-
Digital Health 2024The Joint Commission International (JCI) and the Health Information Management System Society (HIMSS) are global accreditation groups for healthcare. JCI focuses on... (Review)
Review
OBJECTIVE
The Joint Commission International (JCI) and the Health Information Management System Society (HIMSS) are global accreditation groups for healthcare. JCI focuses on overall care quality, while HIMSS-Electronic Medical Record Adoption Model (EMRAM) looks at digital processes. Meanwhile, the Health Quality Standards (SKS) is Turkey's own system. It aligns with JCI and evaluates healthcare similarly. When a health institution wants to be accredited with one of these models, similar scope, process and criteria are repeatedly reviewed from different perspectives. However, it is not known whether the scope, process and criteria included in these models are related to the postmodern management approach (PMMA), which is one of today's business approaches. It is observed that today's businesses are dominated by PMMAs. Similarly, healthcare organizations are also influenced by PMMAs since they are qualified as businesses.
YÖNTEMLER
This study investigated the compatibility of the concepts, processes and criteria covered by SKS, JCI and HIMSS-EMRAM models with PMMAs. Using the Delphi technique, PMMAs were explained to subject-matter experts (SMEs) in the form of written texts delivered. SMEs evaluated whether the standards/criteria are compatible with PMMAs. During this evaluation, they examined whether the standard/criteria included in the relevant model are directly or indirectly indicative of these approaches. SMEs developed their standards/criteria for the approaches which no standards/criteria could be matched with. The binary pairwise comparison method was used to determine the weighted value of the proposed standards/criteria.
SONUÇLAR
SMEs proposed a total of 24 standards and 18 indicators for nine postmodern organizational management approaches.
CONCLUSION
The literature presented a proposal for new standards and indicators. They would be unique. They would address how well these three models fit the PMMA.
PubMed: 38846365
DOI: 10.1177/20552076241258455 -
JMIR Research Protocols Jun 2024Globally, there are marked inconsistencies in how immunosuppression is characterized and subdivided into clinical risk groups. This is detrimental to the precision and...
BACKGROUND
Globally, there are marked inconsistencies in how immunosuppression is characterized and subdivided into clinical risk groups. This is detrimental to the precision and comparability of disease surveillance efforts-which has negative implications for the care of those who are immunosuppressed and their health outcomes. This was particularly apparent during the COVID-19 pandemic; despite collective motivation to protect these patients, conflicting clinical definitions created international rifts in how those who were immunosuppressed were monitored and managed during this period. We propose that international clinical consensus be built around the conditions that lead to immunosuppression and their gradations of severity concerning COVID-19. Such information can then be formalized into a digital phenotype to enhance disease surveillance and provide much-needed intelligence on risk-prioritizing these patients.
OBJECTIVE
We aim to demonstrate how electronic Delphi objectives, methodology, and statistical approaches will help address this lack of consensus internationally and deliver a COVID-19 risk-stratified phenotype for "adult immunosuppression."
METHODS
Leveraging existing evidence for heterogeneous COVID-19 outcomes in adults who are immunosuppressed, this work will recruit over 50 world-leading clinical, research, or policy experts in the area of immunology or clinical risk prioritization. After 2 rounds of clinical consensus building and 1 round of concluding debate, these panelists will confirm the medical conditions that should be classed as immunosuppressed and their differential vulnerability to COVID-19. Consensus statements on the time and dose dependencies of these risks will also be presented. This work will be conducted iteratively, with opportunities for panelists to ask clarifying questions between rounds and provide ongoing feedback to improve questionnaire items. Statistical analysis will focus on levels of agreement between responses.
RESULTS
This protocol outlines a robust method for improving consensus on the definition and meaningful subdivision of adult immunosuppression concerning COVID-19. Panelist recruitment took place between April and May of 2024; the target set for over 50 panelists was achieved. The study launched at the end of May and data collection is projected to end in July 2024.
CONCLUSIONS
This protocol, if fully implemented, will deliver a universally acceptable, clinically relevant, and electronic health record-compatible phenotype for adult immunosuppression. As well as having immediate value for COVID-19 resource prioritization, this exercise and its output hold prospective value for clinical decision-making across all diseases that disproportionately affect those who are immunosuppressed.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
PRR1-10.2196/56271.
Topics: Humans; COVID-19; Delphi Technique; Immunosuppression Therapy; Immunocompromised Host; Consensus; Risk Assessment; SARS-CoV-2; Adult; Research Design
PubMed: 38842925
DOI: 10.2196/56271 -
Frontiers in Public Health 2024The hospital supply chain has revealed increasing vulnerabilities and disruptions in the wake of the COVID-19 pandemic, threatening the healthcare services and patient...
