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The American Journal of Managed Care Jan 2022Computable social risk factor phenotypes derived from routinely collected structured electronic health record (EHR) or health information exchange (HIE) data may...
OBJECTIVES
Computable social risk factor phenotypes derived from routinely collected structured electronic health record (EHR) or health information exchange (HIE) data may represent a feasible and robust approach to measuring social factors. This study convened an expert panel to identify and assess the quality of individual EHR and HIE structured data elements that could be used as components in future computable social risk factor phenotypes.
STUDY DESIGN
Technical expert panel.
METHODS
A 2-round Delphi technique included 17 experts with an in-depth knowledge of available EHR and/or HIE data. The first-round identification sessions followed a nominal group approach to generate candidate data elements that may relate to socioeconomics, cultural context, social relationships, and community context. In the second-round survey, panelists rated each data element according to overall data quality and likelihood of systematic differences in quality across populations (ie, bias).
RESULTS
Panelists identified a total of 89 structured data elements. About half of the data elements (n = 45) were related to socioeconomic characteristics. The panelists identified a diverse set of data elements. Elements used in reimbursement-related processes were generally rated as higher quality. Panelists noted that several data elements may be subject to implicit bias or reflect biased systems of care, which may limit their utility in measuring social factors.
CONCLUSIONS
Routinely collected structured data within EHR and HIE systems may reflect patient social risk factors. Identifying and assessing available data elements serves as a foundational step toward developing future computable social factor phenotypes.
Topics: Delphi Technique; Electronic Health Records; Health Information Exchange; Humans; Risk Factors
PubMed: 35049262
DOI: 10.37765/ajmc.2022.88816 -
Nursing Open Aug 2023This study developed a set of competency evaluation indicators for shift work nurses in China. (Review)
Review
AIM
This study developed a set of competency evaluation indicators for shift work nurses in China.
BACKGROUND
Nurses on night shifts must deal with the treatment, nursing, and management work, which requires excellent competency of night shift nurses in their knowledge, skills, and ability. However, the competency evaluation index system for shift work nurses has not been established yet in China.
METHODS
This study performed a literature review and semi-structured interviews to draft the preliminary competency evaluation indicators for nursing shift work. The Delphi technique was adopted to administer two rounds of questionnaires on 21 nursing experts.
RESULTS
The positive coefficients of experts in the two rounds were 100% and 90.48%, respectively, whereas the authority coefficients were 0.974 and 0.971, respectively. The coefficients of variation were 0.00-0.26 and 0.00-0.16, respectively. The competency evaluation index system for shift work nurses consisted of 2 first-level indicators, 16 second-level indicators, and 67 third-level indicators.
CONCLUSION
The competency index system of shift work nurses is scientific and applicable.
IMPLICATIONS FOR NURSING MANAGEMENT
The competency evaluation index system of shift work nurses would provide an effective practical framework for shift nursing administration to evaluate, train, and assess the competency of shift work nurses.
Topics: Humans; Delphi Technique; China; Nurses
PubMed: 37194137
DOI: 10.1002/nop2.1809 -
Health & Social Care in the Community May 2022Defining alternative health care and the recording of associated adverse events and harm remains problematic. This Canadian study aimed to establish and classify...
Defining alternative health care and the recording of associated adverse events and harm remains problematic. This Canadian study aimed to establish and classify risk-associated alternative health practices in a Delphi study undertaken with an interdisciplinary panel of 17 health experts in 2020. It provides a new functional definition of alternative health care and an initial taxonomy of risk-associated alternative health care practices. A number of risk-associated practices were identified and categorized into general practices that conflict with biomedical care or largely untested therapies, alternative beliefs systems, physical manipulative alternative therapies, and herbal and nutritional supplements. Some risk significant harms including major physical injuries or even death. The lack of systematic methods for recording adverse events in alternative health care makes establishing the frequency of such events challenging. However, it is important that people engaging with alternative health care understand they are not necessarily risk-free endeavours, and what those risks are.
