Organ Donation Coordinators Research Articles

206.4: Compassion fatigue, moral distress, and burnout among organ donation coordinators in Canada: Results from a national mixed-methods study.

206.4: Compassion fatigue, moral distress, and burnout among organ donation coordinators in Canada: Results from a national mixed-methods study.

EXPERIENCES OF ORGAN AND TISSUE DONATION COORDINATORS DURING COVID-19: A QUALITATIVE STUDY

This study was intended to examine the experiences of Organ and Tissue Donation Coordinators (OTDCs) in Turkey involved in the cadaveric donor process during the COVID-19 pandemic. This was a descriptive qualitative study conducted with 12 OTDCs working in nine different regions in Turkey. Consolidated criteria for reporting qualitative research (COREQ) guidelines were used to ensure transparency. Six themes emerged regarding the experiences of OTDCs: 1) intensity in intensive care units, 2) negative effects of the COVID-19 pandemic on OTDCs, 3) changes in the donor diagnostic process, 4) communication difficulties with family, 5) the reduction in potential donors, and 6) a decrease in organ donation activities of OTDCs. The findings emphasized that there were prolongations and changes in the coordination process due to increased patient density in intensive care units, which negatively affected the OTDCs. In addition, it was emphasized that the changes in the diagnostic process, communication difficulties with family members, and fewer potential donors led to a decrease in the number of cadaveric donors. This study highlights important issues experienced by OTDCs in Turkey during the COVID-19 pandemic. The findings also explain the decrease in organ donors during the pandemic. Our study revealed insufficient action plans, guidelines, and communication tools regarding the cadaveric donation process during this time.

Resilience among organ donation coordinators: a Canadian mixed-methods study.

Organ and Tissue Donation Coordinators (OTDCs) are key to the success of deceased organ donation processes. However, reduced resilience can leave them susceptible to the incidence of work-related issues and decrease the quality of the care provided. Therefore, this study aimed to examine the extent of resilience and influencing aspects among OTDCs in Canada. Mixed-method (QUAN-qual) explanatory sequential design. Quantitative data was collected using an online cross-sectional survey approach with demographic data and the validated scales and analyzed using descriptive and inferential statistics. Qualitative data was collected using a descriptive approach with a semi-structured interview guide and analyzed using content analysis. One hundred twenty participants responded to the survey, and 39 participants were interviewed. Most participants from the survey were female (82%), registered nurses (97%) and on average 42 years old. The quantitative data revealed that OTDCs had a high level of perceived compassion satisfaction (ProQOL-CS = 36.3) but a resilience score (CD-RISC = 28.5) lower than other groups of healthcare professionals. OTDCs with over a year of experience in the role were more likely to have higher levels of resilience. The qualitative data identified that participants saw resilience as crucial for their work-related well-being. Although coping strategies were identified as a key factor that enhance resilience, many OTDCs reported difficulty in developing healthy coping strategies, and that the use of unhealthy mechanisms (e.g., alcohol and smoking) can result in negative physical consequences (e.g., weight gain) and reduced resilience levels. Participants reported using a series of coping and protective strategies to help build resilience, but also difficulty in developing healthy mechanisms. The lack of healthy coping strategies were seen as contributing to negative work-related issues (e.g., burnout). Our findings are being used to develop tailored interventions to improve resilience and healthy coping strategies among organ donor coordinators in Canada.

121.6: Understanding compassion fatigue, moral distress, and burnout among organ donation coordinators in Canada: a mixed-methods study.

121.6: Understanding compassion fatigue, moral distress, and burnout among organ donation coordinators in Canada: a mixed-methods study.

Barriers to Deceased Donor Procurements: The Saudi Experience.

Barriers to Deceased Donor Procurements: The Saudi Experience.

Sociodemographic Variables in Canadian Organ Donation Organizations: A Health Information Survey.

We conducted an electronic, self-administered cross-sectional survey of all ODOs in Canada from November 2021 to January 2022. We targeted key knowledge holders familiar with the data collection processes within each Canadian ODO known to Canadian Blood Services. Categorical item responses are presented as numbers and proportions. We achieved a 100% response rate from 10 Canadian ODOs. Most data were collected by organ donation coordinators. Only 2 of 10 ODOs reported using scripts explaining why sociodemographic data are being collected or incorporated training in cultural sensitivity for any given variable. A lack of cultural sensitivity training was endorsed by 50% of respondents as a barrier to the collection of sociodemographic variables by ODOs, whereas 40% of respondents identified a lack of training in sociodemographic variable collection as a significant barrier. Few programs routinely collect sufficient data to examine health inequities with an intersectional lens. Most data collection occurs midway through the ODO interaction, creating a missed opportunity to better understand differences in social identities of patients who register their intention to donate in advance or who decline the donation. National standardization of equity-relevant data collection definitions and processes of the collection is needed.

