Creating a Pediatric Prehospital Destination Decision Tool Using a Modified Delphi Method
Decisions for patient transport by emergency medical services (EMS) are individualized; while established guidelines help direct adult patients to specialty hospitals, no such pediatric equivalents are in wide use. When children are transported to a hospital that cannot provide definitive care, care...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-07-01
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| Series: | Children |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9067/8/8/658 |
| _version_ | 1827685551792193536 |
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| author | Jennifer F. Anders Jennifer N. Fishe Kyle A. Fratta Jessica H. Katznelson Matthew J. Levy Richard Lichenstein Michael G. Milin Joelle N. Simpson Theresa A. Walls Heather L. Winger |
| author_facet | Jennifer F. Anders Jennifer N. Fishe Kyle A. Fratta Jessica H. Katznelson Matthew J. Levy Richard Lichenstein Michael G. Milin Joelle N. Simpson Theresa A. Walls Heather L. Winger |
| author_sort | Jennifer F. Anders |
| collection | DOAJ |
| description | Decisions for patient transport by emergency medical services (EMS) are individualized; while established guidelines help direct adult patients to specialty hospitals, no such pediatric equivalents are in wide use. When children are transported to a hospital that cannot provide definitive care, care is delayed and may cause adverse events. Therefore, we created a novel evidence-based decision tool to support EMS destination choice. A multidisciplinary expert panel (EP) of stakeholders reviewed published literature. Four facility capability levels for pediatric care were defined. Using a modified Delphi method, the EP matched specific conditions to a facility pediatric-capability level in a draft tool. The literature review and EP recommendations identified seventeen pediatric medical conditions at risk for secondary transport. In the first voting round, two were rejected, nine met consensus for a specific facility capability level, and six did not reach consensus on the destination facility level. A second round reached consensus on a facility level for the six conditions as well as revision of one previously rejected condition. In the third round, the panel selected a visual display format. Finally, the panel unanimously approved the PDTree. Using a modified Delphi technique, we developed the PDTree EMS destination decision tool by incorporating existing evidence and the expertise of a multidisciplinary panel. |
| first_indexed | 2024-03-10T08:54:15Z |
| format | Article |
| id | doaj.art-1afecd5090dd49f69700623f460dc998 |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-10T08:54:15Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-1afecd5090dd49f69700623f460dc9982023-11-22T07:14:02ZengMDPI AGChildren2227-90672021-07-018865810.3390/children8080658Creating a Pediatric Prehospital Destination Decision Tool Using a Modified Delphi MethodJennifer F. Anders0Jennifer N. Fishe1Kyle A. Fratta2Jessica H. Katznelson3Matthew J. Levy4Richard Lichenstein5Michael G. Milin6Joelle N. Simpson7Theresa A. Walls8Heather L. Winger9Department of Pediatrics, Johns Hopkins University, Baltimore, MD 21287, USADepartment of Emergency Medicine, University of Florida–Jacksonville, Jacksonville, FL 32224, USADepartment of Pediatrics, Johns Hopkins University, Baltimore, MD 21287, USADepartment of Pediatrics, Johns Hopkins University, Baltimore, MD 21287, USADepartment of Emergency Medicine, Johns Hopkins University, Baltimore, MD 21287, USADivision of Pediatric Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD 21201, USADepartment of Emergency Medicine, Johns Hopkins University, Baltimore, MD 21287, USADepartment of Emergency Medicine, Children’s National Hospital, Washington, DC 20010, USADivision of Emergency Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USABaltimore County Fire Department, Towson, MD 21286, USADecisions for patient transport by emergency medical services (EMS) are individualized; while established guidelines help direct adult patients to specialty hospitals, no such pediatric equivalents are in wide use. When children are transported to a hospital that cannot provide definitive care, care is delayed and may cause adverse events. Therefore, we created a novel evidence-based decision tool to support EMS destination choice. A multidisciplinary expert panel (EP) of stakeholders reviewed published literature. Four facility capability levels for pediatric care were defined. Using a modified Delphi method, the EP matched specific conditions to a facility pediatric-capability level in a draft tool. The literature review and EP recommendations identified seventeen pediatric medical conditions at risk for secondary transport. In the first voting round, two were rejected, nine met consensus for a specific facility capability level, and six did not reach consensus on the destination facility level. A second round reached consensus on a facility level for the six conditions as well as revision of one previously rejected condition. In the third round, the panel selected a visual display format. Finally, the panel unanimously approved the PDTree. Using a modified Delphi technique, we developed the PDTree EMS destination decision tool by incorporating existing evidence and the expertise of a multidisciplinary panel.https://www.mdpi.com/2227-9067/8/8/658emergency medical services (EMS)prehospitalpediatricsemergency caretriagetransport |
| spellingShingle | Jennifer F. Anders Jennifer N. Fishe Kyle A. Fratta Jessica H. Katznelson Matthew J. Levy Richard Lichenstein Michael G. Milin Joelle N. Simpson Theresa A. Walls Heather L. Winger Creating a Pediatric Prehospital Destination Decision Tool Using a Modified Delphi Method Children emergency medical services (EMS) prehospital pediatrics emergency care triage transport |
| title | Creating a Pediatric Prehospital Destination Decision Tool Using a Modified Delphi Method |
| title_full | Creating a Pediatric Prehospital Destination Decision Tool Using a Modified Delphi Method |
| title_fullStr | Creating a Pediatric Prehospital Destination Decision Tool Using a Modified Delphi Method |
| title_full_unstemmed | Creating a Pediatric Prehospital Destination Decision Tool Using a Modified Delphi Method |
| title_short | Creating a Pediatric Prehospital Destination Decision Tool Using a Modified Delphi Method |
| title_sort | creating a pediatric prehospital destination decision tool using a modified delphi method |
| topic | emergency medical services (EMS) prehospital pediatrics emergency care triage transport |
| url | https://www.mdpi.com/2227-9067/8/8/658 |
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