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PubMed1992

Nursing research priorities for the care of the naval hospital patient: a Delphi survey.

The purpose of this study was to identify priorities for nursing research in a naval hospital using the Delphi technique. A general objective was to provide empirically based information to guide the development of a nursing research program at a regional medical treatment facility. Via a three-round Delphi survey, priority research questions were identified for the nursing department of a naval regional medical treatment facility. A serendipitous result was the identification of nursing research priorities within a deployed naval fleet hospital.

Delphi Technique↗

PubMedDate not supplied

Development of an integrative patient history intake tool: a Delphi study.

OBJECTIVE: To identify patient history intake questions common to four fields of medicine--allopathic, naturopathic, chiropractic, and Traditional Chinese Medicine for potential development of an Integrative Patient History Intake Tool. DESIGN: A two-round modified Delphi technique was utilized to generate expert consensus among Oregon healthcare practitioners on the importance of specific patient history intake questions. A panel of faculty members from Oregon Health & Sciences University (OHSU), the National College of Naturopathic Medicine (NCNM), the Oregon College of Oriental Medicine (OCOM), and Western States Chiropractic College (WSCC) identified 321 patient history intake questions, which then were distributed to 106 Oregon healthcare practitioners. The healthcare practitioners were asked to rate the importance of each question through a series of two surveys over the period of 11 weeks. Suggestions for additional intake questions also were invited. RESULTS: The Delphi process resulted in the original 321 initial questions plus 150 additional suggested questions being reduced to 52 intake questions (11% total similarity) for the potential development of the Integrative Patient History Intake Tool. There was a 63% response rate to SURVEY I, and a 73% response rate for SURVEY II. CONCLUSION: The concept of attempting to develop an integrative patient history intake tool is important to improve communication between practitioners of allopathic, naturopathic, chiropractic, and Traditional Chinese Medicine. This study revealed insight into the difficulties faced with such a tool due to the lack of similarity in priorities of questions between these different disciplines. This may also reveal a component of why communication remains difficult between these fields, but should not deter efforts to increase communication in the interest of optimal patient care.

Attitude of Health Personnel↗

PubMed2005

Identifiers suggestive of clinical cervical spine instability: a Delphi study of physical therapists.

BACKGROUND AND PURPOSE: Clinical cervical spine instability (CCSI) is controversial and difficult to diagnose. Within the literature, no clinical or diagnostic tests that yield valid and reliable results have been described to differentially diagnose this condition. The purpose of this study was to attempt to obtain consensus on symptoms and physical examination findings that are associated with CCSI. SUBJECTS: One hundred seventy-two physical therapists who were Orthopaedic Certified Specialists (OCS) or Fellows of the American Academy of Orthopaedic Manual Physical Therapists (FAAOMPT) participated in the survey. METHODS: This study was a 3-round Delphi survey designed to obtain consensual symptoms and physical examination findings for CCSI. RESULTS: The symptoms that reached the highest consensus among respondents were "intolerance to prolonged static postures," "fatigue and inability to hold head up," "better with external support, including hands or collar," "frequent need for self-manipulation," "feeling of instability, shaking, or lack of control," "frequent episodes of acute attacks," and "sharp pain, possibly with sudden movements." The physical examination findings related to cervical instability that reached the highest consensus among respondents included "poor coordination/neuromuscular control, including poor recruitment and dissociation of cervical segments with movement," "abnormal joint play," "motion that is not smooth throughout range (of motion), including segmental hinging, pivoting, or fulcruming," and "aberrant movement." DISCUSSION AND CONCLUSION: The Delphi method is useful in situations where clinical judgments are encountered but empirical evidence to provide evidence-based decision making does not exist. Findings of this study may provide beneficial clinical information, specifically when the identifiers are clustered together, because no set of clinical examination and symptom standards for CCSI currently exists. Diagnosis of CCSI is challenging; therefore, appropriate clinical reasoning is required for distinctive physical therapy assessment using pertinent symptoms and physical examination findings.

Adult↗

PubMed2006

Factors influencing success and failure of health informatics systems--a pilot Delphi study.