BACKGROUND
The hospital supply chain has revealed increasing vulnerabilities and disruptions in the wake of the COVID-19 pandemic, threatening the healthcare services and patient safety. The resilience of hospital supply chains has emerged as a paramount concern within the healthcare system. However, there is a lack of systematic research to develop an instrument tailored to the healthcare industry that is both valid and reliable for measuring hospital supply chain resilience. Therefore, this study aims to construct and validate a comprehensive scale for assessing hospital supply chain resilience, based on dynamic capability theory.
METHODS
This study followed rigorous scale development steps, starting with a literature review and 15 semi-structured interviews to generate initial items. These items were then refined through expert panel feedback and three rounds of Delphi studies. Using data from 387 hospitals in Province S, mainland China, the scale underwent rigorous testing and validation using structural equation modeling. To ensure the most effective model, five alternative models were examined to determine the most suitable parsimonious model.
RESULTS
The study produced a 26-item scale that captures five dimensions of resilience in line with dynamic capability theory: anticipation, adaptation, response, recovery, and learning, all showing satisfactory consistency, reliability and validity.
CONCLUSION
The multi-dimensional scale offers hospital managers a valuable tool to identify areas needing attention and improvement, benchmark resilience against their counterparts, and ultimately strengthen their supply chains against unexpected risks.
Topics: Humans; China; COVID-19; Reproducibility of Results; Hospitals; Delphi Technique; SARS-CoV-2; Surveys and Questionnaires; Resilience, Psychological; Equipment and Supplies, Hospital
PubMed: 38841680
DOI: 10.3389/fpubh.2024.1369391 -
Heliyon Jun 2024Non-traditional security (NTS) threats have a vast and profound impact on many aspects of economic, political, social, and many other areas, especially supply chain...
Non-traditional security (NTS) threats have a vast and profound impact on many aspects of economic, political, social, and many other areas, especially supply chain finance (SCF), particularly in countries like Vietnam, which potentially affects the economic efficiency of businesses' supply chain financial, thereby affecting the general economy of the country and the world. In order to prevent and minimize the negative impacts caused by NTS threats to SCF, this study was conducted to identify NTS threats affecting SCF in Vietnam, at the same time calculate the weight of the impact level and find out the cause and effect relationship between them. Solution strategies are also proposed and ranked, thereby serving as a reference basis for relevant parties to choose appropriate response solutions. Due to the multi-criteria nature of NTS threats, the multiple criteria decision-making (MCDM) method is used in combination with the Z-number concept and Fuzzy set theory to approach the problem of certainty and increase the accuracy of study. The NTS threats are first identified through a literature review and then validated for suitability using the DELPHI technique (DELPHI). Suitable threats will be determined by relationship, weighted by Decision Making Trial And Evaluation Laboratory (DEMATEL) method. Proposed strategies are ranked using the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method. The results indicate that there are 19 NTS factors affecting SCF in Vietnam, and the global economic downturn, pandemic and health crisis, financial crisis and cybersecurity risk are the four root cause factors with the most decisive influence. Businesses and concerns need to prioritize addressing these four threats because they not only have a strong impact but also entail many other threats. The two strategies considered to be the most effective are a sustainable practice and a risk-hedging strategy. Businesses, governments, and stakeholders also should pay attention to the macroeconomic environment, technology, and environment and build sustainable businesses, regularly monitoring economic fluctuations and creating plans to prevent risks.
PubMed: 38841460
DOI: 10.1016/j.heliyon.2024.e31615 -
BMC Psychiatry Jun 2024Polypharmacy is common in older adults with psychiatric disorders, but no consensus has reached about the reliable indicators evaluating the benefits and risks of...
BACKGROUND
Polypharmacy is common in older adults with psychiatric disorders, but no consensus has reached about the reliable indicators evaluating the benefits and risks of drug-drug interactions (DDIs) in polypharmacy. We aimed to identify indicators suitable for evaluating the clinical significance of DDIs in polypharmacy in older adults with psychiatric disorders.
METHODS
The online tools were used to distribute and collect the questionnaires. The Delphi method was applied to analyze experts' opinions. The degree of authority and coordination of experts were analyzed using the coefficient of variation, coefficient of coordination, expert's judgment factor, familiarity with the study content factor, and Kendall coordination coefficient. Statistical analysis was conducted using the IBM SPSS® Statistics Package version 26.0.