The role of healthcare professionals to improve organ donation and transplantation outcome: a national study.

Improve the quality of donor coordination activities caused by an increased organ donation rate. The aim of this study was to assess the influence of organ donation coordinators' characteristics on rate of donation and family consent rate in Recognition Centers (RCs) and Organ Procurement Units (OPUs) in Iran by analyzing the organ procurement and transplantation data. Based on a questionnaire, this retrospective study evaluated the number of confirmed brain deaths, family consent rate, organ recoveries, rate of expired brain death cases before and after family consent in Iran. According to results, the overall family consent rate in the entire country is equal to 60.63%. The work experience had a significant effect on the number of procured organs (P < 0.004), death rate after family consent (P < 0.04), and eligible donor death before family consent (P < 0.03). The type of unit (RCs or OPUs) had significant difference on death after family consent (P < 0.023), the death before family consent (P < 0.014), the sum of procured organ (P < 0.04). The consent rate and donor management in the cases of brain death are unacceptable. The coordinators need training to increase their efficiency in terms of family approach and maintenance of brain death. Only by improving the level of family consent and increasing the coordinators' maintenance skills for brain death cases can the amount of organ donation in Iran be doubled to the current amount.

Factors influencing organ donation in Fujian's Organ Procurement Organization: A retrospective study.

The Organ Procurement Organization (OPO) was established in August 2018. The organization's workload, work efficiency, and quality control of organ donation and procurement have continuously improved, making it one of the most successful OPOs in Fujian Province. This study explores the factors that influence the success and failure of organ donation in Fujian Province, China. Data from 236 potential organ donors registered at an OPO in Fujian Province between January 2020 and May 2022 were retrospectively analyzed. Among the 236 potential organ donors, 71 cases of organ donation were successful (30.08% conversion rate). Univariate analysis showed that demographic factors, such as differences in sex, age, marital status, and domicile location, were significantly associated with successful organ donation (p<.05). Among hospital-related factors, differences in hospital departments were significant (p<.05). Considering disease-related factors, spontaneous respiration was significant (p<.05). For factors related to organ donation, differences in coordinators were significant (p<.05). Multivariate analysis showed that age, domicile location, spontaneous respiration, and coordinators influenced organ donation success (p<.05). Multifactor analysis revealed that factors, such as age ≤50years, domicile location in other provinces, no spontaneous respiration, and highly skilled coordinators, could promote successful organ donation. Programs should clarify the screening criteria for key potential organ donors, enhance the promotion and popularization of organ donation, and boost the number and professional skills of organ donation coordinators to improve the organ donation conversion rate.

341.4: Uncovering Work-Related Problems Among Organ Donation Coordinators: The BRiC Research Program

Introduction: Organ Donation Coordinators (OTDCs) play a fundamental role in deceased organ donation processes. However, due to the emotionally challenging and stressful scenarios faced daily, they are commonly affected by work-related issues (e.g., burnout and compassion fatigue), which can lead to increased turnover, reduced quality of healthcare services and negative impact in Organ Donation Organizations performance. Therefore, Canadian Blood Services has partnered with CHEO Research Institute and the organ and tissue donation community to create a research program to study Burnout and Resilience in OTDCs (The BRiC Research Program). The main objectives of the BRiC Research Program are to investigate the incidence and potential causes of work-related issues among OTDCs and to propose innovative ways of dealing with these issues to support teams and decrease turnover of experienced and exceptional OTDCs. Method: The BRiC Research Program was built using a participatory approach that provides the best evidence possible to help address the specific needs of knowledge users (Organ Donation Organizations and OTDCs). The BRiC started with the development of a core three-phased study: phase 1, we published a scoping review to investigate the available literature on burnout and compassion fatigue among OTDCs; in phase 2, we are using a mixed-methods approach to explore work-related issues among Canadian OTDCs; and in phase 3, informed by phases 1 and 2, we will develop, implement and measurethe impact of interventions designed to address work-related issues among OTDCs. In addition to the core three-phased study, we also completedfour related projects: (1) a working meeting with representatives from Canadian Organ Donation Organizations; (2) a reflective narrative paper co-authored by Canadian OTDCs discussing their views and experiences with work-related issues; (3) a qualitative study that investigated experiences of OTDCs about compassion fatigue, burnout and resilience; and (4) a qualitative study that explored the perceptions of OTDCs related to their experiences in a Relationship Centred Care workshop. Results: An overview of the BRiC Research Program can be found in Figure 1. The outputs of this research program since its launching in 2019 include: a scoping review protocol and a final manuscript publication; three publications regarding the additional projects (reflective narrative, and results from both qualitative studies); 2 poster presentations, 4 invited speaker presentations; and 9 grant applications, 2 granted. Conclusion: The findings from this research program will inform clinical practice through knowledge dissemination activities. As this study has been designed in collaboration with national knowledge disseminators (Canadian Blood Services) and provincial end users (Organ Donation Organizations) it will yield meaningful results that can be readily integrated into strategies to decrease OTDC turnover. We would like to thank Canadian Blood Services and the Children’s Hospital of Eastern Ontario for their support funding this work. We thank all Canadian Organ Donation Organizations and the Organ and Tissue Donation Coordinators for their support and participation in this work.