OBJECTIVES: The aim is to gain information on factors influencing success and failure for Health Informatics applications from a group of medical informaticians. METHODS: Based on the presentations at a special topic conference on success and failure in Health ICT and analysis of the proceedings, we conducted a Delphi study on success and failure aspects. RESULTS: A total of 110 success factors and 27 failure criteria were identified, distributed on categories like functional, organizational, behavioral, technical, managerial, political, cultural, legal, strategy, economy, education and user acceptance. These factors and criteria were rated for six different system types. Unanimously it was agreed that "collaboration and co-operation" and "setting goals and courses" are "essential for the success" of clinical systems, and "user acceptance" for educational systems. Similarly, the score "essential in order to avoid a failure" were given unanimously on clinical systems for "response rate and other performance measures" and on administrative systems for "not understanding the organizational context" with "not understanding or foreseeing the extent to which the new IT-system affects the organization, its structure and/or work procedures" as the highest scoring sub-item. CONCLUSIONS: All success factors and failure criteria were considered relevant by the Delphi expert panel. There is no small set of relevant factors or indicators, but success or failure of a Health ICT depends on a large set of issues. Further, clinical systems and decision support systems depend on more factors than other systems.

Delphi Technique↗

PubMed2007

Telehealth and the recruitment and retention of physicians in rural and remote regions: a Delphi study.

INTRODUCTION: The availability of a medical workforce is a growing concern for rural and remote communities across Canada. In the last decade, various telehealth experiences have highlighted the potential impact of this technology on professional as well as organizational practices. But could telehealth be a strategy to attract and maintain physicians in rural and remote communities? The objective of this study was to identify a reliable list of recruitment and retention factors on which telehealth could have an impact. METHODS: We conducted 2 literature reviews and a Delphi study among 12 telehealth experts across Canada. RESULTS: The literature reviews identified 7 categories of recruitment and retention factors on which telehealth could have an impact: 1) individual, 2) familial, 3) contextual, 4) professional, 5) organizational, 6) educational, and 7) economic. CONCLUSIONS: Experts consulted through the Delphi study reached consensus on 31 out of 34 of the proposed statements about the impact of telehealth. This consensus can now be used as a conceptual model for further studies on the topic.

Career Choice↗

PubMed1990

The Delphi method to validate diagnostic knowledge in computerized ECG interpretation.

We investigated the applicability of the Delphi method for increasing the agreement among multiple cardiologists on, firstly, their classifications of a set of electrocardiograms and, secondly, their reasons for these classifications. Five cardiologists were requested to judge the computer classifications of a set of thirty ECGs. If a cardiologist disagreed with the computer classification, he had to provide a new classification and a reason for this change. The results of this first round were compiled and anonymously fed back to the cardiologists. In a second round the cardiologists were asked once again to judge the ECGs and to rate the reasons provided in the first round. The level of agreement was estimated by means of the kappa statistic. The Delphi procedure substantially increased the agreement on the classifications among the cardiologists. The final agreement was very high and comparable with the intraobserver agreement. There was also a high level of agreement on the reasons provided by the cardiologists. However, their use in improving the program's performance is hampered by the qualitative nature of many of the reasons. Suggestions are given for a more formalized elicitation of knowledge.

Delphi Technique↗

PubMed1989

[The Delphi panel "atherosclerosis report"--concept and experiences].

While the overall mortality in Austria is decreasing and life expectancy is increasing the mortality rate from ischaemic heart disease has been stable for more than 15 years despite therapeutic progress. In many countries well-established prevention programs have helped to decrease the cardiovascular mortality by more than the overall mortality. In order to provide the basis of a nationwide program to reduce morbidity from cardiovascular diseases, their epidemiological importance must be documented convincingly, as well as the available strategies for their prevention and therapy. The most convincing form of documentation is a joint statement by leading medical experts. Hence, the "Delphi panel" method was chosen as the most appropriate approach. In Austria, the Institute of Social Medicine, University of Vienna and the Austrian Society of Hygiene, Microbiology and Preventive Medicine published the "Atherosklerosebericht" (atherosclerotic report), result of a written Delphi panel, in June 1988. Concept and practical experiences are reported below.

Arteriosclerosis↗

PubMed1989

1988 Delphi survey of nursing research priorities for New York State.

In order to inform decisions about nursing research and health care policy, the Council on Nursing Research of the New York State Nurses Association (NYSNA) conducted a Delphi survey to identify the priorities for nursing research in New York state. The Delphi technique is a method of eliciting judgements from experts for the purpose of short-term forecasting and planning. The survey was conducted by mail in three rounds during 1988. Round I required participants to identify three primary research priorities for the nursing profession. In Round II participants ranked the 37 most frequently identified categories from Round I. The highest 16 categories from Round II were ranked by participants in Round III to provide the final 10 nursing research priority categories for New York state. All members of the New York State Nurses Association holding a minimum of a master's degree in nursing were invited to participate. The response rates were: Round I, 34% (N = 872); Round II, 38% (N = 985); Round III 37% (N = 974). Of the 10 nursing research priority categories identified in the final round, 5 relate to nurses, 2 relate to nursing, and 3 relate to clients. None of the high-risk conditions or populations with whom nurses work appear in the top 10, and only 2 of these are ranked in the top 15 priority categories. These priority categories will be used by the NYSNA Council on Nursing Research to influence its future agenda and activities. They can be used by the nursing profession and others for planning, policy making, and establishing nursing research funding priorities.(ABSTRACT TRUNCATED AT 250 WORDS)

