Performance indicators for organ donation and transplantation programmes in Europe : modified Delphi consensus study
(2026) In British Journal of Surgery 113(1).- Abstract
Background: Health system performance assessment helps identify areas for improvement and guides policy initiatives. Although well-validated indicators exist for measuring organ donation and transplantation performance at the facility level, consensus on indicators for assessing national programmes is lacking. The aim of this study was to develop a comprehensive scorecard for evaluating national organ donation and transplantation programmes. Methods: A three-step approach was used. First, a targeted literature review identified potential indicators from regulatory documents, national transplant organization reports, and databases. Second, indicators were mapped to an established transplant system framework and refined through... (More)
Background: Health system performance assessment helps identify areas for improvement and guides policy initiatives. Although well-validated indicators exist for measuring organ donation and transplantation performance at the facility level, consensus on indicators for assessing national programmes is lacking. The aim of this study was to develop a comprehensive scorecard for evaluating national organ donation and transplantation programmes. Methods: A three-step approach was used. First, a targeted literature review identified potential indicators from regulatory documents, national transplant organization reports, and databases. Second, indicators were mapped to an established transplant system framework and refined through preliminary expert consultations. Third, a modified Delphi consensus process validated the indicators. The Delphi panel comprised international experts in health policy, organ donation, transplantation, and patient representation. Participants rated 168 indicators using a five-point Likert scale across two rounds (24 experts completed round 1 and 22 experts completed round 2). Consensus for inclusion required 80% agreement. Results: Of 168 indicators evaluated, 103 achieved consensus for inclusion. After consolidation of organ-specific indicators, the final set contained 84 indicators across seven domains: monitoring and reporting (8 indicators), prevention and need (9 indicators), waiting lists (11 indicators), consent (4 indicators), donation (28 indicators), transplantation (14 indicators), and follow-up (10 indicators). The indicator set incorporates established metrics such as waiting list statistics, donation rates, and complication rates alongside novel system-level indicators addressing structural factors, patient-centredness, and equity in care delivery. Conclusion: This validated indicator set provides a standardized tool for assessing and comparing transplant system performance across European countries, supporting performance benchmarking and evidence-informed policy development.
(Less)
- author
- organization
- publishing date
- 2026
- type
- Contribution to journal
- publication status
- published
- subject
- in
- British Journal of Surgery
- volume
- 113
- issue
- 1
- article number
- znaf293
- publisher
- Oxford University Press
- external identifiers
-
- scopus:105028227126
- pmid:41569582
- ISSN
- 0007-1323
- DOI
- 10.1093/bjs/znaf293
- language
- English
- LU publication?
- yes
- id
- d01ec488-455c-4622-a969-f33814656ec2
- date added to LUP
- 2026-02-25 12:06:26
- date last changed
- 2026-02-26 03:00:05
@article{d01ec488-455c-4622-a969-f33814656ec2,
abstract = {{<p>Background: Health system performance assessment helps identify areas for improvement and guides policy initiatives. Although well-validated indicators exist for measuring organ donation and transplantation performance at the facility level, consensus on indicators for assessing national programmes is lacking. The aim of this study was to develop a comprehensive scorecard for evaluating national organ donation and transplantation programmes. Methods: A three-step approach was used. First, a targeted literature review identified potential indicators from regulatory documents, national transplant organization reports, and databases. Second, indicators were mapped to an established transplant system framework and refined through preliminary expert consultations. Third, a modified Delphi consensus process validated the indicators. The Delphi panel comprised international experts in health policy, organ donation, transplantation, and patient representation. Participants rated 168 indicators using a five-point Likert scale across two rounds (24 experts completed round 1 and 22 experts completed round 2). Consensus for inclusion required 80% agreement. Results: Of 168 indicators evaluated, 103 achieved consensus for inclusion. After consolidation of organ-specific indicators, the final set contained 84 indicators across seven domains: monitoring and reporting (8 indicators), prevention and need (9 indicators), waiting lists (11 indicators), consent (4 indicators), donation (28 indicators), transplantation (14 indicators), and follow-up (10 indicators). The indicator set incorporates established metrics such as waiting list statistics, donation rates, and complication rates alongside novel system-level indicators addressing structural factors, patient-centredness, and equity in care delivery. Conclusion: This validated indicator set provides a standardized tool for assessing and comparing transplant system performance across European countries, supporting performance benchmarking and evidence-informed policy development.</p>}},
author = {{Streit, Simon and Wharton, George and Mah, Jasmine and Van Kessel, Robin and Prionas, Apostolos and Johnston-Webber, Charlotte and Boletis, John and Domínguez-Gil, Beatriz and Forsberg, Anna and França, Ana and Gardiner, Dale and Jeurissen, Patrick and Papanicolas, Irene and Pearcey, Oliver and Rasmussen, Allan and Romagnoli, Jacopo and Mossialos, Elias and Papalois, Vassilios}},
issn = {{0007-1323}},
language = {{eng}},
number = {{1}},
publisher = {{Oxford University Press}},
series = {{British Journal of Surgery}},
title = {{Performance indicators for organ donation and transplantation programmes in Europe : modified Delphi consensus study}},
url = {{http://dx.doi.org/10.1093/bjs/znaf293}},
doi = {{10.1093/bjs/znaf293}},
volume = {{113}},
year = {{2026}},
}