Implementation of a Quality Management System on Organ Donation in the Kingdom of Saudi Arabia (KSA)

Abstract

Introduction World Health Organization (WHO) is advocating for the development of self-sufficiency in Donation and Transplantation (D&T) in all countries, as a practical alternative to combat transplant tourism and commercialism around the world. KSA is a Middle East country with 27.448.000 population. In 2016, 92 deceased donors (3.07 pmp) were reported. Therefore, 265 organ transplantations (9.6 pmp) were performed. Organ shortage represents a major obstacle preventing a further increase of transplantation in KSA. In 2017, the Ministry of Health of KSA launched a 3-year project coordinated by DTI foundation with the support of the Saudi Center for Organ Transplantation (SCOT). The project aims to improve the D&T rates by implementing an organ donation quality management system based on the implementation of the most successful models in organ donation (SEUSA) and quality systems (ODEQUS). Materials and Methods Through the use of SEUSA and ODEQUS methodologies (already described previously by us), as valuable and replicable international collaborative strategies to improve organ donation worldwide, the project methodology includes: a) Competence Authorities involvement; b) Diagnosis of the current situation (national, regional and hospital level) using ODDS (Organ Donation Diagnostic Surveys) and developing in situ expert’s visits; c) Detection of all brain and cardiac deaths in the hospitals implementing the DAS (Decease Alert System); d) implementation of the ODEQUS quality indicators (pilot phase); e) Knowledge exchange activities; f) External hospital audits. Continuous monitoring was performed to allow data collection and analysis. Results and Discussion The pilot phase linked 5 hospitals from different background in Riyadh and Jeddah. D&T healthcare professionals were trained in the application of the quality indicators. An IT tool beta version was created to collect data derived from the clinical donation activity. A 3-year plan was developed to expand the project up to 25 hospitals and to increase the D&T rates of the country. The project allowed to broaden SCOT’s geographical representation with the result of KSA becoming a reference model in D&T in the Middle East region. Conclusion SEUSA and ODEQUS methodologies have shown, to be a good option to consolidate D&T systems. Its use has allowed to homogenize the organ donation process creating a methodology to evaluate the organ procurement performance and defining improvement strategies enhancing the efficiency of transplant systems in KSA.