Transplant Procurement Management - Europa

2 December 2008Transplant Procurement Management

Transplant

Procurement

Management

Xavier Guasch

Institute for LifeLong Learning - Universitat de Barcelona

Sant-Hilari - December 2nd, 2008


Health System GoalsHealth System Goals

•• Promote HealthPromote Health

–– PreventionPrevention

–– TreatmentTreatment

–– ResearchResearch

–– EducationEducation

••To obtainTo obtain--OrgansOrgans

--Tissues & CellsTissues & Cells


Hospital MissionHospital Mission

Live Patient Health

DeadCadaver

OrgansTissues

Transplant


Transplant Procurement ManagementTransplant Procurement Management

TPM

Cadaver Donor Recipient


The New Vital CycleThe New Vital Cycle

SOCIETYSOCIETY

DONATIONDONATION

RECOVERYRECOVERY

TRANSPLANTATIONTRANSPLANTATION

FollowFollow--upup Social AttitudeSocial Attitude

ProcurementProcurementSharingSharing


SourcesSourcesLiving Donors

Neurologic Criteria Cardiorespiratory Criteria

NHBD

Organs and Tissues Tissues

Kidney

Liver

Tissues

Xenotransplantation Clonation Stem Cells

Cadaveric Donors


Donation and Sharing NetworkDonation and Sharing Network

Detector

Detector +

ExtractorONT

HOSPITAL

Detector+

Extractor+

Transplant

REGION

NATIONAL

HOSPITAL

REGIONAL


HospitalHospital

Tx Team

Hospital

OPO

PastPast

Organization ModelsOrganization Models

USAUSA SPAINSPAIN

Tx TeamTPM

Tx Team


TPM staff (TPM staff (pmppmp))

7 7 -- 12126 6 -- 1313Total staffTotal staff

2 2 -- 663 3 -- 77TPMTPM

USAUSASpainSpain


Academic backgroundAcademic background

12,1%

87,9%

0%

20%

40%

60%

80%

100%

Nurses

Doctors

9,1%1,5%

6,1%13,6%

69,7%

Anesthesiology

Surgery

Critical Care

Nephrology

Other


in organ, tissues and cells procurement for transplantation

TRANSPLANT PROCUREMENT MANAGER

Qualified professional withQualified professional with

Scientific & Technical Scientific & Technical proficiencyproficiency


+

EXPERTISE

COMPETENCES KNOWLEDGE


Strategic vision

Team work

Results analysis

Problem solving

COMPETENCES

Abilities

Attitudes

Creativity

Autonomy

Responsibility

Empathy

Flexibility

Tenacity

Diplomacy

Motivation

Values

Social skills

Personal growing

Maturity

Transplant Procurement Management


ClinicalClinical

KNOWLEDGE

•• Donor DetectionDonor Detection

•• Donor EvaluationDonor Evaluation

•• BrainBrain--Death DiagnosisDeath Diagnosis

•• Donor MaintenanceDonor Maintenance

•• Family ApproachFamily Approach

•• Organ ViabilityOrgan Viability

•• Organ ExtractionOrgan Extraction

•• Organ SharingOrgan Sharing

•• Tissue ExtractionTissue Extraction

•• Tissue DistributionTissue Distribution


•• Continuous educationContinuous education

•• Health ProfessionalsHealth Professionals

•• School, UniversitySchool, University

•• General PopulationGeneral Population

KNOWLEDGE

EducationEducation


ResearchResearch

KNOWLEDGE


KNOWLEDGE

QualityQuality

•• Quality and Security of Organs and TissuesQuality and Security of Organs and Tissues

•• Quality and Transparency of the Donation Quality and Transparency of the Donation

ProcessProcess

•• Continuous ImprovementContinuous Improvement

•• CertificationCertification


KNOWLEDGE

ManagementManagement

•• Complex processComplex process

•• Interactions with many actorsInteractions with many actors

–– Donor, FamilyDonor, Family

–– MedicalMedical

–– SocietySociety

•• Legal and Ethical frameworkLegal and Ethical framework

•• CostsCosts

•• ResultsResults


E-learning modules

Face-to-face courses

Blended learning1

991

2008

TPM Educational modalities

Programs:

• Seminars in Essential

• Intermediate programs

• Advanced courses

• Master degrees

Other activities:

