title: Impact of Introducing Full-time In-house Coordinators on Referral and Organ Donation Rates in Rio de Janeiro Public Hospitals: A Health Care Innovation Practice.
abstract: Establishing an organization to promote organ donation and a good organ procurement team assure quality and improve performance on organ donation rates. Brazil's organ procurement structure is based on 2 models disseminated worldwide: the "Spanish model," based on in-house coordinators, and the "American organ procurement organization (OPO) model," with extra-hospital coordinators. In 2006, Brazil's Federal Government had formally introduced the in-house coordination model for every hospital equipped with a mechanical ventilator bed. In January 2012, the Rio de Janeiro State OPO, Programa Estadual de Transplantes, introduced an innovation in the organization of the in-house coordination model in 4 selected public hospitals with high organ donation potential. It consisted in launching full-time in-house coordination teams, with ≥1 physician and 2 nurses per hospital fully dedicated to organ procurement. The objectives were to observe the impact of this innovation in referral and organ donor conversion rates and to analyze the importance of middle managers in health care innovation implementation. Comparing the year before implementation (2011) and the year of 2014 showed that this innovation led to an overall increase in referrals-from 131 to 305 per year (+132%) and conversion rates-from 20% to 42% per year-resulting in an increase in number of donors from 26 to 128 per year (+390%). Despite wide variations among hospitals in the outcomes, our results seem very encouraging and express a positive impact of this model, suggesting that dissemination to other hospitals may increase the number of donors and transplants in our region.
authors.affiliation: Programa Estadual de Transplantes, Rio de Janeiro, Brazil; COPPEAD Business School, Universidade Federal do Rio de Janeiro, Brazil. Electronic address: rodrigosarlo.transplante@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Sarlo
authors.affiliation: Programa Estadual de Transplantes, Rio de Janeiro, Brazil.
authors.forename: G
authors.initials: G
authors.lastname: Pereira
authors.affiliation: Programa Estadual de Transplantes, Rio de Janeiro, Brazil.
authors.forename: M
authors.initials: M
authors.lastname: Surica
authors.affiliation: Programa Estadual de Transplantes, Rio de Janeiro, Brazil.
authors.forename: D
authors.initials: D
authors.lastname: Almeida
authors.affiliation: COPPEAD Business School, Universidade Federal do Rio de Janeiro, Brazil.
authors.forename: C
authors.initials: C
authors.lastname: Araújo
authors.affiliation: COPPEAD Business School, Universidade Federal do Rio de Janeiro, Brazil.
authors.forename: O
authors.initials: O
authors.lastname: Figueiredo
authors.affiliation: Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Brazil.
authors.forename: E
authors.initials: E
authors.lastname: Rocha
authors.affiliation: COPPEAD Business School, Universidade Federal do Rio de Janeiro, Brazil.
authors.forename: E
authors.initials: E
authors.lastname: Vargas
mesh_terms: D001938:Brazil; D004651:Employment; D006779:Hospitals, Public / Q000458:organization & administration*; D006801:Humans; D009726:Nurses; D010561:Personnel Staffing and Scheduling; D012017:Referral and Consultation; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D000078329:Workforce