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JAMA Network Open Aug 2023The ideal hospitalist workload and optimal way to measure it are not well understood.
IMPORTANCE
The ideal hospitalist workload and optimal way to measure it are not well understood.
OBJECTIVE
To obtain expert consensus on the salient measures of hospitalist workload.
DESIGN, SETTING, AND PARTICIPANTS
This qualitative study used a 3-round Delphi technique between April 5 and July 13, 2022, involving national experts within and external to the field. Experts included hospitalist clinicians, leaders, and administrators, as well as researchers with expertise in human factors engineering and cognitive load theory.
MAIN OUTCOMES AND MEASURES
Three rounds of surveys were conducted, during which participants provided input on the salient measures of hospitalist workload across various domains. In the first round, free-text data collected from the surveys were analyzed using a directed qualitative content approach. In the second and third rounds, participants rated each measure's relevance on a Likert scale, and consensus was evaluated using the IQR. Percentage agreement was also calculated.
RESULTS
Seventeen individuals from 14 organizations, encompassing clinicians, leaders, administrators, and researchers, participated in 3 rounds of surveys. In round 1, participants provided 135 unique qualitative comments across 10 domains, with 192 unique measures identified. Of the 192 measures presented in the second round, 6 (3%) were considered highly relevant, and 25 (13%) were considered moderately relevant. In round 3, 161 measures not meeting consensus were evaluated, with 25 (16%) considered highly relevant and 95 (59%) considered moderately relevant. Examples of measures considered highly relevant included a patient complexity score and outcome measures such as savings from hospital days avoided and clinician turnover.
CONCLUSIONS AND RELEVANCE
In this qualitative study measuring hospitalist workload, multiple measures, including those quantifying work demands and the association of those demands with outcomes, were considered relevant for measuring and understanding workloads. The findings suggest that relying on traditional measures, such as productivity-related measures and financial measures, may offer an incomplete understanding of workloads and their association with key outcomes. By embracing a broader range of measures, organizations may be able to better capture the complexity and nuances of hospitalist work demands and their outcomes on clinicians, patients, and organizations.
Topics: Humans; Workload; Hospitalists; Outcome Assessment, Health Care; Consensus; Delphi Technique
PubMed: 37561462
DOI: 10.1001/jamanetworkopen.2023.28165 -
Bulletin of the World Health... Dec 2023
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 38046368
DOI: 10.2471/BLT.23.011223 -
Bulletin of the World Health... Oct 2023
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 37780645
DOI: 10.2471/BLT.23.011023 -
Bulletin of the World Health... Jul 2023
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 37397172
DOI: 10.2471/BLT.23.010723 -
Bulletin of the World Health... Nov 2023
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 37961056
DOI: 10.2471/BLT.23.011123 -
Bulletin of the World Health... Feb 2024
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 38313149
DOI: 10.2471/BLT.24.010224 -
Bulletin of the World Health... Jan 2024
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 38164326
DOI: 10.2471/BLT.24.010124 -
Bulletin of the World Health... Apr 2024
Topics: Humans; Public Health; Delphi Technique; Global Health
PubMed: 38562196
DOI: 10.2471/BLT.24.010424 -
CoDAS 2023To address the need for a standardized assessment tool for assessing cognitive-communication abilities among Indian preschoolers, the current study aimed at describing a... (Review)
Review
PURPOSE
To address the need for a standardized assessment tool for assessing cognitive-communication abilities among Indian preschoolers, the current study aimed at describing a Delphi based development and validation process for developing one such tool. The objectives of the research were to conceptualize and construct the tool, validate its content, and assess its feasibility through pilot testing.
METHODS
The study followed a Delphi approach to develop and validate the tool across four phases i.e. conceptualization; construction; content validation; and pilot testing. The first three phases were performed with a panel of six experts including speech-language pathologists and preschool teachers while the pilot testing was done with 20 typically developing preschoolers. A literature review was also conducted with the Delphi rounds to support the developmental process.
RESULTS
The first two rounds of the Delphi aided in the construction of a culturally and linguistically suitable story-based cognitive-communication assessment tool with the memory (free recall, recognition, and literary recall) and executive function (reasoning, inhibition, and switching) related tasks relevant for preschoolers. The content validation of the tool was continued with the experts till the revisions were satisfactory and yielded an optimum Content Validity Index. The pilot test of the finalized version confirmed its feasibility and appropriateness to assess developmental changes in the cognitive-communication abilities of preschoolers.
CONCLUSION
The study describes the Delphi-based conceptualization, construction, content validation, and feasibility check of a tool to assess cognitive-communication skills in preschool children.
Topics: Humans; Child, Preschool; Delphi Technique; School Teachers; Communication Disorders; Communication; Cognition
PubMed: 37909524
DOI: 10.1590/2317-1782/20232022309 -
Revista de Gastroenterologia de Mexico... 2024Crohn's disease (CD) is a subtype of chronic and incurable inflammatory bowel disease. It can affect the entire gastrointestinal tract and its etiology is unknown.
INTRODUCTION
Crohn's disease (CD) is a subtype of chronic and incurable inflammatory bowel disease. It can affect the entire gastrointestinal tract and its etiology is unknown.
OBJECTIVE
The aim of this consensus was to establish the most relevant aspects related to definitions, diagnosis, follow-up, medical treatment, and surgical treatment of Crohn's disease in Mexico.
MATERIAL AND METHODS
Mexican specialists in the areas of gastroenterology and inflammatory bowel disease were summoned. The consensus was divided into five modules, with 69 statements. Applying the Delphi panel method, the pre-meeting questions were sent to the participants, to be edited and weighted. At the face-to-face meeting, all the selected articles were shown, underlining their level of clinical evidence; all the statements were discussed, and a final vote was carried out, determining the percentage of agreement for each statement.
RESULTS
The first Mexican consensus on Crohn's disease was produced, in which recommendations for definitions, classifications, diagnostic aspects, follow-up, medical treatment, and surgical treatment were established.
CONCLUSIONS
Updated recommendations are provided that focus on definitions, classifications, diagnostic criteria, follow-up, and guidelines for conventional medical treatment, biologic therapy, and small molecule treatment, as well as surgical management.
Topics: Crohn Disease; Humans; Mexico; Delphi Technique; Consensus
PubMed: 38762431
DOI: 10.1016/j.rgmxen.2024.03.001