scholarly journals Using the Delphi Approach to Identify Priority Areas for Health Visiting Practice in an Area of Deprivation

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Rosamund Bryar ◽  
Sandra Anto-Awuakye ◽  
Janice Christie ◽  
Claire Davis ◽  
Karen Plumb
Keyword(s):  
Delphi Process ◽  
Health Needs ◽  
Evidence Based ◽  
Consultation Process ◽  
Social Challenges ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Health Visitors ◽  
The Uk ◽  
High Level

Families with children living in areas of high deprivation face multiple health and social challenges, and this high level of need has impacts on the work of health practitioners working in such areas. All families in the UK with children under five years have access to health visiting services, and health visitors have a key role in mitigating the effects of deprivation by addressing health needs through evidence based practice. This paper reports the first stage of a project in Tower Hamlets, London, an area of significant deprivation, which aims to develop an evidence-based toolkit to support health visitors in their practice with families. The first stage used a modified Delphi process to identify the priority health needs of families in the area between June and July 2012. The three-stage Delphi process involved 25 people: four health visitors, four other members of the health visiting service, and 17 representatives of other services working with families. A focus group event was followed by a second event where individuals completed a questionnaire ranking the 27 priorities identified in the first event. The consultation process concluded with participants completing a second questionnaire, by email, confirming or changing their prioritisation of the topics.

What initiatives do healthcare leaders agree are needed for healthcare system improvement? Results of a modified-Delphi study

2018 ◽  
Vol 32 (8) ◽  
pp. 1002-1012
Author(s):  
Stuart Barson ◽  
Robin Gauld ◽  
Jonathon Gray ◽  
Goran Henriks ◽  
Christina Krause ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Healthcare System ◽  
Professional Training ◽  
Delphi Process ◽  
Content Type ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Health And Social Care ◽  
System Leaders ◽  
Practical Implications

Purpose The purpose of this paper is to identify five quality improvement initiatives for healthcare system leaders, produced by such leaders themselves, and to provide some guidance on how these could be implemented. Design/methodology/approach A multi-stage modified-Delphi process was used, blending the Delphi approach of iterative information collection, analysis and feedback, with the option for participants to revise their judgments. Findings The process reached consensus on five initiatives: change information privacy laws; overhaul professional training and work in the workplace; use co-design methods; contract for value and outcomes across health and social care; and use data from across the public and private sectors to improve equity for vulnerable populations and the sickest people. Research limitations/implications Information could not be gathered from all participants at each stage of the modified-Delphi process, and the participants did not include patients and families, potentially limiting the scope and nature of input. Practical implications The practical implications are a set of findings based on what leaders would bring to a decision-making table in an ideal world if given broad scope and capacity to make policy and organisational changes to improve healthcare systems. Originality/value This study adds to the literature a suite of recommendations for healthcare quality improvement, produced by a group of experienced healthcare system leaders from a range of contexts.

scholarly journals Areas of agreement in the management of childhood non-infectious chronic anterior uveitis in the UK

2019 ◽  
Vol 104 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Ameenat Lola Solebo ◽  
Jugnoo S Rahi ◽  
Andrew D Dick ◽  
Athimalaipet V Ramanan ◽  
Jane Ashworth ◽  
...  
Keyword(s):  
Anterior Uveitis ◽  
Severe Disease ◽  
Evidence Base ◽  
Future Research ◽  
Multiple Sources ◽  
Delphi Consensus ◽  
Modified Delphi ◽  
The Uk ◽  
High Level