RESULTS
After three rounds of expert consultation, five primary and eleven secondary indicators were identified. The primary "pharmacodynamic indicator" included "severity of adverse drug reactions", "duration of adverse drug reaction", "symptom relief", "time to onset of symptomatic relief", "number of days in hospital", and "duration of medication". The secondary "pharmacokinetic indicator" contained "dosage administered" and "dosing intervals". The primary "patient tolerance indicator" contained one secondary indicator of "patient tolerability". The primary indicator "patient adherence" contained one secondary indicator of "patient adherence to medication". The primary indicator "cost of drug combination" contained one secondary indicator of "readmission". These indicators were used to determine the clinical significance of DDIs during polypharmacy.
CONCLUSIONS
The clinical significance of drug combinations should be taken into account when polypharmacy is used in the elderly. The five primary indicators and eleven secondary indicators might be preferred to evaluate their risks and benefits. Medication management in this population requires a multidisciplinary team, in which nurses play a key role. Future research should focus on how to establish efficient multidisciplinary team workflows and use functional factors to assess DDIs in polypharmacy for psychiatric disorders.
Topics: Humans; Polypharmacy; Drug Interactions; Delphi Technique; Mental Disorders; Aged; Male; Female; Drug-Related Side Effects and Adverse Reactions; Middle Aged; Surveys and Questionnaires; Clinical Relevance
PubMed: 38834965
DOI: 10.1186/s12888-024-05872-3 -
Sleep Medicine Jul 2024Sleep problems constitute a common and heterogeneous complaint in pediatric palliative care (PPC), where they often contribute to disease morbidity and cause additional...
OBJECTIVE
Sleep problems constitute a common and heterogeneous complaint in pediatric palliative care (PPC), where they often contribute to disease morbidity and cause additional distress to children and adolescents and their families already facing the burden of life-threatening and life-limiting conditions. Despite the significant impact of sleep problems, clinical evidence is lacking. The application of general pediatric sleep recommendations appears insufficient to address the unique challenges of the PPC dimension in terms of disease variability, duration, comorbidities, complexity of needs, and particular features of sleep problems related to hospice care. Therefore, we initiated an international project aimed at establishing a multidisciplinary consensus.
METHODS
A two-round Delphi approach was adopted to develop recommendations in the areas of Definition, Assessment/Monitoring, and Treatment. After selecting a panel of 72 worldwide experts, consensus (defined as ≥75% agreement) was reached through an online survey.
RESULTS
At the end of the two voting sessions, we obtained 53 consensus recommendations based on expert opinion on sleep problems in PPC.
CONCLUSIONS
This study addresses the need to personalize sleep medicine's approach to the palliative care setting and its peculiarities. It provides the first international consensus on sleep problems in PPC and highlight the urgent need for global guidance to improve sleep-related distress in this vulnerable population and their caregivers. Our findings represent a crucial milestone that will hopefully enable the development of guidelines in the near future.
Topics: Humans; Palliative Care; Consensus; Delphi Technique; Sleep Wake Disorders; Child; Adolescent; Pediatrics; Internationality
PubMed: 38833942
DOI: 10.1016/j.sleep.2024.05.042 -
Thoracic Cancer Jun 2024In this article, the multidisciplinary team of the Taiwan Academy of Tumor Ablation, who have expertise in treating lung cancer, present their perspectives on...
In this article, the multidisciplinary team of the Taiwan Academy of Tumor Ablation, who have expertise in treating lung cancer, present their perspectives on percutaneous image-guided thermal ablation (IGTA) of lung tumors. The modified Delphi technique was applied to reach a consensus on clinical practice guidelines concerning ablation procedures, including a comprehensive literature review, selection of panelists, creation of a rating form and survey, and arrangement of an in-person meeting where panelists agreed or disagreed on various points. The conclusion was a final rating and written summary of the agreement. The multidisciplinary expert team agreed on 10 recommendations for the use of IGTA in the lungs. These recommendations include terms and definitions, line of treatment planning, modality, facility rooms, patient anesthesia settings, indications, margin determination, post-ablation image surveillance, qualified centers, and complication ranges. In summary, IGTA is a safe and feasible approach for treating primary and metastatic lung tumors, with a relatively low complication rate. However, decisions regarding the ablation technique should consider each patient's specific tumor characteristics.
PubMed: 38831606
DOI: 10.1111/1759-7714.15333 -
Scientific Reports Jun 2024While implementing communication interventions, practitioners follow diverse theoretical models. Different conceptual orientations influence the way professionals...
