The consent rate in potential cadaveric donors among racial minorities is 40-50% lower than in Whites. Ongoing programmatic evaluation of the consent process in the service area of the Transplantation Society of Michigan (the Organ Procurement Organization [OPO] for the State of Michigan) indicates that ten facilities accounting for 93% of minority cadaveric organ donor referrals deviate from the high yield approach of utilizing trained and designated donation specialists in the management of the donation request process. We hypothesize that physician behavioral change enabling a culturally sensitive and appropriately trained donation specialist to assume the primary/principal role in the donation request would yield a higher donation rate in minority organ donor referrals. We propose to: (a) develop a 4-hour professional focus group on donation management with eight specialty physician leaders; and (b) design a 2-hour Physician Peer Educational Program to be delivered by the designated physician leaders to a target audience of physicians in selected specialties who practice in the facilities with the highest concentration of minority organ donor referrals.
The aims of this Physician Peer Minority Organ Donation Education Model (PMODEM) are: (1) to utilize the eight physician leaders as instructors/role models for physicians in selected specialties who regularly encounter brain death and thus, potential cadaveric organ donors (Emergency Medicine, Neurosurgery and Trauma); (2) to deliver a 2-hour """"""""best donation management practice"""""""" CME program to 80 practicing physicians in the ten specified minority referral facilities; (3) to collect and manage prospective data on the donation management process in all facilities in the OPO; and (4) to conduct statistical analysis of the impact of the PMODEM on: (a) the use of trained designated requestor; (b) the next-of-kin consent rate among minorities; and (c) the minority donation rate in southeastern Michigan. Sample size calculations indicate a 90% power to detect a 20% increase in minority donor consent rate if 80 physicians undergo the 2-hour educational session. The use of trained designated requestor with expertise in obtaining consent from the next-of-kin has the greatest immediate potential to increase cadaveric organ donation in the racial minorities donors among whom approximately 50% currently refuse to give consent.
