Physician Peer Minority Organ Donation Education Model

描述(由申请人提供)： 少数族裔中潜在身体捐赠者的同意率比白人低40%-50%。对密歇根州移植学会(密歇根州器官采购组织)服务区同意程序的持续方案评估表明，占少数身体器官捐赠者转介的93%的10个机构偏离了利用训练有素和指定的捐赠专家来管理捐赠请求过程的高收益方法。我们假设，医生行为的改变使一位对文化敏感且受过适当培训的捐赠专家能够在捐赠请求中担任主要/主要角色，将在少数族裔器官捐赠者转介中产生更高的捐赠率。我们建议：(A)建立一个由8名专科医生领导组成的4小时捐赠管理专业焦点小组；以及(B)设计一个2小时医生同行教育计划，由指定的医生领导向在少数族裔器官捐赠者转介设施最集中的机构执业的选定专科医生的目标受众讲授。这一医生同行少数民族器官捐赠教育模式(PMODEM)的目标是：(1)利用8名医生领袖作为选定专科医生的导师/榜样，这些医生经常遇到脑死亡，从而成为潜在的身体器官捐赠者(急诊医学、神经外科和创伤)；(2)在10个指定的少数民族转介机构中向80名执业医生提供2小时的“最佳捐赠管理实践”继续医学教育计划；(3)收集和管理OPO所有设施中关于捐赠管理过程的预期数据；以及(4)对PMODEM对以下方面的影响进行统计分析：(A)使用训练有素的指定请求者；(B)少数族裔的近亲同意率；以及(C)密歇根州东南部的少数族裔捐赠率。样本量计算表明，如果80名医生接受2小时的教育课程，则90%的能力可以检测到少数族裔捐赠者同意率增加20%。利用训练有素、具有获得近亲同意的专门知识的指定请求者，最有可能立即增加少数族裔捐赠者的身体器官捐赠，其中约50%的捐赠者目前拒绝表示同意。

DESCRIPTION (provided by applicant): 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.