State transplant coordinators’ views on influencing factors of the performance of organ donation and transplantation services in Brazil: a qualitative study

Abstract

Despite their prominent role in organ donation and transplantation (ODT) results, studies aimed at state transplant coordinators’ managerial views are lacking. This qualitative study explores their perspective on facilitators and barriers to the performance of ODT services. Semi-structured interviews were conducted with coordinators of state transplant centers from 15 out of 27 Brazilian states. Content analysis was applied to identify key themes and organize the perceived factors affecting performance. The factors identified relate to services’ internal management, organizational characteristics of state transplant centers and hospitals performing ODT activities, the socioeconomic, political, and regulatory context surrounding services, and the interface with the general population. A major factor identified is the use of indicators as a critical management tool to locate inefficiencies, guide decision-making, and ground the dialogue with stakeholders. Other factors mentioned are the relationship with hospitals, the state's political stability, the coordinators' interpersonal traits, and relational skills. This article offers practitioners and researchers an overview of the multiple factors influencing the performance of ODT services, intending to enrich the practice and management literature in this relevant health field and stir future research. Based on identified aspects, a list of managerial recommendations is proposed.