Topics: Canada; Complementary Therapies; Delphi Technique; Humans
PubMed: 34041822
DOI: 10.1111/hsc.13386 -
BMJ Open May 2021Nationally and internationally it is well recognised that dementia is poorly recognised and suboptimally managed in the primary care setting. There are multiple and...
Clinical practice guidelines and principles of care for people with dementia: a protocol for undertaking a Delphi technique to identify the recommendations relevant to primary care nurses in the delivery of person-centred dementia care.
INTRODUCTION
Nationally and internationally it is well recognised that dementia is poorly recognised and suboptimally managed in the primary care setting. There are multiple and complex reasons for this gap in care, including a lack of knowledge, high care demands and inadequate time for the general practitioner alone to manage dementia with its multiple physical, psychological and social dimensions. The primary care nurse potentially has a role in assisting the general practitioner in the provision of evidence-based dementia care. Although dementia-care guidelines for general practitioners exist, evidence on resources to support the primary care nurse in dementia care provision is scarce. The 'Australian Clinical Practice Guidelines and Principles of Care for People with Dementia' provides 109 recommendations for the diagnosis and management of dementia. This protocol describes a Delphi study to identify which of the 109 recommendations contained in these multidisciplinary guidelines are relevant to the primary care nurse in the delivery of person-centred dementia care in the general practice setting.
METHODS AND ANALYSIS
Using a Delphi consensus online survey, an expert panel will grade each of the recommendations written in the 'Clinical Practice Guidelines and Principles of Care for People with Dementia' as high-to-low relevance with respect to the role of the primary care nurse in general practice. To optimise reliability of results, quality indicators will be used in the data collection and reporting of the study. Invited panel members will include Australian primary care nurses working in general practice, primary care nursing researchers and representatives of the Australian Primary Health Care Nurses Association, the peak professional body for nurses working in primary healthcare.
ETHICS AND DISSEMINATION
This study has been approved by The University of Newcastle Human Research Ethics Committee (HREC) (H-2019-0029).Findings will be published in a peer-reviewed journal and presented at scientific conferences.
Topics: Australia; Delphi Technique; Dementia; Humans; Primary Care Nursing; Primary Health Care; Reproducibility of Results
PubMed: 33986053
DOI: 10.1136/bmjopen-2020-044843 -
The British Journal of Surgery Jan 2023Competency frameworks outline the perceived knowledge, skills, attitudes, and other attributes required for professional practice. These frameworks have gained in...
BACKGROUND
Competency frameworks outline the perceived knowledge, skills, attitudes, and other attributes required for professional practice. These frameworks have gained in popularity, in part for their ability to inform health professions education, assessment, professional mobility, and other activities. Previous research has highlighted inadequate reporting related to their development which may then jeopardize their defensibility and utility.
METHODS
This study aimed to develop a set of minimum reporting criteria for developers and authors of competency frameworks in an effort to improve transparency, clarity, interpretability and appraisal of the developmental process, and its outputs. Following guidance from the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network, an expert panel was assembled, and a knowledge synthesis, a Delphi study, and workshops were conducted using individuals with experience developing competency frameworks, to identify and achieve consensus on the essential items for a competency framework development reporting guideline.
RESULTS
An initial checklist was developed by the 35-member expert panel and the research team. Following the steps listed above, a final reporting guideline including 20 essential items across five sections (title and abstract; framework development; development process; testing; and funding/conflicts of interest) was developed.
CONCLUSION
The COmpeteNcy FramEwoRk Development in Health Professions (CONFERD-HP) reporting guideline permits a greater understanding of relevant terminology, core concepts, and key items to report for competency framework development in the health professions.
Topics: Humans; Health Occupations; Checklist; Consensus; Delphi Technique
PubMed: 36413510
DOI: 10.1093/bjs/znac394 -
Swiss Medical Weekly Dec 2023Effective funding models are key for implementing and sustaining critical care delivery programmes such as specialised paediatric palliative care (SPPC). In Switzerland,...
