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Table 3 Results of the 11 quality indicators for which consensus was reached by the overall panel after the third Delphi round

From: Development of key interventions and quality indicators for the management of an adult potential donor after brain death: a RAND modified Delphi approach

 

Attribute

Median

Tertile 7–9 (%)

Tertile 7–9 (n)

Structure indicators

1. Existence of donation process procedures.

Relevance

9

89%

16

Formula: existence of procedures for all relevant steps of the donation process?

Feasibility

9

83%

15

2. Existence of a proactive donor detection protocol.

Relevance

9

89%

16

Formula: existence of a donor detection protocol?

Feasibility

8

72%

13

3. Documentation of key interventions of the donation process.

Relevance

8

89%

16

Formula: existence of a documentation form with all relevant key interventions of the donation process?

Feasibility

8

83%

15

4. Seminars on organ donation.

Relevance

8

83%

15

Formula: number of organ donation seminars organized last year?

Feasibility

8

78%

14

Process indicators

5. Detection of all potential donors after brain death in the ICU.

Relevance

9

94%

17

Formula: number of potential donors after brain death in the ICU who are referred to the donor coordinator / number of potential donors after brain death in the ICU.

Feasibility

8

83%

15

6. Evaluation of donors after brain death.

Relevance

9

89%

16

Formula: number of patients declared brain death in the ICU who have been evaluated as donors in consult with a transplant center / number of patients declared brain death in the ICU.

Feasibility

8

78%

14

7. Donor management goals.

Relevance

8

83%

15

Formula: number of actual donors after brain death in the ICU meeting 5 of the 7 donor management goals prior to organ recovery (mean arterial pressure: 60–110 mmHg, number of vasopressors ≤ 1, arterial blood gas pH: 7.3–7.5, serum sodium: 135–155 mEq/L, blood glucose: ≤ 180 mg/dL, urine output: ≥ 0.5 mL/kg/h over 4 h, core body temperature: 35–37 °C) / number of actual donors after brain death in the ICU.

Feasibility

8

72%

13

8. Documentation of cause of no donation.

Relevance

9

94%

17

Formula: number of failed potential donors in which the cause of no donation is properly documented / number of failed potential donors.

Feasibility

8

83%

15

9. Documentation of evaluation of potential donors.

Relevance

8

83%

15

Formula: number of donors correctly evaluated / number of donors evaluated.

Feasibility

8

67%

12

Outcome indicators

10. Family objection to organ donation.

Relevance

9

89%

16

Formula: number of objections (number of potential donor after brain death cases with family objection to organ donation) / number of families interviewed* (number of potential donor after brain death cases in which family members are informed about the possibility of organ donation). *exclusion of donor cases where the patient’s wishes are known (formal or informal).

Feasibility

8

78%

14

11. Conversion rate in donors after brain death.

Relevance

9

78%

14

Formula: number of actual donors after brain death / number of eligible donors after brain death.

Feasibility

9

78%

14