Construction of reference criteria to admit patients to intermediate care units in France: a Delphi survey of intensivists, anaesthesiologists and emergency medicine practitioners (first part of the UNISURC project)
Objectives No consensus criteria describe the medical eligibility of the patients to intermediate care units (IMCUs). In this first part of the UNISURC project, we aimed to develop criteria based on a consensus of physicians from the main specialties involved in IMCU admission decisions.Design We se...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMJ Publishing Group
2023-07-01
|
Series: | BMJ Open |
Online Access: | https://bmjopen.bmj.com/content/13/7/e072836.full |
_version_ | 1797745382751469568 |
---|---|
author | Corinne Alberti Rym Boulkedid Marc Beaussier Benoit Misset Bertrand Guidet Philippe Aegerter Christophe Baillard |
author_facet | Corinne Alberti Rym Boulkedid Marc Beaussier Benoit Misset Bertrand Guidet Philippe Aegerter Christophe Baillard |
author_sort | Corinne Alberti |
collection | DOAJ |
description | Objectives No consensus criteria describe the medical eligibility of the patients to intermediate care units (IMCUs). In this first part of the UNISURC project, we aimed to develop criteria based on a consensus of physicians from the main specialties involved in IMCU admission decisions.Design We selected criteria from IMCU literature, scoring systems and intensive care unit nursing workload. We submitted these criteria to a panel of experts in a Delphi survey. We used a two-round Delphi survey procedure to assess the validity and feasibility of each criterion.Setting Medical practitioners in either public or private French institutions and proposed by the national scientific societies of anaesthesiology, emergency medicine and intensive care. The Delphi rounds took place in 2015–2016.Outcome measures Validity and feasibility of the proposed criteria; uniformity of the judgement across the primary specialty and the hospital category of the responders.Results The criteria submitted to vote were classified as one of: chronic factor (CF); acute factor (AF); specific pathway (SP); nursing activity (NA) and hospital environment (HE). Of 189 experts invited, 81 (41%) responded to the first round and 62 of them (76%) responded to the second round. A definite selection of 63 items was made, distributed across 6 CF, 18 AF, 31 SP, 3 NA and 5 HE. Validity and feasibility were influenced by the specialty or the public/private status of the institution of the responders for a few items.Conclusion We created a set of 63 consensus criteria with acceptable validity and feasibility to assess the medical eligibility of the patients to IMCUs. The second part of the UNISURC project will assess the distribution of each criterion in a prospective multicentre national cohort.Trial registration number NCT02590172. |
first_indexed | 2024-03-12T15:22:29Z |
format | Article |
id | doaj.art-15e2a09fb91941999dc936786636816c |
institution | Directory Open Access Journal |
issn | 2044-6055 |
language | English |
last_indexed | 2024-03-12T15:22:29Z |
publishDate | 2023-07-01 |
publisher | BMJ Publishing Group |
record_format | Article |
series | BMJ Open |
spelling | doaj.art-15e2a09fb91941999dc936786636816c2023-08-10T23:20:07ZengBMJ Publishing GroupBMJ Open2044-60552023-07-0113710.1136/bmjopen-2023-072836Construction of reference criteria to admit patients to intermediate care units in France: a Delphi survey of intensivists, anaesthesiologists and emergency medicine practitioners (first part of the UNISURC project)Corinne Alberti0Rym Boulkedid1Marc Beaussier2Benoit Misset3Bertrand Guidet4Philippe Aegerter5Christophe Baillard6Unité d`Epidémiologie Clinique, AP-HP, Paris, FranceUnité d`Epidémiologie Clinique, INSERM CIC 1426, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, FranceAnesthesiology, Institut Mutualiste Montsouris, Paris, FranceDepartment of Intensive Care, Groupe hospitalier Paris Saint-Joseph, Paris, FranceDepartment of Intensive Care, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, FranceEpidemiology and Public Health Service, Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicetre, FranceParis University, Paris, FranceObjectives No consensus criteria describe the medical eligibility of the patients to intermediate care units (IMCUs). In this first part of the UNISURC project, we aimed to develop criteria based on a consensus of physicians from the main specialties involved in IMCU admission decisions.Design We selected criteria from IMCU literature, scoring systems and intensive care unit nursing workload. We submitted these criteria to a panel of