Background/aimsThere is a paucity of high-level evidence to support the management of childhood uveitis, particularly for those children without juvenile idiopathic arthritis uveitis (JIA). We undertook a modified Delphi consensus exercise to identify agreement in the management of chronic anterior uveitis (CAU), the most common manifestation of childhood disease.MethodsA four-round, two-panel process was undertaken between June and December 2017. Paediatric uveitis specialists identified through multiple sources, including a multicentre network (the Paediatric Ocular Inflammation Group), were invited to participate. They were asked whether they agreed with items derived from existing guidelines on the management of JIA-U when extrapolated to the population of all children with CAU. Consensus was defined as agreement greater than or equal to 75% of respondents.Results26 of the 38 (68%) invited specialists participated with the exercise, and response rates were 100% for rounds one to three, and 92% for round four. Consensus was reached on 23 of the 44 items. Items for which consensus was not reached included management at presentation, use of systemic and periocular steroids for children with severe disease and the role of conventional steroid sparing immunosuppressants beyond methotrexate.ConclusionThe areas of management uncertainty at the level of the group, as indicated by absence of consensus, reflect the areas where the evidence base is particularly poor. Our findings identify the key areas for the future research needed to ensure better outcomes for this blinding childhood ocular inflammatory disorders.

scholarly journals LO41: The development of a standardized provincial massive hemorrhage protocol with a built-in continuous quality improvement framework

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S21-S22
Author(s):  
C. Yeh ◽  
S. Cope ◽  
T. Thompson ◽  
S. McGilvray ◽  
A. Petrosoniak ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Factor Viia ◽  
Stakeholder Analysis ◽  
Massive Hemorrhage ◽  
Delphi Process ◽  
Blood Component ◽  
Evidence Based ◽  
Process Measures ◽  
Modified Delphi ◽  
Working Groups

Background: Massive hemorrhage protocols (MHPs) streamline the complex logistics required for prompt care of the bleeding patient, but their uptake has been variable and few regions have a system to measure outcomes from these events. Aim Statement: We aim to implement a standardized MHP with uniform quality improvement (QI) metrics to increase uptake of evidence-based MHPs across 150-hospitals in Ontario between 2017 and 2021. Measures & Design: We performed ongoing PDSA cycles; 1) stakeholder analysis by surveying the Ontario Regional Blood Coordinating Network (ORBCoN), 2) problem characterization and Ishikawa analysis for key QI metrics based on areas of MHP variability in 150 Ontario hospitals using a web-based survey, 3) creation of a consensus MHP via a modified Delphi process, 4) problem characterization at ORBCoN for the design of a freely available toolkit for provincial implementation by expert working groups, 5) design of 8 key QI metrics by a modified Delphi process, and 6) identification of process measures for QI data collection by implementation metrics. Evaluation/Results: PDSA1-2; 150-hospitals were surveyed. 33% of hospitals lacked MHPs, mostly in smaller sites. Major areas for QI were related to activation criteria, hemostatic agents, protocolized hypothermia management, variable MHP naming, QI metrics and serial blood work requirements. PDSA3; 3 Delphi rounds were held to reach 100% expert consensus for 42 statements and 8 CQI metrics. Major areas for modification were protocol name, laboratory resuscitation targets, cooler configurations, and role of factor VIIa. PDSA4; adaptable toolkit is under development by the steering committee and expert working groups. Implementation is scheduled for Spring 2020. PDSA5; the 8 CQI metrics are: TXA administration < 1 h, RBC transfusion < 15 min, call to transfer for definitive care < 60 min, temp >35°C at end of protocol, Hgb kept between 60-110g/L, transition to group-specific RBC by 90 min, appropriate activation defined by ≥6 units RBC in the first 24 hours, and any blood component wastage. Discussion/Impact: MHP uptake, content, and tracking is variable. A standardized MHP that is adaptable to diverse settings decreases complexity, improves use of evidence-based practices, and provides a platform for continuous QI. PDSA6 will occur after implementation; we will complete an implementation survey, and design a pilot and feasibility study for prospective tracking of patient outcomes using existing prospectively collected inter-hospital and provincial databases.

