quantitative approaches (n = 46, 55%), and were published in transplant journals (n = 34, 40.5%). Qualitative analysis revealed 16 categories that were described as positively influencing success/effectiveness of organ donation programs. Our thematic analysis identified 16 attributes across the 84 articles, which were grouped into 3 categories influencing organ donation programs’ success: context (n = 39, 46%), process (n = 48, 57%), and structural (n = 59, 70%). Limitations: Consistent with scoping review methodology, the methodological quality of included studies was not assessed. Conclusions: This scoping review identified a number of factors that led to successful outcomes. However, those factors were rarely studied in combination representing a gap in the literature. Therefore, we suggest the development and reporting of primary research investigating and measuring those attributes associated with the performance of organ donation programs holistically. Trial Registration: Not applicable.

Brain Death: Health Team’s Experience With Parents of Children and Adolescents

“…Other studies reinforce these findings by pointing out the crucial need for the health team to be empowered and aware on the BDDP stages as well as communication of death. This fact is in the sense of clarifying and explaining each BDDP stage to parents, in addition to understanding their demands, especially when dealing with the death of children and adolescents [18][19] . It is noteworthy that, in this study, the team shows how significant it is to actively listen to children's/adolescents' parents at the same time that active listening allows the team to understand what parents assimilated from the information conveyed in each BDDP stage.…”

Morte Encefálica: Vivência Da Equipe De Saúde Junto Aos Pais De Crianças E Adolescentes

“…Outros estudos reforçam esses achados ao pontuarem a necessidade crucial da equipe de saúde estar habilitada e sensibilizada com as etapas do PDME, bem como da comunicação da morte. Tal fato se dá no sentido de esclarecer e explicar cada uma das etapas do PDME aos pais, além de compreender as suas demandas, em especial por se tratar da morte infantojuvenil [18][19] . Ressalta-se que nesse estudo a equipe deixa transparecer o quão significativo é escutar ativamente os pais dessas crianças/adolescentes, ao mesmo tempo em que a escuta ativa permite a equipe compreender o que os pais assimilaram das informações repassadas em cada uma das etapas do PDME.…”

Living donor liver transplantation: A multi‐disciplinary collaboration towards growth, consensus, and a change in culture

“…26 Defining quality criteria and outcomes for evaluation of living donation programs, as has been done in deceased organ donation, will be important as we move forward and aim to critically appraise new initiatives. 27…”

“…Supporting the long‐term health and wellbeing of living organ donors and incorporating them as key stake holders in a formalized model of donor‐initiated community‐based education to serve as a platform for the greater population education on the societal importance of living donation has been explored 26 . Defining quality criteria and outcomes for evaluation of living donation programs, as has been done in deceased organ donation, will be important as we move forward and aim to critically appraise new initiatives 27 …”