• European projects

• IRODaT

• International consultancy


1991 1991 -- 20082008


METHODOLOGY

Interactive method

Learning by experience

Transplant Coordination Manual

Lectures, Debates and Case studies

DODO

ACTIONACTION

SHOW HOWSHOW HOW

SIMULATIONSIMULATION

KNOW HOWKNOW HOW

COMPETENCECOMPETENCE

KNOWKNOW

KNOWLEDGEKNOWLEDGE

Practices, Role playing, Simulations, Action learning

TPM Follow Up


TPM Courses: 1991-2008 / 5650 participants/ 91 countries

1 / 2 Argentina

3 Portugal 1 Bosnia

4 Lebanon 1 India

2 Malaysia

3 Mexico

1 Chile

3 Brazil3 / 1 Colombia

1 Panama

2 Cuba

11 / 6 / 23 Italy

55 Introductory 14 Intermediate 62 Advanced

ASIA 307 / 70 / 78AMERICA 857 / 33 / 314 EUROPE 1307 / 324 / 2332AFRICA 4 / 20 OCEANIA 4 / 36 /

1 Turkey

1 / 1 Hungary

6 France

1 Croatia1 / 1 Greece

1 Australia

3 / 2 / 1 Poland

1 Peru

1 Switzerland

1 Japan

1 Russia

1 Jordan

9 / 1 / 30 Spain


Austria: 21 / 8 / 4

International Education 1991-2008

Albania: 1

Andorra: 1

Bielorussia: 1

Belgium: 16

Bosnia: 33 Bulgaria: 4 / 6 / 3

Croacia: 28 / 9 / 36

Cyprus: 2 / 6 / 2

Czech Rep. : 6 / 9 / 2

Denmark: 1 / 3

Estonia: 3 / 10 / 4

Finland: 1

France: 259 / 1

FYROM: 2

Germany: 15 / 3 / 7

Greece: 22 / 58 / 41

Hungary: 16 / 14 / 33

Ireland: 2

Italy: 1010 / 74 / 315

Latvia: 1 / 5 / 2

Lithuania: 2 / 9 / 4

Malta: 2 / 5

Moldavia: 2 / 1

Norway: 8

Poland: 51 / 70 / 149

Portugal: 33 / 1 / 67

Romania: 12 / 7 / 7

Russia: 3 / 34

Slovak Rep: 12 / 11 / 4

Slovenia: 24 / 8 / 5

Spain: 660 / 537

Sweden: 42 / 1 / 5

Suiza: 31 / 1

Holand: 21

Ucraina: 2

United Kingdom: 10 / 2

Total Europe3963 participants

62 Advanced Courses: English, Spanish, Italian, French, Polish62 Advanced Courses: English, Spanish, Italian, French, Polish

13 Intermediate Courses + Forums: English, Italian, Polish13 Intermediate Courses + Forums: English, Italian, Polish

55 Introductory Courses: English, Italian, Spanish, Polish, 55 Introductory Courses: English, Italian, Spanish, Polish,

Greek, Portuguese, Hungarian, Catalan, Russian, ArabianGreek, Portuguese, Hungarian, Catalan, Russian, Arabian


Organs

Tissues

Cells

Professionals

Trained


SpainSpain

FranceFrance ItalyItaly


1550

291

1601

252181217

1192

107 85 9443 25 60

200

91

1313

257

492

13348

793

729 24

81

352

198

38

1150

910536

223

64

33

34,3

28

26,6

25,3

23,9

21,9

21,1

20,9

20,2

20,2

19,9

18,7

18,6

18,1

17,8

17,2

16 15,7

14,8

14,5

14,1

13,2

13,2

12,9

12

10,8

9,2

9 9

6,2

1,2

0,8

1,7

3

5,8

7,3

0

200

400

600

800

1000

1200

1400

1600

1800

2000

Spain

Belgiu

mUSA

Franc

e

Portu

gal

Austri

a

Czech

Rep

.Ita

ly

Slovak R

ep.

Irelan

d

Norway

Latv

ia

Eston

ia

Urugu

ayCub

a

Finlan

d

Ger

man

y

Nethe

rland

s

Canad

a

Sweden

Lithu

ania UK

Denm

ark

Cypru

s

Slovenia

Switzer

land

Polan

d

Austra

lia

New Z

eland

Croat

iaBra

zil

Gre

ece

Turke

y

Roman

ia

Bulga

ria

Japa

n

0

5

10

15

20

25

30

35

40

Cadaveric Donors 2007 pmp Cadaveric Donors 2007

Source: Source: IRODatIRODat


1st year

- TA evaluation

- Educational programs design

PROJECT DEVELOPMENT

2nd year

- Training programs implementation

3rd year

- Training programs impact evaluation

- Analysis results

The project aim is to validate a professional Training Program on OrganDonation at different professional levels to contribute to:

