The Specialized Donor Care Facility Model Improves Operating Room Efficiency

BACKGROUND Organ procurement organizations (OPO) coordinate organ donation through two distinct models of care: the conventional model, in which donors are managed at hospitals where brain death occurs, and the specialized donor care facility (SDCF) model, where brain dead donors are transferred to a freestanding facility. The aim of this study is to compare operating room (OR) efficiency for procurements between the SDCF and conventional models of care. METHODS We performed a prospective analysis of OR efficiency between thoracic donor procurement operations performed at a SDCF and other OPOs using the conventional model of care. Key domains of efficiency were chosen based on a literature review and expert panel consensus. Data were collected in real time over a 12-month period via direct observation and personnel interviews. RESULTS Between January 1 and December 31, 2018, data were obtained from 54 procurement operations (n=17, SDCF and n=37, conventional). Donors in the two groups were similar in baseline characteristics. Procurements at the SDCF were performed with fewer non-surgeon team members (2 vs. 4, p<.001) without any difference in the organ yield. SDCF procurements more closely adhered to planned start times (6 vs. 61 minute difference, p<.001), and a trend was observed for SDCF-based procurements to facilitate daytime transplant operations. CONCLUSIONS The SDCF model of donor care outperforms the conventional model in several important measures of OR efficiency. These differences are likely to result in cost savings and improved healthcare provider satisfaction in the highly effort- and resource-intensive landscape of organ transplantation.