Facilitating Change in NORS: Context, Training Needs & Staff Perceptions of NRP

UK organ retrieval is in the midst of large-scale technical transformation, driven by persistent organ shortage and attempts to improve organ quality for transplant recipients. To inform future innovation efforts in organ retrieval, this study explored the context, structures, and NRP implementation experience of a UK-based abdominal organ retrieval team. Methods: Thorough familiarisation with context and settings of organ retrieval was gained through field visits, informal conversations, observation, and attendance at local and national NORS meetings. A qualitative description methodology was employed, and data were obtained through the means of semi-structured interviews and analysed thematically in a NORS abdominal centre. Results: The sample (n=6) comprised of senior surgeons (NORS lead surgeons; n=3), a junior surgeon (n=1), and theatre practitioners (n=2). Descriptive data revealed a unique combination of procedural, psychological, and practical demands placed on organ retrieval staff. Results demonstrated that uncertainty (e.g., call-outs, training opportunities, team composition, location, local team support, delays) was one of the key context factors and challenges for staff, and highlighted the critical role of psychological factors for successful innovation in organ retrieval. In addition, the study identified team’s training needs and challenges, alongside practice and research-led potential solutions to improve training for new and existing staff. Discussion: The data demonstrate that alongside efforts to advance technological aspects of organ preservation, maximise efficiency of the service and refine surgical techniques, development in organ retrieval requires close attention to psychological context for successful implementation of new practice. Although the small sample size limits the ability to generalise the findings, it enabled the views and experiences of participants to be studied more in-depth, resulting in a rich dataset with high information power, established through prolonged engagement and rigorous analysis.