413.10: A Model for Increasing Organ and Tissue Donation: The Social Service in Medicine

Introduction: In Mexico organ donation rate is one of the lowest in latinamerican countries. Before COVID-19, deceased organ donor rate was 3.8 p.m.p. (2019) and for 2020, decreased to 1.2 p.m.p. This represent a major problem since waiting lists still growing; by march 2022 a total of 22,797 persons awaiting for any kind of transplant. Disparity between people waiting for a transaplant and real donors makes urgent to have programs that increase donation. In Mexico there is not an adecuate organization to procure organs (like UNOS), enough resources and personal dedicated to it, therefore most of the times, every hospital organize its own procurement team. Because of this, few hospital can have a dedicated and payed transplant coordinator available all time. In Sonora state, to have personal that can aid in this labor, trained medical students in their last year, whom are dedicated to social service according to our law. Mexico’s medical social service program, consists in last year students of med school attend a health center for medical consultation. The last 10 years there has been a variation in this program and students attend urban, research centers and universities, so they develop health programs to the community. We proposed students from medical social service to get involved in organ donations programs, within a hospital, so can develop skills and knowledge about the field as well as detecting potential donors that become real donors 24/7. Methods: We create an educational program along with four universities that include lectures about organ donation in several fields: conferences about legal framework, detecting a potential donors in hospitals, characterization of donors for tissue as well as solid organs, how to talk to the family about organ donation and all the process of it. At same time they spend time in the organ donation coordination office and divide hours during day and nights so detect potential donors. Results: From 2007 to 2016 we had an overall donation rate of 13.2 donors per year. From 2017, our program of medical social service started and in half of the time we duplicate donation rate to 30.4 donors per year, being 2021 with highest donors (total of 65). Conclusion: Pandemic reduced dramatically organ donation worldwide, and while some countries are doing better, still much work to do. Having young doctors doing medical social service in organ donation coordinations demonstrate can be a good, safe and low cost programs that allow increase organ donation rates significatively. In our hospital we end 2021 with a deceased organ donor rate of 17.2 donors p.m.p., much higher than national media of 1.2. We believe this kind of programs, making feasible to every region of latinamerican countries that have medical social service can help to increase organ donation and transplantation.

341.5: The Experiences of Organ and Tissue Donation Coordinators Participating in a Team Cohesion and Communication Workshop: An Exploratory Descriptive Qualitative Study

341.5: The Experiences of Organ and Tissue Donation Coordinators Participating in a Team Cohesion and Communication Workshop: An Exploratory Descriptive Qualitative Study

Understanding organ donation processes and structures in ontario: A social network analysis approach

