TY - JOUR
T1 - Establishing the core elements of a frailty at the front door model of care using a modified real-time Delphi technique
AU - O’Shaughnessy, Íde
AU - Fitzgerald, Christine
AU - Whiston, Aoife
AU - Harnett, Patrick
AU - Whitty, Helen
AU - Mulligan, Des
AU - Mullaney, Marian
AU - Devaney, Catherine
AU - Lang, Deirdre
AU - Hardimann, Jennifer
AU - Condon, Brian
AU - Hayes, Christina
AU - Holmes, Alison
AU - Barry, Louise
AU - McCormack, Claire
AU - Bounds, Megan
AU - Robinson, Katie
AU - O’Connor, Margaret
AU - Ryan, Damien
AU - Shchetkovsky, Denys
AU - Steed, Fiona
AU - Carey, Leonora
AU - Ahern, Emer
AU - Galvin, Rose
N1 - Publisher Copyright:
© 2023, BioMed Central Ltd., part of Springer Nature.
PY - 2023/12
Y1 - 2023/12
N2 - 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.
AB - 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.
KW - Consensus
KW - Delphi technique
KW - Emergency department
KW - Frailty at the front door
KW - Older adults
UR - http://www.scopus.com/inward/record.url?scp=85174544023&partnerID=8YFLogxK
U2 - 10.1186/s12873-023-00893-9
DO - 10.1186/s12873-023-00893-9
M3 - Article
C2 - 37858041
AN - SCOPUS:85174544023
SN - 1471-227X
VL - 23
SP - 123
JO - BMC Emergency Medicine
JF - BMC Emergency Medicine
IS - 1
M1 - 123
ER -