experts in a Delphi survey. We used a two-round Delphi survey procedure to assess the validity and feasibility of each criterion.Setting Medical practitioners in either public or private French institutions and proposed by the national scientific societies of anaesthesiology, emergency medicine and intensive care. The Delphi rounds took place in 2015–2016.Outcome measures Validity and feasibility of the proposed criteria; uniformity of the judgement across the primary specialty and the hospital category of the responders.Results The criteria submitted to vote were classified as one of: chronic factor (CF); acute factor (AF); specific pathway (SP); nursing activity (NA) and hospital environment (HE). Of 189 experts invited, 81 (41%) responded to the first round and 62 of them (76%) responded to the second round. A definite selection of 63 items was made, distributed across 6 CF, 18 AF, 31 SP, 3 NA and 5 HE. Validity and feasibility were influenced by the specialty or the public/private status of the institution of the responders for a few items.Conclusion We created a set of 63 consensus criteria with acceptable validity and feasibility to assess the medical eligibility of the patients to IMCUs. The second part of the UNISURC project will assess the distribution of each criterion in a prospective multicentre national cohort.Trial registration number NCT02590172.https://bmjopen.bmj.com/content/13/7/e072836.full |
spellingShingle | Corinne Alberti Rym Boulkedid Marc Beaussier Benoit Misset Bertrand Guidet Philippe Aegerter Christophe Baillard Construction of reference criteria to admit patients to intermediate care units in France: a Delphi survey of intensivists, anaesthesiologists and emergency medicine practitioners (first part of the UNISURC project) BMJ Open |
title | Construction of reference criteria to admit patients to intermediate care units in France: a Delphi survey of intensivists, anaesthesiologists and emergency medicine practitioners (first part of the UNISURC project) |
title_full | Construction of reference criteria to admit patients to intermediate care units in France: a Delphi survey of intensivists, anaesthesiologists and emergency medicine practitioners (first part of the UNISURC project) |
title_fullStr | Construction of reference criteria to admit patients to intermediate care units in France: a Delphi survey of intensivists, anaesthesiologists and emergency medicine practitioners (first part of the UNISURC project) |
title_full_unstemmed | Construction of reference criteria to admit patients to intermediate care units in France: a Delphi survey of intensivists, anaesthesiologists and emergency medicine practitioners (first part of the UNISURC project) |
title_short | Construction of reference criteria to admit patients to intermediate care units in France: a Delphi survey of intensivists, anaesthesiologists and emergency medicine practitioners (first part of the UNISURC project) |
title_sort | construction of reference criteria to admit patients to intermediate care units in france a delphi survey of intensivists anaesthesiologists and emergency medicine practitioners first part of the unisurc project |
url | https://bmjopen.bmj.com/content/13/7/e072836.full |
work_keys_str_mv | AT corinnealberti constructionofreferencecriteriatoadmitpatientstointermediatecareunitsinfranceadelphisurveyofintensivistsanaesthesiologistsandemergencymedicinepractitionersfirstpartoftheunisurcproject AT rymboulkedid constructionofreferencecriteriatoadmitpatientstointermediatecareunitsinfranceadelphisurveyofintensivistsanaesthesiologistsandemergencymedicinepractitionersfirstpartoftheunisurcproject AT marcbeaussier constructionofreferencecriteriatoadmitpatientstointermediatecareunitsinfranceadelphisurveyofintensivistsanaesthesiologistsandemergencymedicinepractitionersfirstpartoftheunisurcproject AT benoitmisset constructionofreferencecriteriatoadmitpatientstointermediatecareunitsinfranceadelphisurveyofintensivistsanaesthesiologistsandemergencymedicinepractitionersfirstpartoftheunisurcproject AT bertrandguidet constructionofreferencecriteriatoadmitpatientstointermediatecareunitsinfranceadelphisurveyofintensivistsanaesthesiologistsandemergencymedicinepractitionersfirstpartoftheunisurcproject AT philippeaegerter constructionofreferencecriteriatoadmitpatientstointermediatecareunitsinfranceadelphisurveyofintensivistsanaesthesiologistsandemergencymedicinepractitionersfirstpartoftheunisurcproject AT christophebaillard constructionofreferencecriteriatoadmitpatientstointermediatecareunitsinfranceadelphisurveyofintensivistsanaesthesiologistsandemergencymedicinepractitionersfirstpartoftheunisurcproject |