PhD defence R.G. (Ruben) van Merweland

Summary:

This thesis aimed to research which factors create a barrier to an optimal (timely) referral from the perspective of the main stakeholders involved and which possible solutions exist at the organizational level. This research question was investigated in the context of the FIAT- study, a qualitative study, where FIAT stands for ‘Factors Influencing Access to Kidney Transplantation’. This issue has previously been explored from a not all-inclusive stakeholders’ perspective. Consequently, there was a need for a study that combined stakeholder perspectives across the entire kidney transplant journey and that gave stakeholders the opportunity to comment on each other’s standpoints.

The aim of this thesis was, therefore, to map the complex environment surrounding kidney transplantation, including 1) viewpoints on the cause of the problem, 2) presentation and discussion of the viewpoints of other stakeholders, and 3) the solution preferences of the relevant stakeholders. The outcomes of these three phases were then used to formulate policy changes and strategies that could lead to better access to kidney transplantation. These strategies are formulated using both bottom-up and top-down approaches in order to offer solutions to the problem from different perspectives.