BACKGROUND
Effective funding models are key for implementing and sustaining critical care delivery programmes such as specialised paediatric palliative care (SPPC). In Switzerland, funding concerns have frequently been raised as primary barriers to providing SPPC in dedicated settings. However, systematic evidence on existing models of funding as well as primary challenges faced by stakeholders remains scarce.
AIMS
The present study's first aim was to investigate and conceptualise the funding of hospital-based consultative SPPC programmes in Switzerland. Its second aim was to identify obstacles to and priorities for funding these programmes sustainably.
METHODS
A 4-step process, including a document analysis, was used to conceptualise the funding of hospital-based consultative SPPC programmes in Switzerland. In consultation with a purposefully selected panel of experts in the subject, a 3-round modified Delphi study was conducted to identify funding-relevant obstacles and priorities regarding SPPC.
RESULTS
Current funding of hospital-based consultative specialised paediatric palliative care programmes is complex and fragmented, combining funding from public, private and charitable sources. Overall, 21 experts participated in the first round of the modified Delphi study, 19 in round two and 15 in round three. They identified 23 obstacles and 29 priorities. Consensus (>70%) was obtained for 12 obstacles and 22 priorities. The highest level of consensus (>90%) was achieved for three priorities: the development of financing solutions to ensure long-term funding of SPPC programmes; the provision of funding and support for integrated palliative care; and sufficient reimbursement of inpatient service costs in the context of high-deficit palliative care patients.
CONCLUSION
Decision- and policy-makers hoping to further develop and expand SPPC in Switzerland should be aware that current funding models are highly complex and that SPPC funding is impeded by many obstacles. Considering the steadily rising prevalence of children with life-limiting conditions and the proven benefits of SPPC, improvements in funding models are urgently needed to ensure that the needs of this highly vulnerable population are adequately met.
Topics: Humans; Child; Palliative Care; Switzerland; Concept Formation; Delphi Technique; Consensus
PubMed: 38579319
DOI: 10.57187/s.3498 -
American Journal of Pharmaceutical... Nov 2020To identify and build consensus on priority leadership and professionalism attributes for pharmacy student development among faculty, preceptors, and students. One...
To identify and build consensus on priority leadership and professionalism attributes for pharmacy student development among faculty, preceptors, and students. One hundred individuals (27 faculty members, 30 preceptors, 43 students) were invited to participate in a three-round, modified Delphi. Published literature on leadership and professionalism informed the initial attribute list. In the first round, participants reviewed and provided feedback on this list. In the second round, participants prioritized attributes as highly important, important, or less important for pharmacy student development. Leadership and professionalism attributes that achieved an overall consensus (a priori set to ≥80.0%) of being highly important or important for pharmacy student development were retained. In the third round, participants rank ordered priorities for leadership and professionalism attributes. Fifteen leadership and 20 professionalism attributes were included in round one while 21 leadership and 21 professionalism attributes were included in round two. Eleven leadership and 13 professionalism attributes advanced to round three. Consensus was reached on the top four leadership attributes (adaptability, collaboration, communication, integrity) and five professionalism attributes (accountability, communication, honor and integrity, respect for others, trust). Differences were observed for certain attributes between faculty members, preceptors, and/or students. The modified Delphi technique effectively identified and prioritized leadership and professionalism attributes for pharmacy student development. This process facilitated consensus building and identified gaps among stakeholders (ie, faculty, preceptors, students). Identified gaps may represent varying priorities among stakeholders and/or different opportunities for emphasis and development across classroom, experiential, and/or cocurricular settings.
Topics: Delphi Technique; Education, Pharmacy; Faculty; Humans; Leadership; Professionalism; Students, Pharmacy
PubMed: 34283754
DOI: 10.5688/ajpe8076 -
Clinical Anatomy (New York, N.Y.) Oct 2019The term fascia is increasingly used not only by anatomists but also by other professionals and authors in different health-oriented fields. This goes along with an...