Oral health promotion: Right person, right time prevention

2019 ◽  
Vol 7 (8) ◽  
pp. 394-398
Author(s):  
Laura Warrilow ◽  
Roshni Dave ◽  
Sheridan McDonald
Keyword(s):  
Health Promotion ◽  
Oral Health ◽  
Oral Hygiene ◽  
Evidence Based ◽  
Oral Health Promotion ◽  
Dental Decay ◽  
Balanced Diet ◽  
Health Visitors ◽  
Huge Impact ◽  
The Uk

Dental decay is one of the most common conditions affecting children in the UK; but it can be prevented with a balanced diet and good oral hygiene. Often, this advice comes too late, with many families only registering with a dentist when problems have occurred. Research has shown that health visitors who provide appropriate dental advice can have a huge impact on children's dental and overall health. This article aims to provide evidence-based preventive advice to support health visitors with dental interventions.

scholarly journals Highlighting the clinical need for diagnosing Mycoplasma genitalium infection

2018 ◽  
Vol 29 (7) ◽  
pp. 680-686 ◽  
Author(s):  
Catherine A Ison ◽  
Helen Fifer ◽  
Simon Gwynn ◽  
Paddy Horner ◽  
Peter Muir ◽  
...  
Keyword(s):  
Sexual Health ◽  
Mycoplasma Genitalium ◽  
Health Clinic ◽  
Specific Patient ◽  
Laboratory Staff ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Consensus Statements ◽  
Sexual Contacts ◽  
The Uk

Despite Mycoplasma genitalium (MG) being increasingly recognised as a genital pathogen in men and women, awareness and utility of commercially available MG-testing has been low. The opinion of UK sexual health clinicians and allied professionals was sought on how MG-testing should be used. Thirty-two consensus statements were developed by an expert group and circulated to clinicians and laboratory staff, who were asked to evaluate their level of agreement with each statement; 75% agreement was set as the threshold for defining consensus for each statement. A modified Delphi approach was used and high levels of agreement obviated the need to test the original statement set further. Of 201 individuals who received questionnaires, 60 responded, most (48) being sexual health consultants, more than 10% of the total in the UK. Twenty-seven (84.4%) of the statements exceeded the 75% threshold. Respondents strongly supported MG-testing of patients with urethritis, pelvic inflammatory disease or unexplained persistent vaginal discharge, or post-coital bleeding. Fewer favoured testing patients with proctitis and support was divided for routinely testing Chlamydia-positive patients. Testing of current sexual contacts of MG-positive patients was supported, as was a test of cure for MG-positive patients, although agreement fell below the 75% threshold. Respondents agreed that all consultant- or specialist-led services should have access to testing for MG (98.3%). There was strong agreement for having MG-testing available for specific patient groups, which may reflect concern over antibiotic resistance and the desire to comply with clinical guidelines that recommend MG-testing in sexual health clinic settings.

scholarly journals Designing and developing core physiology learning outcomes for pre-registration nursing education curriculum

2020 ◽  
Vol 44 (3) ◽  
pp. 464-474
Author(s):  
Alison F. Wood ◽  
Colin Chandler ◽  
Siobhan Connolly ◽  
Gabrielle Finn ◽  
Catherine Redmond ◽  
...  
Keyword(s):  
Nursing Education ◽  
Learning Outcomes ◽  
Response Rate ◽  
Questionnaire Response ◽  
Modified Delphi ◽  
Education Group ◽  
The United Kingdom ◽  
Delphi Approach ◽  
Panel Review ◽  
The Uk

Physiology is a key element of “bioscience” education within pre-registration nursing programs, but there is a lack of clarity on what is included. Physiology and bioscience content and delivery are highly varied across both higher education institutions and the related programs in the United Kingdom (UK). Despite evidence highlighting concerns over nurses’ lack of bioscience knowledge and unsafe practice, there is no universally agreed on curriculum with detailed outcomes of minimum levels of knowledge to support nurses in practice and patient care. This study aimed to inform the construction of discipline-specific physiology learning outcomes to clarify relevant physiological topics required in pre-registration nursing. Initially, 360 learning outcomes were identified from various sources. Using a modified Delphi approach, an expert panel from the Bioscience in Nurse Education group reviewed and modified the list to 195 proposed outcomes. These were circulated to universities in the UK who teach nursing ( n = 65). Outcomes that had 80% consensus were automatically included in the next round, with others recommended with modification (response rate 22%). The panel reviewed the modifications, and 182 outcomes were circulated in the second questionnaire (response rate 23%), and further panel review resulting in 177 outcomes agreed. These learning outcomes do not suggest how they should be delivered, but gives the basic level required for qualification as a nurse commensurate with the Nursing and Midwifery Council new standards for the “future nurse.”