BackgroundTransplant rates in Ontario rose steeply in the decade prior to the COVID-19 pandemic. Reasons for that increase remain unclear, but the inter-organizational arrangement of organ donation programs may have contributed. However, there is a paucity of literature investigating these inter-organizational arrangements, with a limited understanding of how communication facilitates organ donation. Understanding these arrangements may help to re-establish rising organ donation rates post-pandemic. ObjectiveTo describe interprofessional interactions of Organ and Tissue Donation Coordinators (OTDCs) during organ donation cases, within organ donation programs in Ontario, from an organizational perspective (describing structure, context, process). MethodsMixed-method social network analysis (SNA) approach analyzing 14 organ donation cases just before the COVID-19 pandemic. ResultsStructure: Social network graphs depict the joint work performed by hospital staff and OTDCs, with a great part of the communication being processed through the OTDC. Context: Network density ranged from 0.05 to 0.24 across cases, and health care professionals perceived an atmosphere of shared vision and trust among team members. Process: Most networks had a degree centralization <0.50 suggesting a decentralized information flow, and participants perceived decisions being jointly made. The characteristic path length of cases ranged from 1.6 to 3.2, suggesting potential for rapid information diffusion. Overall, data reinforced the OTDC role of intermediator within the communication process, and hospital staff perceived OTDCs as central players. Hospital staff and OTDCs reported frustration with some aspects of the flow of information during the organ allocation processes. ConclusionFindings from this study provide a network map of communications within organ donation cases and reinforce the importance of the OTDC role. Opportunities for quality improvement within these processes are identified.

Exploring the Relationship Between Professional Identity and Psychological Resilience of Organ Donation Coordinators in Zhejiang Province (China).

Background: An organ donation coordinator plays an important role in the process of organ donation and transplant. Therefore, investigating and analyzing the current situation in organ donation and examining the correlation between professional identity and psychological resilience of human organ donation coordinator, provides a reference for promoting stable development of organ donation.Methods: A total of 48 coordinators of organ donation in Zhejiang Province were recruited for the study by using the method of convenience sampling. The psychological resilience scale and professional identity questionnaire were used to collect data.Results: The results revealed that the total average score of the professional identity of organ donation coordinators was 34.92 ± 8.57. Compared with the median professional identity score of 34.50, the professional identity of the coordinator in this survey was at a moderate level. The total average score of psychological resilience was 64.44 ± 11.91. There was a significant positive correlation between the professional identity of the coordinator and the total score of psychological resilience (r = 0.641, P < 0.01).Conclusion: The professional identity and psychological resilience of the coordinators in Zhejiang Province were found to be in the middle level and the higher the psychological resilience score, the stronger the professional identity of the coordinators. It is important to improve the level of psychological resilience among organ donation coordinators to enhance their professional identity.

Soliciting organ donations by medical personnel and organ donation coordinators: A factor analysis.

The literature on organ donation in Taiwan lacks a discussion of the roles of medical staff, organ donors, and transplant coordinators in organ donation. The biggest plight of organ donation is lack of the organ donations. When we probed the possibilities of not finish the organ donation procedure, such as religions, traditions and cultural belief, disease cognitions, and the failure of persuasion or the loss of organ donors. There are lots of research literature shown that the attitude of medical personnel would influence the willingness of organ donation or persuasion. This study considered such personnel and their participation in organ donation, specifically analyzing factors influencing their effectiveness. Snowball sampling was adopted to recruit medical staff, organ donors, and transplant coordinators for an online survey. The results revealed that some participants were unclear as to how to initiate the organ donation process and what practical operations are involved. Even with the necessary qualifications, some participants remained passive when soliciting organ donations in clinical practice. Organ donation coordinators with experience in caring for organ donors who attended organ donation courses performed well in soliciting organ donations. The researchers recommend that training courses on clinical planning and organ donation are incorporated into intensive care training and that they serve as the basis for counsellors soliciting organ donations to increase nurses’ willingness to solicit organ donations.

Family veto in organ donation: the experiences of Organ and Tissue Donation Coordinators in Ontario.

PurposeIn Ontario, an individual’s registered wish for organ donation is legally valid consent following death. Family veto occurs when the deceased donor’s substitute decision-maker (SDM) overrides this consent to donate, evoking a legal and ethical conflict. The objective of this study was to examine the experiences of Organ and Tissue Donation Coordinators (OTDCs) working with SDMs who vetoed a deceased donor’s consent for organ donation.MethodsQualitative focus groups were conducted with ten OTDCs in Ontario, Canada who reported experience with family veto. An interpretative phenomenological approach informed data analysis. Themes emerged through team consensus and were further refined through collaborative and reflexive engagement.ResultsFour themes emerged regarding family veto: 1) the significance of the OTDC role, 2) emotional distress and the “understandable” family veto, 3) barriers contributing to family veto, and 4) strategies towards a culture of organ donation. Findings highlighted the importance of patient advocacy in the OTDC role, while revealing the emotional distress of experiencing family veto. OTDCs identified timing and healthcare providers’ perceived ambivalence toward organ donation as critical barriers to family authorization. Value-positive language, role reframing, and increased education were offered as strategies to address these barriers and reduce family veto.ConclusionThis study highlights important considerations about organ donation authorization processes in Ontario. Findings support practice changes towards reducing family veto and further research nationally. Collaborations with key stakeholders are warranted to align healthcare practices, donation policies, and education initiatives towards a shared goal of increasing organ donation.

