Improving primary palliative care – a Delphi consensus study on measures for general practice in Germany

Background The majority of severely ill and dying people in Germany can be administered primary palliative care (PPC) by general practitioners (GP). However, the current provision of PPC does not match the needs of the population. Although several public health strategies aim at strengthening the role of GPs in PPC provision, it remains challenging for GP teams to integrate PPC into their daily routines. Aim A Delphi study with GPs was conducted to achieve consensus on specific measures for improving the integration of PPC into everyday GP practice. Methods The study is part of the junior research project “Primary Palliative Care in General Practice” (ALLPRAX). After having developed, tested and evaluated 26 practical measures for GP practices to improve their PPC, a Delphi consensus study among GPs took place. In 2020, 569 GPs were asked to rate the relevance and feasibility of the measures on a 4-point Likert scale via an anonymous online questionnaire. Consensus was defined as a sum percentage of ‘strongly agree’ and ‘somewhat agree’ responses ≥75% after two rounds. Between these rounds, measures that were not consented in the first round were adapted in light of respondents’ free text comments and suggestions. Results The response rate was 11.3% in round 1 (n = 64) and 53.1% in round 2 (n = 34). From the initial n = 26 measures, n = 20 measures achieved consensus and were included in the final intervention package. The consented measures pertained to four main topics: advance care planning with patients, consulting and informing patients and family caregivers, GP office organisation and continuing education. N = 6 measures did not achieve consensus, predominantly due to time and workload constraints. Conclusion The consented measures provide valuable support to improve the provision of PPC by GPs. They can be used freely and flexibly, according to the needs of individual GP teams, and are thus suitable for implementation nationwide. Trial registration The study was registered in the German Clinical Trials Register (Registration N° DRKS00011821; 4 December 2017; https://apps.who.int/trialsearch/) and the German Register of Health Care Research (Registration N° VfD_ALLPRAX_16_003817; 30 March 2017).

Core Competencies for a Biomedical Laboratory Scientist – a Delphi study

Background After completing university education Biomedical Laboratory Scientists work in clinical laboratories, in biomedical research laboratories, in biotech, and in pharmaceutical companies. Laboratory diagnostics have undergone rapid development over the recent years, and the pace shows no signs of abatement. Rapid development challenges the competence of the staff and will most certainly influence the education of future staff. This study was aimed to examine what was considered the necessary competencies needed to pursue a career as a Biomedical Laboratory Scientist Methods A modified Delphi technique was used, and the panel of experts expressed their views in a three questionnaire series. Consensus was defined as the point when 75% or more of the panel participants agreed that a particular competence was necessary. Results The study highlights the perceived importance of mostly generic competencies that relate to quality, quality assurance, and accuracy, as well as different aspects of safety, respect, trustworthiness (towards patients/clients and colleagues), and communication skills. The results also stress the significance of self-awareness and professionality. Conclusions We identified important competencies for Biomedical Laboratory Scientists. Together with complementary information from other sources, i.e., guidelines, laws, and scientific publications, the competencies identified can be used as learning outcomes in a competency-based education to provide students with all competencies needed to work as professional Biomedical Laboratory Scientists.

Integration strategies for advanced construction technologies in the US AECO industry

Advanced Construction Technologies (ACTs) have fundamentally altered the way the US Architecture, Engineering, Construction, and Operations (AECO) industry operates. Over the past few decades, the US AECO industry has undergone a technological awakening, which promises to improve project quality and efficiency in a multitude of ways. The shift towards technology adoption began with Building Information Modeling (BIM), which for many years struggled to gain acceptance due to a largely ad-hoc integration strategy for organizations. As technologies continue to emerge and develop beyond, and in parallel with BIM, there are no tools available to help evaluate, plan and integrate such advancements in US AECO workflows. A series of semi-structured interviews were conducted with US AECO industry technology experts to establish a cursory list of the factors which impede or promote the successful integration of ACTs. These factors were evaluated, ranked and rated through a Delphi study, conducted with a panel of industry experts who at the time specialized or leveraged ACTs. A novel continuously iterative Delphi platform was deployed to gain the requisite expert input for the importance rating and impact ranking for each of the factors cited as influential in technology integration. The collected data was used to help bridge the identified gap between ACT development and successful integration of ACTs into US AECO industry workflows. Within the context of existing technology integration theories, this study identifies and evaluates factors which influence technological integration success within the US AECO industry. This study begins the process of establishing a foundation of understanding as it relates to meaningful ACT integration.

Development of a screening tool for pelvic floor dysfunction in female athletes: protocol of a Delphi consensus

Background/aim: Several epidemiological studies have found a high prevalence of Pelvic Floor Dysfunction (PFD) among female athletes. However, according to several authors, these data could even be underestimated, both in research and clinical practice. Screening for potential PFD is often delayed and risk factors are not often evaluated. As a consequence, withdrawal from sport, negative influence on performance, worsening symptoms and unrecognized diagnosis may occur. The aim of our research is to develop a screening tool for pelvic floor dysfunction in female athletes useful for clinicians (musculoskeletal/sport physiotherapists, sports medicine physicians, team physicians) to guide referral to a PFD expert (e.g. pelvic floor/women's health physiotherapist, gynecologist, uro-gynecologist, urologist). Methods: A 2-round modified Delphi study will be conducted to ascertain expert opinion on which combination of variables and risk factors should be included in the screening tool. Conclusion: The implementation of the present screening tool into clinical practice may facilitate the referral to a PFD expert for further assessment of the pelvic floor and therefore, to identify potential dysfunction and, eventually, the related treatment pathway.