Delphi Technique↗

PubMed1995

[Consensus process in the field of health inequalities. The Delphi technique].

OBJECTIVE: An approach to finding the determinants of the risk of health inequality among foreign immigrants living in the city of Barcelona. DESIGN: A descriptive study done by interviewing a group of key informers, using the Delphi technique. SETTING: Barcelona city Health Region. PARTICIPANTS: 20 professionals from different sectors and levels of care were selected because of the relationship of their work area to the immigrant population. Primary Care, specialist, hospital, Family Planning and Public Health professionals took part from the health field; Primary Care, planning and non-governmental organisations from the social field. MEASUREMENTS AND MAIN RESULTS: A series of mailed questionnaires were used to elicit the participants' opinions and perceptions of the determinants of foreign immigrants' health inequalities. The final reply figure was 90%. Of the overall points granted to the agreed situations, 52.4% concerned aspects relating to their general living situation, 25.1% to health care and 22.4% to socio-cultural questions. CONCLUSIONS: The results show that, in addition to the health-care field, general living situation and socio-cultural questions play a fundamental part in determining foreign immigrants' health inequalities. We considered that the Delphi was a useful and rapid technique for obtaining qualitative information on the determinants of health inequalities and that it permitted us to contribute information which was complementary to other studies of inequalities which used classical health indicators.

Delphi Technique↗

PubMed1995

Using a Delphi Technique in a needs assessment for an innovative approach to advanced general dentistry education.

The University of Kentucky College of Dentistry has been awarded a $500,000 grant to develop and test a university-based educational program leading to a graduate certificate in Advanced General Dentistry, by the use of "extended campus" and distance learning methods. As an aid in developing this curriculum, dentists in general practice in non-urban Kentucky were asked about their educational needs. A Delphi Technique approach to this assessment was adopted. Forty dentists in general practice in non-urban areas in eastern and southern Kentucky were sent four mailings in which they rated or re-rated 65 topics for inclusion in the curriculum. A total of 59 topics were voted to be essential or desirable for the curriculum, 40 of them by a 2/3 majority. The Delphi Technique was workable for involving students in curriculum design. The curriculum produced by this method has also proven to be attractive to the dentists and their colleagues.

Curriculum↗

PubMedDate not supplied

The Delphi methodology (Part Two): A useful administrative approach.

The Delphi methodology can provide nurse administrators with relevant and accurate information to facilitate decision making. This paper, the second of a two part series, familiarizes nurse administrators with the application of the Delphi methodology in needs assessments, priority setting, changes in nursing practice, identification of cost containment approaches, development of effectiveness indicators, values clarification, and forecasting. Examples from the health sciences literature and our experiences in administration are presented to outline appropriate approaches for nurse administrators planning similar applications.

Decision Making↗

PubMedDate not supplied

Three decision-making aids: brainstorming, nominal group, and Delphi technique.

The methods of brainstorming, Nominal Group Technique, and the Delphi technique can be important resources for nursing staff development educators who wish to expand their decision-making skills. Staff development educators may find opportunities to use these methods for such tasks as developing courses, setting departmental goals, and forecasting trends for planning purposes. Brainstorming, Nominal Group Technique, and the Delphi technique provide a structured format that helps increase the quantity and quality of participant responses.

Decision Support Techniques↗

PubMed1994

Priorities for pharmaceutical policies in developing countries: results of a Delphi survey.

The use of the Delphi method as a systematic and logical approach to establishing consensus among international experts on the priorities for interventions in national drug policies in developing countries is described. The Delphi survey showed a high degree of reliability, as evidenced by the high response rate, the quality of respondents, and the high standard for consensus. In addition to creating consensus on key issues and key components for priority intervention, the study identified six components that could constitute a basic framework for designing drug policy in developing countries. The study's conclusions have important implications for decision-makers within international development agencies and national governments.

