ObjectiveTo construct the terminology standard of hospital quality and safety. MethodsThe draft terminology standard was constructed through group discussions, and the final draft terminology standard was formed after one round of Delphi expert consultation and two rounds of expert consensus meetings. ResultsThe recovery rate of the questionnaire was 100%, and the authority coefficient of experts was 0.87. A total of 15 experts were invited to two rounds of expert consensus meetings. The terminology standard for hospital quality and safety (TCHAS 10-1-1-4—2022) was finally released, including 4 first-level categories, 20 second-level categories, and 370 terms in total. ConclusionThe terminology standard of hospital quality and safety developed in this study is scientific and reliable, which can be used as a tool to assist medical institutions in carrying out standardized management.
In the context of the rapid development of contemporary medical industry and the unbalanced development of various subspecialties, expert consensus plays an extremely important role in guiding clinical practice and improving the quality of medical care. However, there are some deficiencies and limitations in the formation process and final report of the expert consensus. Therefore, this paper summarizes and reviews the definition, applications, and functions of expert consensus and the new progress of expert consensus formation methods by fully reviewing the literature, and puts forward the prospect. The purpose is to provide a reference for the production and application of expert consensus related to medical care, improve the outcomes of medical care, and upgrade the quality and level of medical services.
Objectives To construct patient trust evaluation index system based on the background of hierarchical medical system, and to provide reference for the evaluation of the degree of patient trust on medical institutions and offer guidence to the implementation and further improvement of the hierarchical medical policy in China. Methods Based on literature review, the modified Delphi method was used to carry out 2 rounds of expert consultations from 11 experts in different fields to determine the indicators of patient trust evaluation index system. Results Questionnaire recovery rates of 2 rounds were 100.00% and 90.91%, the expert authority coefficient was greater than 0.75, the coefficient of variation of each index was less than 0.25, and the coordination coefficient of experts in the total index were 0.236 and 0.424 (P<0.001). Patient trust evaluation index system was preliminary constructed including medical environment, service trust, technical skills, pharmaceutical and equipment, the overall trust 5 first-level indexes and 20 level two indexes. Conclusions The patient trust evaluation index system can be used to evaluate patients' trust in different levels of medical institutions under the hierarchical medical system.
ObjectiveTo build core items of database for traumatic brain injury (TBI) in rehabilitation medical database.MethodsRelevant factors in TBI database were summarized through database search in combination of acknowledged relevant items of TBI in rehabilitation medical database. Delphi method was used for experts to determine which items should be included by two rounds of questionnaires.ResultsThe average authority coefficient of experts was 0.94. After two rounds of questionnaires, 73 were included. Its contents include: general conditions, brain damage and disposal, relevant rehabilitation assessment scales, previous rehabilitation treatment, treatment expenses, and contents that require attention during re-evaluation.ConclusionsAfter two rounds of Delphi evaluation, the core items of database for TBI are identified with high recognition and consistency from experts.
Objective To explore the certification management of specialty nurses in China based on the existent problems to provide evidence for practice and decision making for management of the specialty nurses. Methods The modified Delphi technique was applied in this study from July to December 2017. A structured consultation questionnaire based on expert interview and literature review was designed, and modified after preliminary experiment. Then the questionnaires were delivered to 32 nurse experts to complete 3 rounds of Delphi process, which reached consensus gradually. Results The response rates of three round consultations were 96.9% (31/32), 100.0% (31/31), and 96.8% (30/31), respectively. The suggestion rates were 25.8% (8/31), 16.1% (5/31), 0% (0/31), respectively. The familiar coefficient, adjustment coefficient and authority coefficient was 0.82, 0.87 and 0.85, respectively. The experts had the agreement finally for all of the 16 items in the consultation questionnaire, and they formed an expert opinion draft on specialty nurse certification and registration. Conclusion It’s crucial and essential to establish a certification and registration system in China and renew the credentials regularly to promote the management and construction of specialty nurse team.
