Improving the request process to increase family consent for organ donation.
The greatest impediment to organ donation is refusal of family consent. This study examined the impact of 3 modifiable elements of the donation request on family consent rates: (1) decoupling (i.e., the family understands and accepts brain death before discussion of organ donation is begun); (2) the procurement coordinator participates in the request for consent; and (3) donation is requested in a quiet, private place. Data on the request process were collected prospectively for 707 medically suitable potential donors who had been referred to 3 organ procurement organizations. The average rate of consent for donation was 62.2%. Higher consent rates were independently associated with the 3 characteristics studied. These components were summarized in the Request Process Scale. Multivariate regression analyses indicated that consent rates can be as high as 74% when all 3 process elements are present. Hospitals and organ procurement organizations should incorporate these elements into their standard of practice when requesting organ donation.
Gortmaker
S L
SL
Dept of Health and Social Behavior, Harvard School of Public Health, Boston, MA 02115, USA. sgortmak@hsph.harvard.edu
Beasley
C L
CL
Sheehy
E
E
Lucas
B A
BA
Brigham
L E
LE
Grenvik
A
A
Patterson
R H
RH
Garrison
N
N
McNamara
P
P
Evanisko
M J
MJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005190:Family / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011368:Professional-Family Relations; D011446:Prospective Studies; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D009927:Tissue and Organ Procurement / Q000379:methods* / Q000706:statistics & numerical data; D014481:United States