scholarly journals Content validity of a health science evidence-based practice questionnaire (HS-EBP) with a web-based modified Delphi approach

2016 ◽  
Author(s):  
Juan Carlos Fernández-Domínguez ◽  
Albert Sesé-Abad ◽  
Jose Miguel Morales-Asencio ◽  
Pedro Sastre-Fullana ◽  
Sandra Pol-Castañeda ◽  
...  
Keyword(s):  
Content Validity ◽  
Evidence Based Practice ◽  
Health Science ◽  
Evidence Based ◽  
Web Based ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Science Evidence

Reporting Guidelines for Social Media Research (RESOME): Study protocol (Preprint)

2021 ◽  
Author(s):  
Aradhna Kaushal ◽  
Caroline Bravo ◽  
Stephen Duffy ◽  
Douglas Lewins ◽  
Ralph Möhler ◽  
...  
Keyword(s):  
Social Media ◽  
Behaviour Change ◽  
Consensus Meeting ◽  
Reporting Guidelines ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Media Research ◽  
Social Media Research ◽  
High Level ◽  
Media Interventions

BACKGROUND Social media applications platforms such as Facebook, Twitter and Instagram are being increasingly utilised to deliver public health interventions. Despite the high-level of research interest, there is no consensus or guidance on how to report social media interventions. Reporting guidelines which incorporate elements from behaviour change theories and social media engagement frameworks could foster more robust evaluations that capture outcomes demonstrating impact on behaviour change and engagement. OBJECTIVE The aim of this project is to develop, publish and promote a list of reporting guidelines for the social media research (RESOME). METHODS RESOME guidelines will be developed by using a modified Delphi approach, where two rounds of questionnaires are sent to experts and stakeholders asking them to rate their agreement with a series of statements until a level of consensus is reached, followed by a virtual consensus meeting to finalise the reporting guidelines. After the consensus meeting, the reporting guidelines will be written up in the form of a paper outlining the need for the new guideline, how the guidelines were developed, along with the finalised checklist for reporting. Prior to publication, we will pilot the guidelines to check for understanding and simplify the language used if necessary. RESULTS The first draft of the RESOME reporting guidelines have been developed with the Delphi method to be carried out in June and July of 2021. As of May 2021, this study has been approved by the UCL Ethics committee (ID:14687/004). CONCLUSIONS Developing reporting guidelines for social media research will contribute to improved reporting and will make it easier to assess effectiveness of social media interventions. Future work will be needed to evaluate usefulness and practicality.

scholarly journals Enhancing organizational readiness for implementation: constructing a typology of readiness-development strategies using a modified Delphi process

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Sigal Vax ◽  
Marianne Farkas ◽  
Zlatka Russinova ◽  
Kim T. Mueser ◽  
Mari-Lynn Drainoni
Keyword(s):  
Transtheoretical Model ◽  
Implementation Strategies ◽  
Delphi Process ◽  
Organizational Readiness ◽  
Evidence Based Practices ◽  
Modified Delphi ◽  
Implementation Outcomes ◽  
Contemplation Stage ◽  
Preparation Stage ◽  
High Level

