Interim Results of a National Test of the Rapid Assessment of Hospital Procurement Barriers in Donation (RAPiD)

Abstract

Organ donation remains a major public health challenge with over 114 000 people on the waitlist in the United States. Among other factors, extant research highlights the need to improve the identification and timely referral of potential donors by hospital health-care providers (HCPs) to organ procurement organizations (OPOs). We implemented a national test of the Rapid Assessment of hospital Procurement barriers in Donation (RAPiD) to identify assets and barriers to the organ donation and patient referral processes; assess hospital–OPO relationships and offer tailored recommendations for improving these processes. Having partnered with seven OPOs, data were collected at 70 hospitals with high donor potential in the form of direct observations and interviews with 2358 HCPs. We found that donation attitudes and knowledge among HCPs were high, but use of standard referral criteria was lacking. Significant differences were found in the donation-related attitudes, knowledge and behaviors of physicians and emergency department staff as compared to other staff in intensive care units with high organ donor potential. Also, while OPO staff were generally viewed positively, they were often perceived as outsiders rather than members of healthcare teams. Recommendations for improving the referral and donation processes are discussed.

Nurses' attitudes and knowledge regarding organ and tissue donation and transplantation in a provincial hospital: A descriptive and multivariate analysis

“…As a result of their proximity to patients and their relatives, nurses are seen as a key element in raising awareness about donation, and their personal attitudes play a vital role in improving attitudes among society as a whole (Sque et al , ; Mills & Koulouglioti, ; Jawoniyi & Gormley, ). Furthermore, nurses frequently think more about donation than physicians (Traino et al , ).…”

Organ Transplantation and the Uniform Anatomical Gift Act: A Fifty‐Year Perspective

“…Another barrier to donation is the relationship between the staffs of receiving hospitals and the OPO in each region. One study of this relationship concluded that only a small minority of hospital employees viewed OPO staff as part of their team and that improvement in this relationship was needed …”

The Influence of End-of-Life Care on Organ Donor Potential

“…The consequential knowledge gap in organ donation practices in non-ICU physicians leads to a loss of potential organ donors (3,4). Organ donation expertise tends to be focused within the ICU.…”

“…We tried to limit this bias by interviewing the physicians in the days or weeks following the inclusion. 4 In the other cases a reason for not discussing tissue donation was given (n = 20) or no reason was given (n = 8). Most of our patients would fall within the donation after circulatory death group, and only a minority in donation after brain death.…”