Estephan Arredondo BS, Msc, is a biologist specialized in Organ, Tissues and Cell Donation from the University of Barcelona. He is currently director of the Tissues and Cells Unit at DTI Foundation. His studies are based on how to develop networks to procure human tissue for research and isolation of human liver cells. He has been involved in several European projects related to international cooperation in organ donation such as the BSA project, implementation of quality indicators project in KSA, etc. He also in charge of the development of innovative tools at DTI Foundation.
Quorum: IT tool for organ donation quality system management: Pilot program in the Kingdom of Saudi Arabia
Estephan Arredondo1, José Luís Escalante1, Francesco Procaccio1, Joaquim Albiol1, Besher Attar2, Elsayed Gadalla2, Mohammad Alghonaim2, Martí Manyalich1.
1Donation and Transplantation Institute, DTI Foundation, Barcelona, Spain; 2Saudi Center for Organ Transplantation, Riyadh, Saudi Arabia
Background: World Health Organization (WHO) is advocating for the development of self-sufficiency in Donation and Transplantation (D&T) in all countries, as an alternative to combat transplant tourism and commercialism around the world.
Quality management systems are necessary to establish the methodology, responsibilities, resources, activities, etc., targeted at obtaining good and measurable results. Computerized and automatic tools allow better data management and greater efficiency in the process of detection and use of potential donors
Objective: To validate QUORUM IT tool through a pilot study in KSA. To check that the use of this tool promotes better donation and transplantation rates in the hospitals.
Methods: QUORUM IT tool contains the quality indicators from the successful EU-funded ODEQUS project (Organ Donation European Quality System) in order to collect all the information needed to measure and evaluate relevant healthcare aspects in the donation process. QUORUM classified following the critical pathway for deceased donation as: potential, eligible, actual and utilized donor. The evaluation process is organized in three thematic areas. Structure: Donation team members with ICU background & Time dedicated by the key donation person. Process: identification of all possible donors in the ICU & evaluation of brain-dead donors; Outcomes: patient/family consent, unexpected cardiac arrest, brain-death identification & conversion rate in DBD donors.
QUORUM IT tool was created within the framework of a collaboration project between the Ministry of Health of the KSA, DTI Foundation (Spain) and the support from the SCOT. DTI experts visited different KSA hospitals in order to evaluate their quality indicators, discuss with local doctors, and made a constant monitoring process.
Results: Since 2018, QUORUM system has been implemented in 4 KSA hospitals at the Riyadh and Jeddah region. After the first year of the pilot, the possible donation alerts have increased from 100 in 2017 to 298 in 2018. Thus, 255 potential, 106 eligible and 26 actual donors have been registered during the project implementation. An increase in the possible donor detection (198%) and the potential donor referral (207%) has been identified, plus a 54% in eligible donors and a 44% in the donation rate.
Conclusion: QUORUM helps hospitals with the auditing system and self-assessment as well as with the external evaluation. The implementation of the QUORUM IT tool has represented an improvement in the organ donation system in the Kingdom of Saudi Arabia. The use of Quality Indicators allows system weakness detection and comparison between different hospitals. Using QUORUM, the Donation & Transplantation rates have improved in KSA since 2018. This IT tool can be adapted and replicated in other countries applying a similar background and methodology.
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