While implementing communication interventions, practitioners follow diverse theoretical models. Different conceptual orientations influence the way professionals embrace the subject of communication and its disorders. This research project explores the co-creation and validation of a new model and intervention program to analyze and improve communication between persons with Complex Communication Needs and their caregivers. The methodology incorporated a comprehensive narrative review, as foundation for the new model and intervention proposal. Succeeding this stage, the team implemented an online Delphi Panel to improve and validate these results, involving 17 international renowned experts. Following the Appropriateness Method, 25 indications were subject to scrutiny and rated as appropriate with minimal values of disagreement among the evaluators. Qualitative feedback was used to improve the research products. Quality assurance measures were taken to ensure quality and transparency of the results. A new conceptual framework of atypical interpersonal communication and intervention program result from the investigation. The new model is inspired by the Transactional model and principles of Dialogism. The intervention consists of consultations with caregivers, using video analysis and a dialogical methodology to enhance communication. The next research phase is to pilot-test the intervention program with clinicians supporting persons with disability at risk of social isolation.
Topics: Humans; Communication; Social Isolation; Caregivers; Delphi Technique; Female; Male; Disabled Persons
PubMed: 38830956
DOI: 10.1038/s41598-024-63519-5 -
BMJ Open Jun 2024Families with children who have cystic fibrosis (CF) face a multitude of challenges. They require complex and time-consuming daily care, various forms of knowledge and...
Development and validation of a supportive programme for family caregivers of children suffering from cystic fibrosis: protocol for a sequential exploratory mixed-methods study.
INTRODUCTION
Families with children who have cystic fibrosis (CF) face a multitude of challenges. They require complex and time-consuming daily care, various forms of knowledge and intricate care responsibilities. One of the most critical challenges that Iranian families of children with CF face is the lack of adequate support from health teams in the early stages of diagnosis, frequent hospitalisation and the postdischarge process. Unfortunately, limited studies have been conducted in this field, and the Iranian society lacks a comprehensive support programme for these families after leaving treatment centres or home care teams. Therefore, it is necessary to identify and redefine the needs of these families for better care and support in Iran.
METHODS AND ANALYSIS
A mixed-method research design with an exploratory sequential approach will be used in this study. The study consists of three stages: stage (1) the qualitative phase (conventional content analysis and scoping review); stage (2) the programme design phase (development of a support programme) and stage (3) the quantitative phase (validation of the programme through the Delphi method). In the first stage, data will be collected through interviews. Key concepts, evidence and gaps in research will also be identified, collected and analysed through a scoping review. In the second stage, a support programme will be designed based on the results of the content analysis of interviews and the findings from the scoping review. In the final phase, the study will aim to validate the designed programme through a Delphi study.
ETHICS AND DISSEMINATION
This study formed part of a Ph.D. degree and was approved by the ethics committee of Tabriz University of Medical Sciences (IR.TBZMED.REC.1402.395). Informed consent will be obtained from all study participants. Findings will be published in a peer-reviewed journal.
Topics: Humans; Cystic Fibrosis; Caregivers; Iran; Child; Research Design; Delphi Technique; Program Development; Qualitative Research; Social Support; Family
PubMed: 38830739
DOI: 10.1136/bmjopen-2023-081560 -
Evaluation and Program Planning Aug 2024In the intensely developing information society, the education of pre-service teachers presents an organisational, methodological, and conceptual challenge. Recent years...
In the intensely developing information society, the education of pre-service teachers presents an organisational, methodological, and conceptual challenge. Recent years have necessitated reflection on the content and modalities of the formation of digital competence in pre-service teachers. This article - considers which components the digital competences of the new generations of teachers should contain and how this area can be effectively developed within academic education. The article is the result of interviews conducted with 35 experts (recognized scholars in the field of media pedagogy) from North and South America, Africa, Australia and Oceania, Asia, and Europe. Qualitative interviews using the Delphi methodology were conducted between June and September 2022. Using grounded theory principles, it was noted that there is a need to modify pre-service teachers' curricula in the following areas: creating, retrieving and managing digital content; integrating ICT into subject content; developing soft skills; enhancing interactivity in the classroom; social aspects of ICT; distance learning; new socio-technical processes; advanced digital competencies; predictive learning; analysing the impact of ICT on human life; data protection; e-risks; low digital competencies; understanding media messaging; and supporting people with disabilities.
Topics: Humans; Curriculum; Delphi Technique; Education, Distance; Professional Competence; Digital Technology; Grounded Theory; Interviews as Topic; Qualitative Research
PubMed: 38830317
DOI: 10.1016/j.evalprogplan.2024.102449