There are wide differences in the effectiveness of donation programs among the European countries. The national donation rates may range, for example, from 1.5 deceased donors pmp* in Bulgaria to 34.4 deceased donors pmp in Spain. Kidney living donation rates vary from 1.2 pmp in Poland to 25.3 pmp in the Netherlands (data from 2009).
Such data reveal that the possibilities of European citizens getting an organ graft differ notably, depending on where they live. These differences can be partly explained by the type of donation programs implemented, but other issues such as the structure of their donation services, their efficiency and social factors have a big impact.
For this reason, the ODEQUS Project (Organ Donation European Quality System) aims at creating useful evaluation tools meant to increase the efficiency of organ donation in all European countries.
According to an analysis of the best practices in organ donation, such tools have been designed and included in a Quality System. They should help to increase the number of citizens attended by the European donation programs, despite economic, legal or cultural differences.
ODEQUS Project involves 14 associated partners and 5 collaborating partners, including 16 countries, and it is co-financed by the European Agency for Health and Consumers (EAHC 20091108). 2001108), involucra a 14 partners asociados y 5 partners colaboradores, incluyendo 16 países.
The main objective of the ODEQUS Project is to define a methodology to assess the performance of organ procurement at hospital level.
More specifically, other objectives of the project are:
- To identify and develop Quality Criteria (QC) in the 3 different types of organ donation: after brain death (DBD), after cardiac death (DCD) and living donation (LD), focused mainly at hospital level.
- To create Quality Indicators (QI) in order to assess organizational structures, clinical procedures and outcomes
- To develop auditing tools in order to evaluate the implementation of best practices described in the QC and used by the QI.
- To train healthcare professionals on how to use the QI and evaluation tools.
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The Executive Agency for Health and Consumers (EAHC) is entrusted by the European Commission to implement the Health Programme. This is mainly done through financing four types of different actions: projects, conferences, joint actions and operation grants. Those actions intend to have a special European dimension, meaning that a minimum of various partners of different European Countries have to be involved in the project plan.
Austria: Medical University of Vienna
Croatia: Ministry of Health and Social Welfare
France: Agence de la Biomédecine
Germany: Deutsche Stiftung Organtransplantation
Italy: Fondazione per l’Incremento dei Trapianti d’Organo e di Tessuti FITOT Onlus
Portugal: Autoridade para Serviços de Sangue e de Transplantaçao
Romania: Fundatia pentru Transplant
Fundació Bosch i Gimpera
Fundación para la investigación Biomédica del Hospital Gregorio Marañón
Servicio Madrileño de Salud
Sweden: Karolinska Institute
United Kingdom: NHS Blood and Transplant
Greece: Hellenic Transplant Organization EOM
Hungary: Hungarian National Blood Transfusion Service
Malta: Mater dei Hospital
Slovenia: Slovenija transplant
Turkey: Antalya Medicalpark Hastanesi, Organ Nakil Koordinatörü
Universitat de Barcelona
Gloria Paez TPM Educational Director – Project Consultant
María Paula Gómez, DTI Foundation Medical Director – Project Expert
Xavier Guasch, Hospital de La Plana – Project Scientific Director
Luciana Teixeira, TPM International Projects Coordinator – Project Manager
The standards of best practices have been identified according to:
- Expert’s opinion
- Literature review and research for evidence, whenever possible
- Survey sent to 11 European countries to know about the current use of QI at hospital level.
The main fields considered to assess the organizational structures have been: legal framework, accreditation and certification, organization, human and material resources, education and research.
As for the clinical procedures, the main fields considered have been: donor identification, clinical evaluation, death diagnosis, donor maintenance, family/personal consent, organ viability, surgical recovery and preservation, number of donors/organs/transplants.
Two types of training have been designed:
- Development of Quality Criteria and Quality Indicators
- Use of the evaluation tools derived from the Quality Criteria and Quality Indicators. External evaluations will be conducted in selected hospitals.
- Development of QC and QI
- Use of the evaluation tools derived from the QC and QI. External evaluations will be conducted in selected hospitals.