The impact of social, cognitive and attitudinal dimensions on college students' support for organ donation.

This study investigates how college students can be social support catalysts for organ donation and how social, cognitive and attitudinal dimensions impact organ donor registration. A total of 317 people participated in the exploratory portion of the project and a total of 1800 responses were obtained from an online survey to members of a national student organization. The findings show that perceptions of the benefits of organ donation and altruistic motives had the greatest impact on the support for organ donation while respondents' knowledge about how to register to be an organ donor was the dominant dimension for donor registration status. Social-based communications had the next greatest impact for both support and donor registration. Based on the findings, an 18-month social media campaign was launched with the student organization that had 20 421 website visitors, 4473 Facebook members, 1189 YouTube video submissions with 164 000 views, motivated 19 623 people to go to a state's organ donor registration page, and had 9000 documented organ donor registrations. Within the student organization, organ donor registration increased by 28%. On the basis of these project results, Donate Life America and other sponsors have provided funding for two additional years.

A hierarchical communication model of the antecedents of health care professionals' support for donations after cardiac death.

Using structural equation modeling, the direct and indirect impact of five variables on the support of donation after cardiac death from the perspective of health care professionals were investigated: knowledge, trust in the transplant team, whether patients are in a state of irreversibility, whether health care professionals participate in a patient's death, and perceptions about the brain death versus cardiac death donation process. In total, 10/15 relationships posited in the model had significant pathways. The results provide insight into sequential communication strategies for generating support for donations after cardiac death.

Increasing organ donations after cardiac death by increasing DCD support among health care professionals: a case report.

This case report focuses on the University of Wisconsin Hospital and Clinics Organ Procurement Organization (UWHC-OPO) efforts to produce a verifiable and demonstrable increase in organ donations by developing a replicable, transferable and feasible model intervention for increasing health care professionals' support for donation after cardiac death (DCD). A grant from the US Department of Health and Human Services funded a 3-year study allowing the UWHC-OPO to (i) identify barriers to and opportunities for increasing DCD support among those involved in the donation request process, (ii) implement this better understanding of these support factors in the creation of intervention materials designed to increase knowledge of and support for DCD and finally (iii) to track and document the progress made in increasing knowledge, support, number of hospitals with DCD protocols, actual requests made and number of DCD donors. The results of the model intervention were extremely positive, showing lasting increases in DCD knowledge and support, adoption of DCD protocols and referrals in the two tracking survey stages following the intervention. Perhaps most notably, DCD donor numbers within the UWHC-OPO region increased 93% in the year following the intervention and 179% to date.

An empirical examination of the antecedents of the acceptance of donation after cardiac death by health care professionals.

Findings are reported from a US Department of Health and Human Services (DHHS) funded study to identify barriers to increasing support for donations after cardiac death by health professionals. A donations after cardiac death (DCD) acceptance model is conceptualized and tested via 806 survey responses from certified requestors, all of whom had their identities protected through Institutional Review Board (IRB) protocol. The overall model was significant and explained 35% of the variation in DCD support. Greater knowledge about DCD, greater trust in the organ procurement organization (OPO) and a belief that futility has been reached were all positively associated with DCD acceptance. Negative perceptions of DCD versus brain death, transitioning from caregiving to donation advocate, concerns about the DCD process and the idea that DCD leads to active participation in the death reduced its support. The three greatest impediments to support of DCD exist when health professionals feel they are playing an active role in killing the patient, that a state of death has not yet been reached, and that DCD has more psychological barriers than does the brain death donation process. Opportunities and strategic initiatives are discussed to overcome these barriers, including the value of communication and education initiatives and the need for well-trained requestors. The implementation of these strategic guidelines helped to increase the number of DCD donors by 225%.

The role physicians play throughout the birthing process.

The second of a series, this study examines the effect of physician service performance on women's perceptions of physician quality before, during, and after delivery. We also examine changing physician-patient relationships throughout the birthing experience and compare our findings to those reported in a previous study that focused on nurse-patient relationships. Our findings show that physicians can have a profound impact on patient quality assessments and that these perceptions are prone to change as patients progress through the three birthing stages.

