The construction of a system of donation coordinators in Poland since 2010 has initiated work on the creation of a system for monitoring donation potential, as well as the identification of areas for improvement in the utilization of donor potential.
Action Steps
Create a system of donor coordinators(TC)
Building a system for monitoring potential donors
Stratification of hospitals for deceased donor potential
Evaluation of deceased donor potential DBD in ICUs
Factors affecting donation rates according to transplant coordinators
Results: In Poland in more 200 hospitals have implemented a system of employing donor organ procurement TC. Donation rates during the 21 months of coordinators' work were compared with the same period. The effect of the implemented was a 27% increase in the number of potential donors; 20% increase in the number of organs used and multi-organ donations from 54% to 56%; a reduction in the ratio of organs used to current donors from 2.65 to 2.57; and an increase in family refusals from 8.5% to 9.3%. A positive effect was achieved in 102 hospitals 51%. Better results were achieved in regions where donation rates were initially low, which were 59% in university hospitals, 63% in hospitals in big cities, 77% in hospitals with two TC 67%.
To improve these results, the following should be introduced: quality systems, training of medical staff, and techniques for monitoring donation potential
The next step was to implement a system for reporting all deaths in key wards for donations, and to present the basics of the functioning, structure and use of the www.koordynator.net system, its technical structure and to show good practices (know-how) proven in Poland, for other countries that suffer from organ shortage.
To be able to calculate the potential of organ donation in a hospital, region, and country, it was necessary to develop stratification system for all hospitals taking into account their characteristics in having or not having departments crucial for donor identification and recruitment, such as an intensive care unit(ICU or neurology and neurosurgery, and stroke departments), number of beds, and patient profiles(pediatric vs adult). There are 1032 hospitals in Poland, and 388 have facilities and tools to confirm death according to neurological criteria.
Next the analysis was made based on 840 monthly reports from 70 hospitals. Numbers and indicators connected to the organ donation potential, both in the hospital and the ICU scales, have been calculated: numbers of beds and admissions, total number of deaths, deaths due to reasons leading to death to neurologic criteria, number of brain death diagnoses, number of organ donations.
The next step was to create a system of TC at various levels:
hospital TC
organ procurement and TC associated with transplant centers
provincial TC
central TC of Poltransplant

Analyzing the opinions of TC, we can identify key areas:
support of the hospital management
build a hospital quality systems
training medical staff