Resource barriers to the facilitation of organ and tissue donation reported by Australian emergency clinicians

Objective. To explore emergency department clinicians' perceived resource barriers to facilitating organ and tissue donation (OTD). Methods. A cross-sectional national online survey of Australian emergency department (ED) clinicians. Results. ED clinicians reported a range of resource barriers that hinder the facilitation of OTD, most notably a lack of time to discuss OTD with a patient's family (74.6%). Those reporting more resource barriers had been less involved in OTD-related tasks. For example, those reporting a lack of time to assess a patient's suitability to be a potential donor had less experience with OTD-related tasks in the last calendar year than did those who reported that they often or always have enough time for this (P<0.01). In addition, ED clinicians working in DonateLife network hospitals were more involved in OTD-related tasks (P<0.01) and reported fewer resource shortages in the ED and the hospital overall. Conclusions. Resource shortages hinder the facilitation of OTD in the ED and are related to decreased involvement in OTD-related tasks. In addition, ED clinicians working in DonateLife hospitals are more involved in OTD-related tasks and report fewer resource shortages overall. Addressing resource shortages and extending the DonateLife network could benefit OTD rates initiated from the ED. What is known about the topic? Increasing the rate of organ and tissue donation (OTD) has become progressively more urgent as waiting lists for organs and tissues are growing globally. Recently a missed potential donor pool was recognised in emergency departments (EDs) and the Organ and Tissue Authority implemented a 'clinical trigger' tool to aid with the identification of potential donors in EDs. However, many Australian studies have reported worsening ED overcrowding and resource shortages in recent years with an adverse effect on patient care and satisfaction as well as on ED clinicians' work-related stress and satisfaction. International literature has identified that certain resource barriers hinder the facilitation of organ and tissue in EDs. However, there is currently no literature available on how resource barriers in Australian EDs affect the facilitation of OTD. What does this paper add? Our study shows that Australian ED clinicians perceive a range of resource barriers that hinder the facilitation of OTD, most notably a lack of time to discuss OTD with a patient's family or to identify potential donors. We also found that those reporting more resource barriers had been less involved in OTD-related tasks in the last calendar year. In addition, those that work in hospitals that are part of the DonateLife network, and thus have dedicated staff available for OTD-related tasks, were more involved in OTD-related tasks and reported fewer resource shortages in the ED and the hospital overall. What are the implications for practitioners? To maximize the number of potential donors recognised and referred from the ED, it may be important to decrease the resource barriers identified in this study. Notably, the presence of specialist OTD staff, a function of being part of a DonateLife network hospital, may result in a decreased perception of resource barriers in the ED and more engagement with OTD-related tasks by ED clinicians.

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