Dissecting the HMO-benefits managers relationship: what to measure and why.

The relationship between health maintenance organizations (HMO) and employee benefits managers (EBM) is multidimensional and complex. Relationship marketing theory is used to illustrate its role in strengthening interorganizational bonds and reducing defections to other health plans. The importance of various service dimensions in the HMO-EBM relationship can change depending on whether the measure used is overall satisfaction, overall quality, and loyalty to the HMO. By dissecting relationships in this way, HMOs can develop strategies that take multiple routes for building and maintaining strong partnerships with employee benefits managers.

Exploring the role nurses play at different stages of the birthing process. Developing strong and long-term relationships with women by examining relationship-building stages prior to delivery, during delivery, and after delivery.

The health care community is becoming increasingly aware of the need to develop strong and long-term relationships with the women who make up the majority of the health care market. The perceived quality of obstetric care positively impacts future revenue streams by creating "family" loyalty for an umbrella of other health services offered by the provider organization. This article examines the differential impact that various service performance dimensions have on women's perceptions of quality for different stages of the birthing process, and how relationship-marketing principles can be utilized to develop loyal partnerships. The three distinct relationship-building stages are examined--birthing experiences prior to delivery, during delivery, and after delivery--along with their implications for perceptions of quality analyzed.

Using relationship marketing to develop and sustain nurse loyalty: a case of a rural health care institution.

The prosperity of a health care organization is contingent on its ability to compete for and retain a high quality staff of "loyal" nurses. Although the benefits of maintaining a loyal nursing staff are obvious, turnover in the health care industry is dangerously high. One solution for reducing turnover is to develop and sustain a loyal nursing staff. The purpose of this article is to apply customer-oriented marketing theories and practices to better understand how strong nurse-provider relationships can be developed and maintained over time. The authors first examine relationship marketing literature as it applies to nurse relationship and management issues. Second, a framework for conceptualizing internal marketing efforts devoted to enhancing nursing staff satisfaction and retention in tested. Finally, strategies for practicing relationship marketing will be provided.

Relationships building. Measure service quality across health care encounters.

The relationships between service quality and satisfaction is a function of multiple service encounters across a wide variety of exchange partners within a health care organization. Studying the patient provider relationship leads to improved service quality. The authors report their findings from a study that tests a relationship-building framework that integrates service quality issues across multiple internal health care publics. Strategies for developing a strong patient-provider relationship bond are also discussed.

Building relationships with physicians. Internal marketing efforts help strengthen organizational bonds at a rural health care clinic.

Physician turnover is costly for health care organizations, especially for rural organizations. One approach management can take to reduce turnover is to promote physician loyalty by treating them as an important customer segment. The authors develop an information--oriented framework for generating physician loyalty and illustrate how this framework has helped to eliminate physician turnover at a rural health care clinic. Rural health care organizations must develop a more internal marketing orientation in their approach to establishing strong relationship bonds with physicians.

Integrating multiple publics into the strategic plan. The best plans can be derailed without comprehensive up-front research.

The mission of a health care organization represents its vision for the future. The authors present an approach used to develop an organizational mission for a large multispecialty physician clinic. In implementing the strategic planning process, research objectives must be clearly stated that identify in advance how the data will be used. Failure to integrate strategic data from all relevant publics will likely result in a mission statement that misses the significant interests of one or more stakeholders and reduces the effectiveness of the strategic planning process. Although costly, comprehensive research can uncover some surprising differences in perception that, if ignored, might complete defeat strategic planning efforts.

Taking the direct route.

Direct marketing holds much potential for the health care industry, but little has been written about hospitals' use of DM techniques. The authors discuss the distinct characteristics of direct marketing, report findings from an exploratory study of how U.S. hospitals have incorporated DM into their communication programs, and construct a profile of high and low users.