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    Creating a pediatric prehospital destination decision tool using a modified Delphi method

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    Author
    Anders, Jennifer F.
    Fishe, Jennifer N.
    Fratta, Kyle A.
    Katznelson, Jessica H.
    Levy, Matthew J.
    Lichenstein, Richard
    Milin, Michael G.
    Simpson, Joelle N.
    Walls, Theresa A.
    Winger, Heather L.
    Date
    2021-07-29
    Journal
    Children
    Publisher
    MDPI AG
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.3390/children8080658
    Abstract
    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 evidencebased 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 pediatriccapability 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. © 2021 by the authors.
    Sponsors
    Health Resources and Services Administration
    Keyword
    Emergency care
    Emergency medical services (EMS)
    Pediatrics
    Prehospital
    Regionalization
    Specialty care
    Transport
    Triage
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/16502
    ae974a485f413a2113503eed53cd6c53
    10.3390/children8080658
    Scopus Count
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