Organización Nacional de Trasplantes, Madrid, Spain.
Am J Transplant. 2012 Sep;12(9):2498-506. doi: 10.1111/j.1600-6143.2012.04128.x. Epub 2012 Jun 8.
A benchmarking approach was developed in Spain to identify and spread critical success factors in the process of donation after brain death. This paper describes the methodology to identify the best performer hospitals in the period 2003-2007 with 106 hospitals throughout the country participating in the project. The process of donation after brain death was structured into three phases: referral of possible donors after brain death (DBD) to critical care units (CCUs) from outside units, management of possible DBDs within the CCUs and obtaining consent for organ donation. Indicators to assess performance in each phase were constructed and the factors influencing these indicators were studied to ensure that comparable groups of hospitals could be established. Availability of neurosurgery and CCU resources had a positive impact on the referral of possible DBDs to CCUs and those hospitals with fewer annual potential DBDs more frequently achieved 100% consent rates. Hospitals were grouped into each subprocess according to influencing factors. Hospitals with the best results were identified for each phase and hospital group. The subsequent study of their practices will lead to the identification of critical factors for success, which implemented in an adapted way should fortunately lead to increasing organ availability.
西班牙制定了一项基准方法，旨在确定和推广脑死亡后器官捐献过程中的关键成功因素。本文介绍了 2003 年至 2007 年期间在全国范围内有 106 家医院参与的该项目中，确定表现最佳的医院的方法。脑死亡后的捐献过程分为三个阶段：从外部单位向重症监护病房（CCU）转介可能的脑死亡供体（DBD），CCU 内对可能的 DBD 进行管理，以及获得器官捐献同意书。在每个阶段都构建了评估绩效的指标，并研究了影响这些指标的因素，以确保可以建立可比的医院组。神经外科和 CCU 资源的可用性对将可能的 DBD 转介到 CCU 有积极影响，而每年潜在 DBD 较少的医院更频繁地达到 100%的同意率。根据影响因素，将医院分组到每个子过程中。为每个阶段和医院组确定了表现最佳的医院，并对其做法进行后续研究，以确定成功的关键因素。这些因素以适应的方式实施，有望增加器官的可用性。
