title: Hospital characteristics associated with increased conversion rates among organ donors in New England.
abstract: BACKGROUND
  It is unknown whether hospital characteristics affect institutional performance with regard to organ donation. We sought to determine which hospital- and patient-level characteristics are associated with high organ donor conversion rates after brain death (DBD).
  
  
  METHODS
  Data were extracted from the regional Organ Procurement Organization (2011-2014) and other sources. Hospitals were stratified into high-conversion hospitals (HCH; upper-tertile) and low-conversion hospitals (LCH; lower-tertile) according to conversion rates. Hospital- and patient-characteristics were compared between groups.
  
  
  RESULTS
  There were 564 potential DBD donors in 27 hospitals. Conversion rates differed between hospitals in different states (p < 0.001). HCH were more likely to be small (median bed size 194 vs. 337; p = 0.024), non-teaching hospitals (40% vs. 88%; p = 0.025), non-trauma center (30% vs. 77%; p = 0.040). Potential donors differed between HCH and LCH in race (p < 0.01) and mechanism of injury/disease process (p < 0.01).
  
  
  CONCLUSIONS
  There is significant variation between hospitals in terms of organ donor conversion rates. This suggests that there is a pool of potential donors in large specialized hospitals that are not successfully converted to DBD.
authors.affiliation: Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School & Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: arturo.riosdiaz@jefferson.edu.
authors.forename: Arturo J
authors.initials: AJ
authors.lastname: Rios-Diaz
authors.affiliation: Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School & Harvard T.H. Chan School of Public Health, Boston, MA, USA; Division of Trauma, Burns, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School Brigham, Boston, MA, USA.
authors.forename: Olubode A
authors.initials: OA
authors.lastname: Olufajo
authors.affiliation: New England Organ Bank, Waltham, MA, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Stinebring
authors.affiliation: New England Organ Bank, Waltham, MA, USA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Endicott
authors.affiliation: New England Organ Bank, Waltham, MA, USA.
authors.forename: Brandon T
authors.initials: BT
authors.lastname: McKown
authors.affiliation: Kadoorie Centre for Critical Care Research, University of Oxford, John Radcliffe Hospital, Oxford, UK.
authors.forename: David
authors.initials: D
authors.lastname: Metcalfe
authors.affiliation: Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School & Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Cheryl K
authors.initials: CK
authors.lastname: Zogg
authors.affiliation: Division of Trauma, Burns, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School Brigham, Boston, MA, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Salim
mesh_terms: D001926:Brain Death; D005260:Female; D006739:Hospital Administration; D006801:Humans; D008297:Male; D009511:New England; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*
keywords: Athorization rate; Authroization rate; Conversion rate; DCD; Donor; Donor after brain death; Hospital characteristics; Hospital performance; Organ donation; Transplant center; Trauma center