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BMC Health Services Research
Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

Development of key interventions and quality indicators for the management of an adult potential donor after brain death: a RAND modified Delphi approach

Authors: Pieter Hoste, Eric Hoste, Patrick Ferdinande, Koenraad Vandewoude, Dirk Vogelaers, Ann Van Hecke, Xavier Rogiers, Kristof Eeckloo, Kris Vanhaecht, on behalf of the Donation after Brain Death Study Group

Published in: BMC Health Services Research | Issue 1/2018

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Abstract

Background

A substantial degree of variability in practices exists amongst donor hospitals regarding the donor detection, determination of brain death, application of donor management techniques or achievement of donor management goals. A possible strategy to standardize the donation process and to optimize outcomes could lie in the implementation of a care pathway. The aim of the study was to identify and select a set of relevant key interventions and quality indicators in order to develop a specific care pathway for donation after brain death and to rigorously evaluate its impact.

Methods

A RAND modified three-round Delphi approach was used to build consensus within a single country about potential key interventions and quality indicators identified in existing guidelines, review articles, process flow diagrams and the results of the Organ Donation European Quality System (ODEQUS) project. Comments and additional key interventions and quality indicators, identified in the first round, were evaluated in the following rounds and a subsequent physical meeting. The study was conducted over a 4-month time period in 2016.

Results

A multidisciplinary panel of 18 Belgian experts with different relevant backgrounds completed the three Delphi rounds. Out of a total of 80 key interventions assessed throughout the Delphi process, 65 were considered to contribute to the quality of care for the management of a potential donor after brain death; 11 out of 12 quality indicators were validated for relevance and feasibility. Detection of all potential donors after brain death in the intensive care unit and documentation of cause of no donation were rated as the most important quality indicators.

Conclusions

Using a RAND modified Delphi approach, consensus was reached for a set of 65 key interventions and 11 quality indicators for the management of a potential donor after brain death. This set is considered to be applicable in quality improvement programs for the care of potential donors after brain death, while taking into account each country’s legislation and regulations regarding organ donation and transplantation.
Appendix
Available only for authorised users
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Metadata
Title
Development of key interventions and quality indicators for the management of an adult potential donor after brain death: a RAND modified Delphi approach
Authors
Pieter Hoste
Eric Hoste
Patrick Ferdinande
Koenraad Vandewoude
Dirk Vogelaers
Ann Van Hecke
Xavier Rogiers
Kristof Eeckloo
Kris Vanhaecht
on behalf of the Donation after Brain Death Study Group
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3386-1

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