title: [Efficiency indicators to assess the organ donation and transplantation process: systematic review of the literature].
abstract: OBJECTIVE
  To search the literature and identify indicators used to monitor and control the organ donation and transplantation process and to group these indicators into categories.
  
  
  METHODS
  In November 2014, a systematic review of the literature was carried out in the following databases: Biblioteca Virtual em Saúde (BVS), EBSCO, Emerald, Proquest, Science Direct, and Web of Science. The following search terms (and the corresponding terms in Brazilian Portuguese) were employed: "efficiency," "indicators," "organ donation," "tissue and organ procurement," and "organ transplantation." Of the 344 articles retrieved, 23 original articles published between 1992 and 2013 were selected and reviewed for analysis of efficiency indicators.
  
  
  RESULTS
  The review revealed 117 efficiency indicators, which were grouped according to similarity of content and divided into three categories: 1) 71 indicators related to organ donation, covering mortality statistics, communication of brain death, clinical status of donors and exclusion of donors for medical reasons, attitude of families, confirmation of donations, and extraction of organs and tissues; 2) 22 indicators related to organ transplantation, covering the surgical procedure per se and post-transplantation follow-up; and 3) 24 indicators related to the demand for organs and the resources of hospitals involved in the process.
  
  
  CONCLUSIONS
  Even if organ transplantation is a recent phenomenon, the high number of efficiency indicators described in the literature suggests that scholars interested in this field have been searching for ways to measure performance. However, there is little standardization of the indicators used. Also, most indicators focus on the donation step, suggesting gaps in the measurement of efficiency at others points in the process. Additional indicators are needed to monitor important stages, such as organ distribution (for example, organ loss indicators) and post-transplantation aspects (for example, survival and quality of life).
authors.affiliation: Universidade Federal do Rio de Janeiro (UFRJ), Instituto COPPEAD de Administração, Centro de Estudos em Gestão de Serviços de Saúde (CESS), Rio de Janeiro (RJ), Brasil.
authors.forename: Marina Martins
authors.initials: MM
authors.lastname: Siqueira
authors.affiliation: Universidade Federal do Rio de Janeiro (UFRJ), Instituto COPPEAD de Administração, Centro de Estudos em Gestão de Serviços de Saúde (CESS), Rio de Janeiro (RJ), Brasil.
authors.forename: Claudia Affonso
authors.initials: CA
authors.lastname: Araujo
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem (EPE), Departamento de Enfermagem, São Paulo (SP), Brasil.
authors.forename: Bartira
authors.initials: B
authors.lastname: de Aguiar Roza
authors.affiliation: Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem (EPE), Departamento de Enfermagem, São Paulo (SP), Brasil.
authors.forename: Janine
authors.initials: J
authors.lastname: Schirmer
mesh_terms: D001938:Brazil; D004526:Efficiency; D006761:Hospitals; D006801:Humans; D016377:Organ Transplantation; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000458:organization & administration*