Hospital Profiling and Hospital Stratification System as a Step for Assessment the Potential of Organ Donation From Deceased Donors.

AIM: To be able to calculate the potential of organ donation from deceased donors in a single hospital, region, and country, it is necessary to develop a useful stratification system for all hospitals taking into account their characteristics in having or not having departments crucial for donor identification and recruitment, such as an intensive care unit (ICU or neurology and neurosurgery departments), number of beds, and patient profiles (pediatric vs adult). MATERIALS AND METHODS: There are 1032 hospitals in Poland, and 388 have facilities and tools to confirm death according to neurological criteria. These hospitals with the potential of deceased donation were characterized accordingly to the criteria presented above. RESULTS: The largest group of institutions were first-degree referral hospitals having ICUs only for adults (161 hospitals), followed by hospitals with ICU and stroke departments for adults (76), then hospitals for adults with ICU and neurological department with no stroke beds (25), and hospitals for adults with second-degree referral and with ICU, stroke departments, and neurosurgery. In the case of pediatric patients and possible pediatric organ donation, the largest group consisted of 5 hospitals with pediatric ICU, pediatric neurology, and pediatric neurosurgery units. The remaining hospitals were unique in the country range. An exemplary analysis of 1 of the 40 stratified groups (19 out of 388 hospitals) showed that differences in actual activity in the donation process between similar hospitals are significant (from 0 to 62 donations in a 3-year period). CONCLUSION: We believe the results of this study are fundamental for the calculation of potential donation in the country. Our thesis is that hospitals from the same group should have the same potential and should be active in donation process on the same level. Formal comparative analysis of historical data on donor referral from active and nonactive hospitals will allow us to estimate the lost numbers of possible donations and will help focus efforts to improve transplantation systems.

System of Monitoring Potential Deceased Organ Donations in Over 200 Hospitals in Poland Using a Web Tool: Implementation and Structure.

BACKGROUND: In 2010 the formation of the Polish Hospitals Network of Organ Donation Coordinators, originated by Poltransplant, began. One of the goals of this project is to report all deaths in hospital ICUs in which a coordinator is posted. The aim of this strategy is to monitor donation potential, following the recruitment process of potential donors and indicating stages of that process that may be improved to increase effective recruitment. Until the end of 2014 all data were forwarded to Poltransplant as Excel files, but since January 1, 2015, reporting and data collection have been are performed using web tool www.koordynator.net. AIMS: The aim of the paper is to present the essentials in functioning principles, structure, and usage of the www.koordynator.net system, its technical construction, and to display good practices (know-how) tested by 1 country, for countries such as Poland, that contend with organ insufficiency. METHODS: The application www.koordynator.net allows for remote addition of individual records with information about deceased patients in hospital ICUs, the forwarding of data about potential and actual organ donors, the generation of complete reports about deceased patients in each hospital monthly, and the introduction of historical data. SUMMARY: Introduction of a potential donation monitoring system in 209 hospitals with transplant coordinators increases the number of identified potential and effective actual donors due to self-assessment analysis. Eventually, the www.koordynator.net reporting system allowed for external evaluation by coordinators from other hospitals, regional coordinators, and Poltransplant. The system is a modern tool that improves and increases the quality system in the organ donation field (quality assurance program).