Abstract Background Knowledge about the development of organizational readiness for implementation (ORI) is limited. ORI, referred to as the willingness and capacity of all relevant stakeholders to change practice, is critical for increasing the adoption rate of evidence-based practices and improving implementation outcomes. However, no methodology currently guides ORI’s enhancement or addresses differences in readiness needs across an organization. This study used the transtheoretical model (TTM) as a framework for classifying a well-established compilation of implementation strategies into three readiness stages: pre-contemplation, contemplation, and preparation. Methods A modified Delphi method was used to establish consensus among a panel of purposefully selected research and field implementation experts. The Delphi process involved three rounds of online questionnaires. The third round also included a live video discussion to clarify definitions in an effort to increase consensus among experts. Results Of the 73 strategies reviewed, the experts identified 75% (n = 55) as relevant for pre-implementation and reached a high-level agreement on the assignment of 7% (n = 5) of the strategies to the pre-contemplation stage (ORI-1), 25% (n = 18) to the contemplation stage (ORI-2), and 52% (n = 38) to the preparation stage (ORI-3). Several strategies were identified as relevant to more than one stage. Conclusions Participating experts were able to reach high-level agreement on the relevance of specific sets of implementation strategies to each of the three ORI stages. The lowest number of strategies was assigned to ORI-1 and the highest number to ORI-3. Given the overlap of strategies across ORI stages, there is a need to better understand the specific utilization of such strategies at different stages. Future studies are needed to empirically evaluate the relevance and applicability of this expert-informed typology based on implementers’ experiences in the field.

scholarly journals An Assessment Framework for e-Mental Health Apps in Canada: Results of a Modified Delphi Process (Preprint)

2018 ◽  
Author(s):  
Jennifer Zelmer ◽  
Krystle van Hoof ◽  
MaryAnn Notarianni ◽  
Trevor van Mierlo ◽  
Megan Schellenberg ◽  
...  
Keyword(s):  
Mental Health ◽  
Delphi Process ◽  
Security And Privacy ◽  
Rapid Review ◽  
Evidence Based ◽  
Assessment Framework ◽  
Health Apps ◽  
Modified Delphi ◽  
Mapping Process ◽  
Guiding Principles

BACKGROUND The number of e-mental health apps is increasing rapidly. Studies have shown that the use of some apps is beneficial, whereas others are ineffective or do not meet users’ privacy expectations. Individuals and organizations that curate, recommend, host, use, or pay for apps have an interest in categorizing apps according to the consensus criteria of usability and effectiveness. Others have previously published recommendations for assessing health-related apps; however, the extent to which these recommendations can be generalized across different population groups (eg, culture, gender, and language) remains unclear. This study describes an attempt by Canadian stakeholders to develop an e-mental health assessment framework that responds to the unique needs of people living in Canada in an evidence-based manner. OBJECTIVE The objective of our study was to achieve consensus from a broad group of Canadian stakeholders on guiding principles and criteria for a framework to assess e-mental health apps in Canada. METHODS We developed an initial set of guiding principles and criteria from a rapid review and environmental scan of pre-existing app assessment frameworks. The initial list was refined through a two-round modified Delphi process. Participants (N=25) included app developers and users, health care providers, mental health advocates, people with lived experience of a mental health problem or mental illness, policy makers, and researchers. Consensus on each guideline or criterion was defined a priori as at least 70% agreement. The first round of voting was conducted electronically. Prior to Round 2 voting, in-person presentations from experts and a persona empathy mapping process were used to explore the perspectives of diverse stakeholders. RESULTS Of all respondents, 68% (17/25) in Round 1 and 100% (13/13) in Round 2 agreed that a framework for evaluating health apps is needed to help Canadian consumers identify high-quality apps. Consensus was reached on 9 guiding principles: evidence based, gender responsive, culturally appropriate, user centered, risk based, internationally aligned, enabling innovation, transparent and fair, and based on ethical norms. In addition, 15 informative and evaluative criteria were defined to assess the effectiveness, functionality, clinical applicability, interoperability, usability, transparency regarding security and privacy, security or privacy standards, supported platforms, targeted users, developers’ transparency, funding transparency, price, user desirability, user inclusion, and meaningful inclusion of a diverse range of communities. CONCLUSIONS Canadian mental health stakeholders reached the consensus on a framework of 9 guiding principles and 15 criteria important in assessing e-mental health apps. What differentiates the Canadian framework from other scales is explicit attention to user inclusion at all stages of the development, gender responsiveness, and cultural appropriateness. Furthermore, an empathy mapping process markedly influenced the development of the framework. This framework may be used to inform future mental health policies and programs.

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