Establishing the core elements of a frailty at the front door model of care using a modified real-time Delphi technique
Abstract Background Innovations 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 envi...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-10-01
|
| Series: | BMC Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12873-023-00893-9 |
| _version_ | 1797577711073361920 |
|---|---|
| author | Íde O’Shaughnessy Christine Fitzgerald Aoife Whiston Patrick Harnett Helen Whitty Des Mulligan Marian Mullaney Catherine Devaney Deirdre Lang Jennifer Hardimann Brian Condon Christina Hayes Alison Holmes Louise Barry Claire McCormack Megan Bounds Katie Robinson Margaret O’Connor Damien Ryan Denys Shchetkovsky Fiona Steed Leonora Carey Emer Ahern Rose Galvin |
| author_facet | Íde O’Shaughnessy Christine Fitzgerald Aoife Whiston Patrick Harnett Helen Whitty Des Mulligan Marian Mullaney Catherine Devaney Deirdre Lang Jennifer Hardimann Brian Condon Christina Hayes Alison Holmes Louise Barry Claire McCormack Megan Bounds Katie Robinson Margaret O’Connor Damien Ryan Denys Shchetkovsky Fiona Steed Leonora Carey Emer Ahern Rose Galvin |
| author_sort | Íde O’Shaughnessy |
| collection | DOAJ |
| description | Abstract Background Innovations 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. Methods A 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. Results Fifty 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. Conclusion Development 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. |
| first_indexed | 2024-03-10T22:12:53Z |
| format | Article |
| id | doaj.art-f14774df7c0448329b8b64ad23987fec |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-03-10T22:12:53Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-f14774df7c0448329b8b64ad23987fec2023-11-19T12:34:40ZengBMCBMC Emergency Medicine1471-227X2023-10-012311810.1186/s12873-023-00893-9Establishing the core elements of a frailty at the front door model of care using a modified real-time Delphi techniqueÍde O’Shaughnessy0Christine Fitzgerald1Aoife Whiston2Patrick Harnett3Helen Whitty4Des Mulligan5Marian Mullaney6Catherine Devaney7Deirdre Lang8Jennifer Hardimann9Brian Condon10Christina Hayes11Alison Holmes12Louise Barry13Claire McCormack14Megan Bounds15Katie Robinson16Margaret O’Connor17Damien Ryan18Denys Shchetkovsky19Fiona Steed20Leonora Carey21Emer Ahern22Rose Galvin23School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of LimerickSchool of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of LimerickSchool of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of LimerickClinical Design and Innovation, Health Service Executive, National Clinical Programme for Older PeopleClinical Design and Innovation, Health Service Executive, National Clinical Programme for Older PeopleClinical Design and Innovation, Health Service Executive, National Clinical Programme for Older PeopleClinical Design and Innovation, Health Service Executive, National Clinical Programme for Older PeopleClinical Design and Innovation, Health Service Executive, National Clinical Programme for Older PeopleClinical Design and Innovation, Health Service Executive, National Clinical Programme for Older PeopleClinical Design and Innovation, Health Service Executive, National Clinical Programme for Older PeopleSchool of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of LimerickSchool of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of LimerickSchool of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of LimerickDepartment of Nursing and Midwifery, University of LimerickSchool of Medicine, Faculty of Education and Health Sciences, University of LimerickSchool of Medicine, Faculty of Education and Health Sciences, University of LimerickSchool of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of LimerickSchool of Medicine, Faculty of Education and Health Sciences, University of LimerickSchool of Medicine, Faculty of Education and Health Sciences, University of LimerickEmergency Department, Limerick EM Education Research Training (ALERT), University Hospital LimerickDepartment of HealthDepartment of Occupational Therapy, University Hospital LimerickClinical Design and Innovation, Health Service Executive, National Clinical Programme for Older PeopleSchool of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of LimerickAbstract Background Innovations 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. Methods A 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. Results Fifty 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. Conclusion Development 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.https://doi.org/10.1186/s12873-023-00893-9Older adultsEmergency departmentFrailty at the front doorConsensusDelphi technique |
| spellingShingle | Íde O’Shaughnessy Christine Fitzgerald Aoife Whiston Patrick Harnett Helen Whitty Des Mulligan Marian Mullaney Catherine Devaney Deirdre Lang Jennifer Hardimann Brian Condon Christina Hayes Alison Holmes Louise Barry Claire McCormack Megan Bounds Katie Robinson Margaret O’Connor Damien Ryan Denys Shchetkovsky Fiona Steed Leonora Carey Emer Ahern Rose Galvin Establishing the core elements of a frailty at the front door model of care using a modified real-time Delphi technique BMC Emergency Medicine Older adults Emergency department Frailty at the front door Consensus Delphi technique |
| title | Establishing the core elements of a frailty at the front door model of care using a modified real-time Delphi technique |
| title_full | Establishing the core elements of a frailty at the front door model of care using a modified real-time Delphi technique |
| title_fullStr | Establishing the core elements of a frailty at the front door model of care using a modified real-time Delphi technique |
| title_full_unstemmed | Establishing the core elements of a frailty at the front door model of care using a modified real-time Delphi technique |
| title_short | Establishing the core elements of a frailty at the front door model of care using a modified real-time Delphi technique |
| title_sort | establishing the core elements of a frailty at the front door model of care using a modified real time delphi technique |
| topic | Older adults Emergency department Frailty at the front door Consensus Delphi technique |
| url | https://doi.org/10.1186/s12873-023-00893-9 |
| work_keys_str_mv | AT ideoshaughnessy establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT christinefitzgerald establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT aoifewhiston establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT patrickharnett establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT helenwhitty establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT desmulligan establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT marianmullaney establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT catherinedevaney establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT deirdrelang establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT jenniferhardimann establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT briancondon establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT christinahayes establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT alisonholmes establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT louisebarry establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT clairemccormack establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT meganbounds establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT katierobinson establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT margaretoconnor establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT damienryan establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT denysshchetkovsky establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT fionasteed establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT leonoracarey establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT emerahern establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique AT rosegalvin establishingthecoreelementsofafrailtyatthefrontdoormodelofcareusingamodifiedrealtimedelphitechnique |