Delphi Technique↗

PubMed1993

Characteristics of strong departments of family medicine: results of a Delphi survey.

BACKGROUND: The establishment and support of strong university-based departments of family medicine is central to the success of family practice. The purpose of this study was to provide existing and developing departments of family medicine with information on the characteristics of strong established departments. METHODS: Chairs of existing departments were asked to identify the five strongest university-based departments in the country. Based on an 80% response rate, a select group of 24 chairs representing the strongest departments was surveyed using a Delphi technique. RESULTS: A systems and contingency model was used as the basis for organizing the Delphi responses. Seven core factors were identified and ranked by the chairs for each of the six systems and subsystems of the model describing university-based departments. CONCLUSIONS: Key ingredients that are common to most strong departments are the ability of the department to respond to the external environment, the presence of state and federal financial support, leadership and vision by the chair, strong clinically oriented faculty, management practices that keep everyone informed, and mutual support and respect within the department.

Delphi Technique↗

PubMed1995

Use of a Delphi technique to prioritize clinical nursing research needs.

School of nursing faculty and nursing service personnel at an academic medical center in the South, collaboratively using a Delphi method, were able to prioritize the top three unit based clinical nursing research needs. The benefits were evident as research conducted at the staff level linked the research efforts with the quality improvement efforts on the Labor, Delivery and OB Receiving Units. The Delphi method, a consensus building technique, offered a clear, concise, accurate and non-threatening approach for staff nurses to participate in research.

Clinical Nursing Research↗

PubMed1996

-Factors of dissatisfaction with health care. A Delphi study-.

OBJECTIVE: To study the causes of the disagreement between the general atmosphere of insatisfaction inherent in the assistance offered by the health care system and the favourable evaluation that the public shows in the questionnaires carried out in the field of primary health care. The less satisfactory issues of the health service offert are also identified. DESIGN: A Delphi thecnique has been used as consensus method. SETTING: Community setting: Salamanca urban area. PARTICIPANTS: The Delphi group is made up of people working in jobs with a pronounced social character: members of neighbour associations, educators, social workers, etc. Three consecutive questionnaires were distributed among fifty people. Twenty-seven of them completed the three rounds. MEASUREMENTS AND MAIN RESULTS: The score of the reasons of disagreement perceived as the most important were: the difficulties of access at a specialised level, 8.3 points; the inequality of the services offered by the two organizative models that coexist in the primary health care, 7.1; the lack of discrimination between the primary and the specialized level, 6.8. The highest scores were for the following complaints: excessive waiting lists at the second care level (8.5), delay in solving the problems (7.8) and masification at the consultancy (7.1). The most satisfactory aspects are the possibility of free choice of doctor, 7.9 points; the previous appointement system, 7.6; and a reliable relationship with the doctor, 7.3. CONCLUSIONS: To take into account these factors in the future design and interpretation of inquiries will increase their information validity and usefulness.

Adult↗

PubMed1997

Vision 21 Delphi panel: senior Army Medical Service Corps Officers' vision of behaviors for success of future Medical Service Corps officers.

A Delphi study was conducted of Army senior Medical Service Corps leaders (O6s) to identify the expected behaviors and competencies needed to ensure that junior officers will achieve successful careers as Medical Service Corps officers in the 21st century. A Delphi mailing was conducted in two phases. In the first iteration, 41 behaviors were identified to be of importance. In the second mailing, the 41 behaviors were rated for relative importance on a 7-point bipolar rating scale (1 = unimportant, 7 = most important). Comparisons were made between the ratings of administrative and biomedical scientific/technical (BS/T) series. Discriminant models developed to compare demographics between administrative and BS/T officers indicated that administrative officers had more time in grade, years of service, and professional military education, whereas BS/T officers reported significantly more civilian education. Minor differences among the two groups emerged for behavior ratings; however, the final priority order of behaviors reflected a high degree of consensus from both groups.

Clinical Competence↗

PubMed1997

[The Delphi technique to validate nursing interventions].

Know-how and science are universal and have been developed very fast, and nurses have realized their roles in this scientific development. Aiming at analyzing the Delphi though a description of its use in the validity of nursing interventions, to the spinal cord injured in rehabilitation, it was possible to get reliable results by means of a flexible technique and above all of appreciating the opinion and skills of each nurse who deals with the spinal cord injured. This Delphi Technique has given opportunity for specialists to show the interventions recommended to this kind of patients, even so, this context had some needed requirements which identify the make--think in nursing.

Clinical Competence↗