The term fascia is increasingly used not only by anatomists but also by other professionals and authors in different health-oriented fields. This goes along with an inconsistent usage of the term, in which many different tissues are included by different authors causing an increasing amount of confusion. The Fascia Research Society acted to address this issue by establishing a Fascia Nomenclature Committee (FNC) with the purpose of clarifying the terminology relating to fascia. This committee conducted an elaborate Delphi process to foster a structured consensus debate among different experts in the field. This process led to two distinct terminology recommendations from the FNC, defining the terms "a fascia" and "the fascial system." This article reports on the process behind this proposed terminology as well as the implications for inclusion and exclusion of different tissue types to these definitions. Clin. Anat. 32:929-933, 2019. © 2019 The Authors. Clinical Anatomy published by Wiley Periodicals, Inc. on behalf of American Association of Clinical Anatomists.
Topics: Connective Tissue; Consensus Development Conferences as Topic; Delphi Technique; Fascia; Humans; Terminology as Topic
PubMed: 31183880
DOI: 10.1002/ca.23423 -
The Journal of Nursing Education Jun 2023Factors identified as important to nursing student clinical learning include the environment, the clinical facilitator, and student human factors. (Review)
Review
BACKGROUND
Factors identified as important to nursing student clinical learning include the environment, the clinical facilitator, and student human factors.
METHOD
A modified Delphi study generated clinical nurse educators' expert consensus of the importance of factors that influence student learning during clinical placements. Short-answer questions exploring facilitation of learning were also provided.
RESULTS
Thirty-four nurse educators participated in the first round, and 17 nurse educators participated in the second round. Final consensus of at least 80% agreement was reached for all factors. Enablers of student learning included a positive workplace culture, student attitude, and clear communication between facilitator and student. Barriers to student learning included lack of time for teaching, short placement duration, and poor student and facilitator attitude.
CONCLUSION
Further investigation is needed on how these factors are addressed during placements including a review of the quality of resources provided to students and clinical facilitators for student learning. .
Topics: Humans; Students, Nursing; Delphi Technique; Education, Nursing, Baccalaureate; Learning; Attitude of Health Personnel
PubMed: 37279976
DOI: 10.3928/01484834-20230404-01 -
BMC Public Health Nov 2020Ensuring the current public health workforce has appropriate competencies to fulfill essential public health functions is challenging in many low- and middle-income... (Review)
Review
BACKGROUND
Ensuring the current public health workforce has appropriate competencies to fulfill essential public health functions is challenging in many low- and middle-income countries. The absence of an agreed set of core competencies to provide a basis for developing and assessing knowledge, skills, abilities, and attitudes contributes to this challenge. This study aims to identify the requisite core competencies for practicing health professionals in mid-level supervisory and program management roles to effectively perform their public health responsibilities in the resource-poor setting of Uttar Pradesh (UP), India.
METHODS
We used a multi-step, interactive Delphi technique to develop an agreed set of public health competencies. A narrative review of core competency frameworks and key informant interviews with human resources for health experts in India were conducted to prepare an initial list of 40 competency statements in eight domains. We then organized a day-long workshop with 22 Indian public health experts and government officials, who added to and modified the initial list. A revised list of 54 competency statements was rated on a 5-point Likert scale. Aggregate statement scores were shared with the participants, who discussed the findings. Finally, the revised list was returned to participants for an additional round of ratings. The Wilcoxon matched-pairs signed-rank test was used to identify stability between steps, and consensus was defined using the percent agreement criterion.
RESULTS
Stability between the first and second Delphi scoring steps was reached in 46 of the 54 statements. By the end of the second Delphi scoring step, consensus was reached on 48 competency statements across eight domains: public health sciences, assessment and analysis, policy and program management, financial management and budgeting, partnerships and collaboration, social and cultural determinants, communication, and leadership.
CONCLUSIONS
This study produced a consensus set of core competencies and domains in public health that can be used to assess competencies of public health professionals and revise or develop new training programs to address desired competencies. Findings can also be used to support workforce development by informing competency-based job descriptions for recruitment and performance management in the Indian context, and potentially can be adapted for use in resource-poor settings globally.
Topics: Consensus; Delphi Technique; Health Personnel; Humans; India; Professional Competence; Public Health
PubMed: 33203407
DOI: 10.1186/s12889-020-09711-4