ObjectiveBy establishing a set of evaluation system for thoracoscopic clinical function and applicability, to evaluate and compare the advantages and disadvantages of different brands of thoracoscopes, and to provide some suggestions for the innovation and upgrade of thoracoscopes, especially for the domestic thoracoscopes.MethodsThe project coordination team initially formulated the evaluation index system for the clinical function and applicability of thoracoscope by querying literature and brainstorming. The Delphi expert consultation method was used to distribute questionnaires to the selected experts. Experts provided scores which were based on the importance of each indicator, and clarified the basis of their judgment and the familiarity with the evaluation indicators. After two rounds of screening by Delphi method, a thoracoscopic clinical function and applicability satisfactory questionnaire was formed. The appropriate sample for pre-investigation was selected, and the reliability and validity were tested. The index composition was adjusted based on the results of the test to form a final evaluation scale.ResultsThe project coordination team initially formulated 24 thoracoscope-related evaluation indicators. After two rounds of experts consultation, the item "brightness adjustment" was deleted without any additional entries. The positive coefficients of the experts in the first round and the second round were 100.0% and 80.0%, respectively. The two rounds of authoritative coefficients were 0.86 and 0.90, and the coordination coefficients were 0.272 (P<0.001) and 0.523 (P<0.001), respectively. A total of 140 questionnaires were issued in this pre-investigation. The recovery rate was 100.0% and the effective rate was 90.0%. The Cronbach's α value of the scale was 0.936, and the Spearman-Brown split-half reliability coefficient was 0.972. The factor analysis finally extracted 3 common factors. The total variance of the cumulative interpretation was 70.9%. The three common factors were named "operation related", "image related" and "device related".ConclusionThe evaluation index system developed in this study has good reliability and validity, and can be used as a tool to evaluate the clinical function and applicability of thoracoscopes.
ObjectivesTo construct a symptom assessment system suitable for surgical lung cancer patients, and to objectively evaluate the types and severity of postoperative symptoms in patients so as to provide evidence-based basis for the treatment of postoperative symptoms of lung cancer patients.MethodsPostoperative symptom items of lung cancer were formed according to previous researches, literature review, the current lung cancer symptom assessment tools, and expert interviews. The Delphi method was used to conduct two rounds of expert consultation and a postoperative symptom inventory was established for lung cancer patients.ResultsNine first-level symptom items were eventually formed: cough, pain, shortness of breath, fatigue, dizziness, nausea or vomiting, subcutaneous emphysema, insomnia, and constipation. The first round of active coefficient and authority coefficient of experts were 85.0% and 0.88, and the second round were 88.2% and 0.87. The Kendall coordination coefficients of the nine first-level symptom items were 0.47 (P<0.001) and 0.43 (P<0.001), respectively.ConclusionsThe evaluation system of postoperative symptom items for lung cancer patients is highly recognized by experts and has good consistency.
Objective To construct an index system for the rational use of foods for special medical purposes (FSMP) by medical institutions. Methods Based on the literature review and the survey of 300 medical institutions, we developed a questionnaire for expert consultation and conducted two rounds of expert consultation using Delphi method and consensus meeting method to determine the final index system for the rational use of FSMP in medical institutions. Results After two rounds of expert consultation and expert consensus conference meetings, it was finally determined that medical institutions should reasonably use the FSMP comprehensive evaluation index system, including 3 first-level catalog indicators, 17 second-level catalog indicators, and 13 third-level catalog indicators. Conclusion This index system can help promote the rationalization and standardization of FSMP clinical application in medical institutions in China and improve the quality of clinical nutrition care.
ObjectiveTo construct a health in all policies (HiAP) evaluation index system for earthquake-stricken areas based on national health policies.MethodsFrom April to December 2020, this study combined the methods of comprehensive review of relevant literature, on the foundation of the evaluation indicators pool was preliminarily constructed. The Delphi method and analytic hierarchy process were adopted to construct the evaluation indicators system in earthquake-stricken areas and analyzed the weights of indicators.ResultsA total of 5 first-level indicators (investment, action, short-term effect, medium-term effect, long-term effect), 15 second-level indicators, and 44 third-level indicators with satisfactory logical consistency of HiAP evaluation indicators system in earthquake-stricken areas had been constructed.ConclusionsThe HiAP evaluation indicators system constructed in this study can be used to comprehensively evaluate the implementation of HiAP earthquake-stricken areas.
ObjectiveTo select the key questions of the reporting quality of acupuncture therapy network meta-analysis. MethodsA question pool about reporting quality of acupuncture therapy network meta-analysis was conducted by preliminary literature research and qualitative systematic review. A correspondence questionnaire was designed and the selection of key questions was carried out through two rounds of expert consultation using the Delphi method. ResultsA total of 21 key questions were selected for the network meta-analysis report standard of acupuncture, including whether to report details of acupuncture interventions (e.g., needle type, acupoints used, number of needles inserted, depth of needle insertion, retention time, needling techniques, and treatment duration), diagnostic criteria for diseases or traditional Chinese medicine syndromes, and qualifications of acupuncture practitioners. Of these, the only three key questions answered by the preferred reporting items for systematic reviews and network meta-analysis (PRISMA-NMA) were summary, protocol and registration, and source of funding, while the remaining 19 were specific to acupuncture-related report standards. ConclusionThe conducted key question on reporting guideline of acupuncture network meta-analysis can improve the standardization and rigor of relevant research and better utilize its academic and clinical value.