• Increase organ donation knowledge

• Maximize the growth of organ donation rates

• Disseminate reliable information to the community

ETPOD ETPOD projectproject

•• 20 partners20 partners

•• 17 countries17 countries

•• 20072007--20092009

•• DG SANCO DG SANCO FundedFunded

Objective:Objective:

Impact of Impact of

3 different 3 different

training programs training programs

on organ donationon organ donation

ETPOD ETPOD projectproject

•• 20 partners20 partners

•• 17 countries17 countries

•• 3 years3 years

•• DG SANCO DG SANCO FundedFunded

Objective:Objective:

Impact of Impact of

3 different 3 different

training programs training programs

on organ donationon organ donation

Austria – UHVBulgaria – EAT

Cyprus – PSTC

Estonia – TUC

France – ABM

Germany – DSO

Greece – EOM

Italy – FITOTItaly – ISS

Lithuania – NBT

Poland – Poltransplant

Poland – MUW

Portugal – ASST

Romania – UTM

Slovak Rep. – UHMSlovenia – Slovenija-Transplant

Spain – IL3

Spain – IMAS

Sweden – MUH

Turkey – AUTC

January 2007

December 2009

Country

Target AreaTarget Area

Area

Target AreasTarget Areas

Working GroupsWorking Groups

•• Structure and DonationStructure and Donation

•• Training needsTraining needsWG1

WG2

WG3

WG4

•• Three programsThree programs

Virtual PlatformVirtual Platform

http://etpod.il3.ub.edu

Analysis

TA information

Courses implementation

Courses design

Training needs

TA definition

2nd semester1st semester2nd semester1st semester2nd semester1st semester

200920082007

TimingTiming

Analysis

TA information


Courses design

Training needs

TA definition


200920082007

TimingTiming

Analysis

TA information


Courses design

Training needs

TA definition


200920082007

TimingTiming

Analysis

TA information


Courses design

Training needs

TA definition


200920082007

TimingTiming

Analysis

TA information


Courses design

Training needs

TA definition


200920082007

TimingTiming

Analysis

TA information


Courses design

Training needs

TA definition


200920082007

TimingTiming

Analysis

TA information


Courses design

Training needs

TA definition


200920082007

TimingTiming

Analysis

TA information


Courses design

Training needs

TA definition


200920082007

Research studyResearch study

Essentials in Organ DonationEssentials in Organ Donation

•• 3.000 health professionals (120 per TA)3.000 health professionals (120 per TA)•• 8 h seminar8 h seminar•• ICU, Emergency dept, ICU, Emergency dept, OuthospitalOuthospital emergency systemsemergency systems•• Local languageLocal language•• 44ººT 2008T 2008

WG2

•• 50 senior coordinators (2 per TA)50 senior coordinators (2 per TA)•• EE--learning learning –– Feb/Mar 2008Feb/Mar 2008

–– Pedagogical methodologyPedagogical methodology–– EOD ContentsEOD Contents

•• Face to Face Face to Face –– Lisbon Lisbon –– May 2008May 2008

Training for TrainersTraining for Trainers

Organ Donation Quality ManagersOrgan Donation Quality Managers

•• 25 health professionals (1 per TA)25 health professionals (1 per TA)–– Responsible for Donation / TransplantationResponsible for Donation / Transplantation

•• July 2008July 2008–– StructureStructure

–– QualityQuality

–– LeadershipLeadership

WG4

Professional TrainingProfessional Trainingin Organ Donationin Organ Donation

•• 50 junior transplant coordinators (2 per TA)50 junior transplant coordinators (2 per TA)

••Blended learningBlended learning

WG3

On Line TrainingOn Line Training

http://tpm.elearning.ubvirtual.comhttp://tpm.elearning.ubvirtual.com

WG3

Face to FaceFace to Face

•• PresentationsPresentations–– NHBDNHBD

–– EthicsEthics

–– LegislationLegislation

WG3

Donor Detection and EvaluationDonor Detection and Evaluation

Brain DeathBrain Death

Donor ManagementDonor Management

Family ApproachFamily Approach

Organ Procurement Organ Procurement

TeamworkTeamwork

Social NetworkSocial Network

I hear and I forget

I see and I remember

I do and I understand

Confucius500 BC


www.tpm.org

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Transplant Procurement Management - Europa