Potential organ donor identification and system accountability: expert guidance from a Canadian consensus conference
Autor: | Jehan Lalani, Stefanie Linklater, Michaël Chassé, Janet E. Squires, Jeremy M. Grimshaw, David Hartell, Amber Appleby, Ken Lotherington, Sam D. Shemie, Samara Zavalkoff, Greg Knoll |
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Rok vydání: | 2018 |
Předmět: |
Referral
business.industry MEDLINE 030208 emergency & critical care medicine General Medicine Audit 030230 surgery 3. Good health 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine Nursing Anesthesia Donation Health care Accountability Medicine Performance measurement business Know-how |
Zdroj: | Canadian Journal of Anesthesia/Journal canadien d'anesthésie. 66:432-447 |
ISSN: | 1496-8975 0832-610X |
Popis: | Deceased donation rates in Canada remain below the predicted potential and lag behind leading countries. Missing a potential donor leads to preventable death and disability of transplant candidates and increased healthcare costs. Stakeholders were invited to a national consensus conference on improving deceased organ donor identification and referral (IDR 2) donor IDR 3) enhancing accountability: gaps and solutions; and 4) enhancing accountability: quality/safety organizations. Thirty-seven consensus statements were generated. At the healthcare professional (HCP) level, key statements include: 1) donation be consistently addressed as part of end-of-life care but only after a decision to withdraw life-sustaining treatment; 2) HCP know how and when to identify and refer potential donors; and 3) transplant candidates be informed of local allocation guidelines and performance. At the healthcare system level, key statements include: 1) national adoption of clinical criteria to trigger IDR 2) dedicated resources to match donation activities, including transfer of a potential donor; 3) performance measurement through death audits; 4) reporting and investigation of missed donation opportunities (MDO); 5) recognition of top performers; and 6) missed donor ID&R be considered a preventable and critical safety incident. Our consensus statements establish HCP and healthcare system responsibilities regarding potential organ donor ID&R and include the tracking, reviewing and elimination of MDO through system-wide death audits. Once implemented, these consensus statements will help honour patients’ wishes to donate, improve service to potential transplant recipients, and support HCPs in fulfilling their ethical and legal responsibilitites. Next steps include implementation, assessment of their impact on donation rates, and investigation of new evidence-based targets for system improvement. |
Databáze: | OpenAIRE |
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