Burnout and compassion fatigue among organ and tissue donation coordinators: a scoping review

ObjectivesTo collate and synthesise available literature on burnout and compassion fatigue (CF) among organ and tissue donation coordinators (OTDCs) and to respond to the research question: what is known about...

Burnout and compassion fatigue among organ donation coordinators: a scoping review protocol.

The objective of this review is to develop a comprehensive description of burnout and compassion fatigue, including risk/protective factors, among organ and tissue donation coordinators worldwide. Research on turnover rates among organ and tissue donation coordinators has shown that job tenure generally lasts less than three years, a possible consequence of burnout and compassion fatigue. Increased turnover rates of organ and tissue donation coordinators have significant impact on the ability of ODOs to optimize organ donation. This current scoping review will help inform understanding of the nature of burnout and compassion fatigue in this population as well as the available strategies for managing it. Articles examining health care professionals working as organ and tissue donation coordinators, with the main concepts of interest being burnout and/or compassion fatigue, will be considered. Articles within the context of organ and tissue donation coordinators in acute care settings at any part of the organ donation process will also be considered for inclusion in this review. Quantitative and qualitative studies, text and opinion papers, unpublished material (eg, unpublished research data, reports, institutional protocols, government documents) provided by researchers in the organ donation field worldwide will also be examined for possible inclusion. The scoping review will be performed in accordance with JBI methodology. Published and unpublished papers from 1980 to the present will be searched. Databases will include MEDLINE (Ovid), CINAHL, Embase, LILACS, PsycINFO, and PTSDpubs, while appropriate gray literature will be searched. Two reviewers will screen the papers according to predefined inclusion and exclusion criteria, extract data for specific variables, and perform descriptive examination.

Qualitative Study on the Influencing Factors and Countermeasures Against Job Burnout Among Organ Donation Coordinators.

Background: Most organ donation coordinators suffer varying degrees of anxiety, depression and poor sleep caused by constant work pressure, and their professional identity is only at a medium level. All of this leads to a great risk of job burnout.Objective: To identify the influencing factors of and effective countermeasures against job burnout among organ donation coordinators.Method: Semistructured interviews were used for data collection. In-person or phone interviews were conducted from December 2017 to June 2018.Results: 12 organ donation coordinators who came from 7 different provinces and cities in China were interviewed. The interview data were sorted, and relevant topics were extracted and summarized in terms of two aspects, namely, factors that influenced job burnout in organ donation coordinators and effective countermeasures for dealing with job burnout.Conclusion: Factors influencing job burnout among organ donation coordinators include personal factors, job responsibilities, salary and benefit factors, and donor family factors. Measures to help organ donation coordinators effectively address burnout include self-regulation, social support, and positive events.

Evidence-Based Review and Discussion Points.

Evidence-Based Review and Discussion Points.

Organ Donation at the End of Life: Experiences From the 3 Wishes Project.

The 3 Wishes Project (3WP) promotes holistic end-of-life care in the intensive care unit (ICU) to honor dying patients, support families, and encourage clinician compassion. Organ donation is a wish that is sometimes made by, or on behalf of, critically ill patients. Our objective was to describe the interface between the 3WP and organ donation as experienced by families, clinicians, and organ donation coordinators. In a multicenter evaluation of the 3WP in 4 Canadian ICUs, we conducted a thematic analysis of transcripts from interviews and focus groups with clinicians, organ donation coordinators, and families of dying or died patients for whom donation was considered. We analyzed transcripts from 26 interviews and 2 focus groups with 18 family members, 17 clinicians, and 6 organ donation coordinators. The central theme describes the mutual goals of the 3WP and organ donation-emphasizing personhood and agency across the temporal continuum of care. During family decision-making, conversations encouraged by the 3WP can facilitate preliminary discussions about donation. During preparation for donation, memory-making activities supported by the 3WP redirect focus toward personhood. During postmortem family care, the 3WP supports families, including when donation is unsuccessful, and highlights aspirational pursuits of donation while encouraging reflections on other fulfilled wishes. Organ donation and the 3WP provide complementary opportunities to engage in value-based conversations during the dying process. The shared values of these programs may help to incorporate organ donation and death into a person's life narrative and incorporate new life into a person's death narrative.