Protocol of the DENIM study: a Delphi-procedure on the identification of trauma patients in need of care by physician-staffed Mobile Medical Teams in the Netherlands

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Frank Willem Bloemers²  Lidwine Brigitta Mokkink⁴  Herman Martinus Timotheus Christiaans¹  Maartje Terra²  Georgios Fredericus Giannakopoulos³  Leo Maria George Geeraedts²  Annelieke Maria Karien Harmsen² 

[1] Department of Anaesthesiology, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands;Department of Surgery, VU University Medical Centre Amsterdam, Amsterdam, 1081 HV, The Netherlands;Department of Surgery Slotervaart Hospital, Amsterdam, The Netherlands;Department of Epidemiology and Biostatistics, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands

关键词: Ambulance;    Helicopter;    Mobile Medical Team;    Trauma;    Dispatch;    Protocol;    Delphi;    DENIM;   

Others  :  1132007
DOI  :  10.1186/s13049-015-0089-z

 received in 2014-10-07, accepted in 2015-01-06,  发布年份 2015

【 摘 要 】

Background

In The Netherlands, standard prehospital trauma care is provided by emergency medical services and can be supplemented with advanced trauma care by Mobile Medical Teams. Due to observed over and undertriage in the dispatch of the Mobile Medical Team for major trauma patients, the accuracy of the dispatch criteria has been disputed. In order to obtain recommendations to invigorate the dispatch criteria, this study aimed at reaching consensus in expert opinion on the question; which acute trauma patient is in need of care by a Mobile Medical Team? In this paper we describe the protocol of the DENIM study (a Delphi-procedure on the identification of prehospital trauma patients in need of care by Mobile Medical Teams).

Methods

A national three round digital Delphi study will be conducted to reach consensus. Literature was explored for relevant topics. After agreement on the themes of interest, the steering committee will construct questions for the first round. In total, 120 panellists with the following backgrounds; Mobile Medical Team physicians and nurses, trauma surgeons, ambulance nurses, emergency medical operators will be invited to participate. Group opinion will be fed back between each round that follows, allowing the panellists to revise their previous opinions and so, converge towards group consensus.

Discussion

Successful prehospital treatment of trauma patients greatly depends on the autonomous decisions made by the different professionals along the chain of prehospital trauma care. Trauma patients in need of care by the Mobile Medical Team need to be identified by those professionals in order to invigorate deployment criteria and improve trauma care. The Delphi technique is used because it allows for group consensus to be reached in a systematic and anonymous fashion amongst experts in the field of trauma care. The anonymous nature of the Delphi allows all experts to state their opinion whilst eliminating the bias of dominant and/or hierarchical individuals on group opinion.

