Spotlight paper in BMJ Open: Amina Silva

The CDTRP would like to congratulate Amina Silva, registered nurse and PhD candidate at Queen’s University, for her recent publication entitled: “Quality improvement tools to manage deceased organ donation processes: a scoping review” in BMJ Open! Amina has also been a CDTRP trainee for many years and works closely with Dr. Vanessa Silva e Silva, assistant professor at Brock University.

Our Communications Manager, Stéphanie Larivière, asked Amina a few questions about the publication that you can read below.

How do you explain that such few references were included in the review despite the thousands of results?

As part of the methodology we decided to use (Scoping review) we used a broad and sensitive search strategy to locate the international literature on quality improvement (QI) tools used in deceased organ donation. Although that resulted in a large number of references, only a few of them were relevant to the topic. Most of the excluded references discussed QI strategies without including tools, or were not specific to the deceased organ donation process. That can be because many QI tools are developed as internal process and are not usually disseminated through scientific publication.

How has the CDTRP supported the project?

CDTRP support was essential to the conduction of this work, they provided support through qualified supervision by Dr. Vanessa Silva e Silva and Dr. Samantha Arora and helped us to find other collaborators for that work (e.g., using the ARDOT meetings). Also, CDTRP is supporting the dissemination of this project by providing opportunities for knowledge translation strategies through public presentations.

How do you think the research will advance the field?

This scoping review shows that there is limited literature published on the use of QI tools to manage the deceased organ donation process; as well as the limited existing literature lacks details on the development and testing of these tools. By mapping existing tools, we aim to facilitate both clinician choices among available tools, as well as research work building on existing knowledge.

What are the next steps and how could the CDTRP support the future directions of this work?

Future efforts should be made towards combining efforts to evaluate the existing tools and provide comprehensive evidence to guide clinical and improve the quality of the deceased organ donation process. Some possible next steps include: creating a national group focused on QI strategies in OD; and further developing and testing QI tools.


To collate and summarise the literature on the quality improvement tools that have been developed for deceased organ donation processes after circulatory determination of death and neurological determination of death.

Scoping review using the Joanna Briggs Institute framework.

Data sources
We searched for published (MEDLINE, Embase, PsycINFO, CINAHL, Web of Science) and unpublished literature (organ donation organisation websites worldwide). The search was initially conducted on 17 July 2021 and updated on 1 June 2022. Included articles discussed the creation and/or use of quality improvement tools to manage deceased organ donation processes. Two independent reviewers screened the references, extracted and analysed the data.

40 references were included in this review, and most records were written in English (n=38), originated in Canada (n=21), published between 2016 and 2022 (n=22), and were specific for donation after neurological determination of death (n=20). The tools identified included checklists, algorithms, flow charts, charts, pathways, decision tree maps and mobile apps. These tools were applied in the following phases of the organ donation process: (1) potential donor identification, (2) donor referral, (3) donor assessment and risk, (4) donor management, (5) withdrawal of life-sustaining measures, (6) death determination, (7) organ retrieval and (8) overall organ donation process.

We conducted a thorough investigation of the available quality improvement tools for deceased organ donation processes. The existing evidence lacks details in the report of methods used for development, testing and impact of these tools, and we could not locate tools specific for some phases of the organ donation process. Lastly, by mapping existing tools, we aim to facilitate both clinician choices among available tools, as well as research work building on existing knowledge.

Read the full paper here.

About Amina Silva

Amina Silva is a registered nurse and is in the last year of her PhD at Queen’s University. Her clinical background is focused on end-of-life care, kidney transplantation and eye donation processes. Her research program is focused on organ donation processes, end-of-life and survivorship care and simulation-based educational strategies. Amina is also a research coordinator for the BRiC program (Studying Burnout and Compassion Fatigue among OTDCs in Canada), a research assistant at Queen’s University, and a simulation facilitator at University of Ottawa.