Learning Organization Practices of Organ Procurement Organizations: A Key to Increasing Organ Donation

Date of Degree


Document Type


Degree Name

Doctor of Philosophy (PhD)




Dorothy Ettling


Robert Connelly


Sara Kolb


John Velasquez


As the number of patients awaiting transplantation increases exponentially, the 59 U.S. organ procurement organizations (OPOs) search for innovative approaches to increase organ donation. Researchers have conducted case studies of some effective OPOs’ organizational practices; however, analysis of the organizational practices of all 59 OPOs was needed. This study examined the relationships between learning organization (LO) practices and OPO effectiveness. LO practices were measured using OPO mid-level managers’ responses to the Dimensions of the Learning Organization Questionnaire (Watkins & Marsick, 1997). OPO effectiveness was measured using the Organ Acquisition Rate (OAR), a metric that estimated each OPO’s organizational growth rate using data provided by United Network for Organ Sharing (UNOS). Correlational and multiple regression analyses were conducted to determine if significant relationships between LO practices and OPO OAR exist, and to identify which LO practice(s) predict OPO OAR. Phenomenological investigations were conducted with one Small and one Large effective OPO to obtain details of the LO practices that influence OPO OAR. Forty (68%) OPOs participated in the study, with 113 OPO managers responding as informants. All 11 UNOS regions participated. The findings indicate that a significant positive relationship exists between Small OPO (population < 4,680,000) LO practices and Small OPO OAR (p < .05). A significant relationship between Large OPO (population > 4,680,000) LO practices and Large OPO OAR was not found. No LO practices were found to predict Small or Large OPO OAR. Although specific strategies differ between Small and Large OPOs, the phenomenological investigations strongly support the premise that effective OPOs intentionally engage in LO practices. Practices such as providing learning opportunities, conducting referral reviews and performance gap assessments, benchmarking, and soliciting critical stakeholders’ feedback were described to foster the formation of inventive strategies to improve OPO organizational effectiveness. The results of this study imply that one solution to increasing organ donation may be for OPO leaders to employ LO practices, which utilize members’ shared knowledge to create innovative strategies to increase their OAR.

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