Consequences of More Coordinator Engagement to Take Consent for Organ Donation: Comparisons of New Versus Experienced Staff

The method of obtaining family consent for organ donation after occurrence of brain death in Iran is an opt-in process. Because of complicated cultural, legal, religious, and familial structures in Iran, it is not simple to take consent for organ donation in brain death situations. The process needs the professional staff to be experienced and have an appropriate personality to obtain consent. We previous used a limited number of experienced coordinators to take consent. We revised our decision 2 years ago because of lack of trained personnel. From the beginning of 2017, we have started training courses regarding approaching families for donations for all interested coordinators. After participants finished the theoretical and practical training, we allowed them to interview themselves to practice a first evaluation for a suitable potential donor. We have continued this strategy and have gathered feedback from participating coordinators. At the beginning of 2017, 9 coordinators who were previously qualified for handling other steps of organ donation were put into a compact training program to train for family interviews. In 2016, the experienced interviewers had a 88% success rate compared with a success rate of 83% in 2017 for inexperienced interviewers (P = .1). No significant differences were shown. Despite younger ages of donors obtained in 2017, median donated organs per donor decreased from 2.81 to 2.66. The average time interval between first contact with families and establishment of family consent was not significantly different between experienced and inexperienced coordinators (9.2 vs 8.7 h). Although with the new strategy we experiensed a decrease in the consent rate, we believe this strategy will have long-term beneficial effects for our organization and the decreased rate will be a temporary decline. Interviews showed that this strategy made our coordinators more motivated and responsible for their job. As a result, both volume and quality of organ procurement activities will be increased.