e-Article
Establishing the core elements of a frailty at the front door model of care using a modified real-time Delphi technique
Document Type
Original Paper
Author
O’Shaughnessy, Íde; Fitzgerald, Christine; Whiston, Aoife; Harnett, Patrick; Whitty, Helen; Mulligan, Des; Mullaney, Marian; Devaney, Catherine; Lang, Deirdre; Hardimann, Jennifer; Condon, Brian; Hayes, Christina; Holmes, Alison; Barry, Louise; McCormack, Claire; Bounds, Megan; Robinson, Katie; O’Connor, Margaret; Ryan, Damien; Shchetkovsky, Denys; Steed, Fiona; Carey, Leonora; Ahern, Emer; Galvin, Rose
Source
BMC Emergency Medicine. 23(1)
Subject
Language
English
ISSN
1471-227X
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.