Creating a pediatric prehospital destination decision tool using a modified Delphi method
AuthorAnders, Jennifer F.
Fishe, Jennifer N.
Fratta, Kyle A.
Katznelson, Jessica H.
Levy, Matthew J.
Milin, Michael G.
Simpson, Joelle N.
Walls, Theresa A.
Winger, Heather L.
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AbstractDecisions 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.
SponsorsHealth Resources and Services Administration
Emergency medical services (EMS)
Identifier to cite or link to this itemhttp://hdl.handle.net/10713/16502