Benchmarking in the Process of Donation After Brain Death: A Methodology to Identify Best Performer Hospitals

• Published in: American journal of transplantation Vol. 12; no. 9; pp. 2498 - 2506
• Main Authors: Matesanz, R., Coll, E., Domínguez‐Gil, B., de la Rosa, G., Marazuela, R., Arráez, V., Elorrieta, P., Fernández‐García, A., Fernández‐Renedo, C., Galán, J., Gómez‐Marinero, P., Martín‐Delagebasala, C., Martín‐Jiménez, S., Masnou, N., Salamero, P., Sánchez‐Ibáñez, J., Serna, E., Martínez‐Soba, F., Pastor‐Rodríguez, A., Bouzas, E., Castro, P.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.09.2012; Wiley
• Subjects: Benchmarking; Biological and medical sciences; Brain Death; Consent; donation referral; donor evaluation; donor management; donor pool; Hospitals - standards; Humans; Medical sciences; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue and Organ Procurement; Suboptimal donor; Human; Evaluation; Methodology; Brain death; donor pool; donor evaluation; donation referral; Clinical management; Treatment; Consent; Donation; Pool; Hospital; donor management
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2012.04128.x

A benchmarking approach was developed in Spain to identify and spread critical success factors in the process of donation after brain death. This paper describes the methodology to identify the best performer hospitals in the period 2003–2007 with 106 hospitals throughout the country participating in the project. The process of donation after brain death was structured into three phases: referral of possible donors after brain death (DBD) to critical care units (CCUs) from outside units, management of possible DBDs within the CCUs and obtaining consent for organ donation. Indicators to assess performance in each phase were constructed and the factors influencing these indicators were studied to ensure that comparable groups of hospitals could be established. Availability of neurosurgery and CCU resources had a positive impact on the referral of possible DBDs to CCUs and those hospitals with fewer annual potential DBDs more frequently achieved 100% consent rates. Hospitals were grouped into each subprocess according to influencing factors. Hospitals with the best results were identified for each phase and hospital group. The subsequent study of their practices will lead to the identification of critical factors for success, which implemented in an adapted way should fortunately lead to increasing organ availability. The authors provide a detailed description of a benchmarking methodology that allows the identification of best performer hospitals in the process of donation after brain death.