【 授权许可】

   
2015 Harmsen et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Kuehl A: Prehospital Systems and Medical Oversight. Kendall/Hunt Pub, Dubugue, Iowa; 2002.
• [2]Ambulancezorg Nederland: Policy Document on Responsible Ambulance Care, 4. NVMMA V&VN, Ambulancezorg Nederland; 2013.
• [3]Hoogerwerf N, Heijne A, Geeraedts LM Jr, van Riessen C, Scheffer GJ: Helicopter emergency medical service missions at night: 2 years of experience in the Dutch regional emergency healthcare network east. Ned Tijdschrift Geneeskd 2010, 154:A2149.
• [4]Giannakopoulos GF, Lubbers WD, Christiaans HM, van Exter P, Bet P, Hugen PJ, Innemee G, Schubert E, de Lange-Klerk ES, Goslings JC, Jukema GN: Cancellations of (helicopter-transported) mobile medical team dispatches in the Netherlands. Langenbecks Arch Surg 2010, 395:737-745.
• [5]Giannakopoulos GF, Bloemers FW, Lubbers WB, Christiaans HMT, van Exter P, de Lange-de Klerk ESM, Zuidema WP, Goslings JC, Bakker FC: Criteria for cancelling helicopter emergency medical services (HEMS) – dispatches. Emerg Med J 2011, 29:582-586.
• [6]Ringburg AN, de Ronde G, Thomas SH, van Lieshout EM, Patka P, Schipper IB: Validity of helicopter emergency medical services dispatch criteria for traumatic injuries: a systematic review. Prehosp Emerg Care 2009, 13:28-36.
• [7]Landelijk netwerk aute zorg. MMT Inzet- en cancelcriteria. [http://www.lnaz.nl/cms/Inzet-_en_cancelcriteria_MMT_-_LNAZ-AZN.pdf]
• [8]Centre for Evidence-Based Medicine. Levels of evidence. [http://www.cebm.net/ocebm-levels-of-evidence/]
• [9]Zwakhals SLN, Kommer GJ, Kostlova B. Spoed bij nacht en ontij; Vraag en aanbod van Mobiele Medische Teams in het donker. (Ministerie van Volksgezondheid. Rijksinstituut voor Volksgezondheid en Milieu). 2008;1:2–67.
• [10]Williams PL, Webb C: The Delphi technique: a methodological discussion. J Adv Nurs 1994, 19:180-186.
• [11]Keeney S, Hasson F, McKenna HP: A critical review of the Delphi Technique as a research methodology for nursing. Int J Nurs Stud 2000, 38:195-200.
• [12]Okoli C, Pawlowski SD: The Delphi method as a research tool: an example, design considerations and applications. Inform Manage 2004, 42:15-29.
• [13]Frazier DM, Allgeier C, Homer C, Marriage BJ, Ogata B, Rohr F, Splett PL, Stembridge A, Singh RH: Nutrition management guideline for maple syrup urine disease: an evidence- and consensus-based approach. Mol Genet Metab 2014, 112:210-217.
• [14]Powel C: The Delphi technique: myths and realities. J Adv Nurs 2003, 41:376-382.
• [15]Evers S, Goossens M, De Vet H, Van Tulder M, Ament A: Criteria list for assessment of methodological quality of economic evaluations: consensus on health economic criteria. Int J Technol Assess Health Care 2005, 21:240-245.
• [16]Verhagen AP, de Vet HC, de Bie RA, Kessels AG, Boers M, Bouter LM, Knipschild PG: The Delphi list: a criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus. J Clin Epidemiol 1998, 51:1235-1241.
• [17]Strauss HJ, Zeigler LM: The Delphi technique and its uses in social science research. J Creat Behav 2011, 9:253-259.
• [18]Linstone HA, Turoff M, Helmer O: The Delphi Method. Techniques and Applications. Murray Turoff and Harold A. Linstone, California; 2002.
• [19]Akins RB, Tolson H, Cole BR: Stability of response characteristics of a Delphi panel: application of bootstrap data expansion. BMC Med Res Methodol 2005, 1:5-37.
• [20]Buck AJ, Gross M, Hakim S, Weinblatt J: Using the Delphi process to analyze social policy implementation: a post hoc case form vocational rehabilitation. Policy Sci 1993, 26:271-289.
• [21]Couper MR: The Delphi technique: characteristics and sequence model. ANS Adv Nurs Sci 1984, 7:72-77.
• [22]Graham B, Regehr G, Wright JG: Delphi as a method to establish consensus for diagnostic criteria. J Clin Epidemiol 2003, 56:1150-1156.
• [23]Crisp J, Pelletier D, Duffield C, Adams A, Nagcy S: The Delphi method? Nurs Res 1997, 46:116-118.
• [24]Hasson F, Keeney S, McKenna H: Research guideline for the Delphi survey technique. J Adv Nurs 2000, 32:1008-1015.
• [25]The Delphi Method: An Experimental Study of Group Opinion. Lexington Books, Lexington; 1972.
• [26]Hsu C, Sandford BA: Minimizing non-response int The Delphi Process: how to respond to non-response. Pract Assess Res Eval 2007, 12:1-6.