Establishing the core elements of a frailty at the front door model of care using a modified real-time Delphi technique

BMC Emergency Medicine

Research

Emer Ahern¹  Patrick Harnett¹  Catherine Devaney¹  Deirdre Lang¹  Marian Mullaney¹  Helen Whitty¹  Des Mulligan¹  Jennifer Hardimann¹  Fiona Steed²  Louise Barry³  Leonora Carey⁴  Denys Shchetkovsky⁵  Christina Hayes⁶  Brian Condon⁶  Katie Robinson⁶  Íde O’Shaughnessy⁶  Christine Fitzgerald⁶  Rose Galvin⁶  Alison Holmes⁶  Aoife Whiston⁶  Claire McCormack⁷  Megan Bounds⁸  Margaret O’Connor⁹  Damien Ryan^1,10 

[1] Clinical Design and Innovation, Health Service Executive, National Clinical Programme for Older People, Dublin, Ireland;Department of Health, Baggot Street, Dublin, Ireland;Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland;Department of Occupational Therapy, University Hospital Limerick, Dooradoyle, Limerick, Ireland;Emergency Department, Limerick EM Education Research Training (ALERT), University Hospital Limerick, Dooradoyle, Limerick, Ireland;School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland;School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland;School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland;College of Medicine, University of Arizona, Tucson, USA;School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland;Department of Ageing and Therapeutics, University Hospital Limerick, Dooradoyle, Limerick, Limerick, Ireland;School of Medicine, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland;Emergency Department, Limerick EM Education Research Training (ALERT), University Hospital Limerick, Dooradoyle, Limerick, Ireland;

关键词: Older adults;    Emergency department;    Frailty at the front door;    Consensus;    Delphi technique;   

DOI  :  10.1186/s12873-023-00893-9

 received in 2023-08-07, accepted in 2023-10-11,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundInnovations in models of care for older adults living with frailty presenting to the emergency department (ED) have become a key priority for clinicians, researchers and policymakers due to the deleterious outcomes older adults experience due to prolonged exposure to such an environment. This study aimed to develop a set of expert consensus-based statements underpinning operational design, outcome measurement and evaluation of a Frailty at the Front Door (FFD) model of care for older adults within an Irish context.MethodsA modified real-time Delphi method was used. Facilitation of World Café focus groups with an expert panel of 86 members and seperate advisory groups with a Public and Patient Involvement panel of older adults and members of the Irish Association of Emergency Medicine generated a series of statements on the core elements of the FFD model of care. Statements were analysed thematically and incorporated into a real-time Delphi survey, which was emailed to members of the expert panel. Members were asked to rank 70 statements across nine domains using a 9-point Likert scale. Consensus criteria were defined a priori and guided by previous research using 9-point rating scales.ResultsFifty members responded to the survey representing an overall response rate of 58%. Following analyses of the survey responses, the research team reviewed statements for content overlap and refined a final list of statements across the following domains: aims and objectives of the FFD model of care; target population; screening and assessment; interventions; technology; integration of care; evaluation and metrics; and research.ConclusionDevelopment of a consensus derived FFD model of care represents an important step in generating national standards, implementation of a service model as intended and enhances opportunities for scientific impact. Future research should focus on the development of a core outcome set for studies involving older adults in the ED.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023