Combining and Using the Utrecht Method and the Analytic Hierarchy Process to Facilitate Professional and Ethical Deliberation and Decision Making in Complementary and Alternative Medicine: A Case Study among a Panel of Stakeholders

Abbas

Ghanem

2019

BMC Health Serv Res

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Background: Medication transcription errors (MTEs) are frequent in hospitalized patient settings. Definitions and scenarios that represent potential MTEs in the Palestinian nursing practice were not previously approached using formal consensus techniques. This investigation was conducted to develop a consensual definition of MTEs and scenarios that represent different MTE situations by a panel of nurses and other healthcare professionals.Methods: In this observational study, consensus was sought using the Delphi technique. Panelists (n = 64) were invited and recruited from different hospitals in Palestine and a two-iterative rounds Delphi technique was used to achieve consensus on a proposed definition of MTEs and 76 different scenarios representing potential MTEs.Results: Consensus was achieve to accept the definition and to consider 69 of the 76 proposed scenarios (77.6%) as MTEs, exclude 3 scenarios (3.9%), and 4 scenarios (5.3%) remained equivocal. Equivocal scenarios might be considered as MTEs or not depending on the clinical situation. Conclusions:Consensus was achieved on a definition of MTEs and scenarios representing MTEs by a panel of nurses and other healthcare professionals. This study showed that it was possible to develop and achieve consensus on a definition and scenarios representing MTE situations using formal consensus techniques. Such consensual definitions could be useful in future epidemiological studies investigating MTEs. Using consensual definitions might reduce methodological variations, promote congruence in error counting and reporting, and permit comparing error rates in different hospital settings.

Section: Methodsmentioning

confidence: 99%

Medication transcription errors in hospitalized patient settings: a consensual study in the Palestinian nursing practice

Abbas

Ghanem

2019

BMC Health Serv Res

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“…Patients in Palestine receive healthcare services from three main providers: (1) governmental sector, (2) private sector, and (3) international and nongovernmental organizations like the United Nations Relief and Works Agency for Palestine Refugees (UNRWA) [ 36 ]. In addition to conventional Western medicine, many Palestinians turn to the different modalities of CAM [ 7 , 8 , 10 – 13 , 28 ]. These CAM modalities are either used to complement or as alternatives to conventional Wester medicines.…”

Section: Methodsmentioning

confidence: 99%

“…In addition to industry and community pharmacy practice, the pharmacy graduates are trained to assume all roles in healthcare facilities including primary, secondary, and tertiary healthcare facilities. Pharmacists are the main providers of CAM [ 8 , 11 ]. As recent studies have reported a worldwide increase in using CAM modalities among hospitalized patients [ 14 , 15 ], like their peers elsewhere, pharmacists in Palestine are expected to deliver a variety of pharmaceutical care services to patients using such modalities, particularly, those admitted to healthcare facilities that employ integrative medicine paradigm.…”

Section: Methodsmentioning

confidence: 99%

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Development of Key Performance Indicators for Capturing Impact of Pharmaceutical Care in Palestinian Integrative Healthcare Facilities: A Delphi Consensus Study

Evidence-Based Complementary and Alternative Medicine

2020

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Background. The current study was performed to develop a consensus-based core inventory of key performance indicators (KPIs) to be used in capturing the impact of pharmaceutical care in healthcare facilities that employ integrative medicine paradigm in Palestine. Methods. A panel of healthcare professionals and risk/quality assurance managers was composed employing a judgmental sampling technique. The study tool was a questionnaire. Views and opinions of the panelists on the roles of pharmacists in caring for patients admitted to or visiting healthcare facilities that employ integrative medicine were collected using 11 statements. An initial inventory of activities and services that potentially can be used as KPIs was compiled from the literature and interviews with key contact experts in the domain. Three iterative Delphi rounds were conducted among the panelists (n = 50) to achieve formal consensus on the KPIs that should be used. The consensus-based KPIs were ordered by the scores of the panelists. Results. A total of 8 consensus-based KPIs were developed. The KPIs related to the number of problems related to medications and complementary and alternative medicine (CAM) that were resolved by pharmacists and CAM practitioners (p < 0.0001), number of patients for whom reconciliations were documented (p < 0.0001), number of patients receiving direct, comprehensive, and/or collaborative care (p < 0.0001), and number of patients for whom pharmacists and CAM practitioners were involved in implementing a therapeutic plan (p < 0.05) were rated significantly higher than the KPI (#8) related to the participation in multi-healthcare provider discussions/deliberations. Conclusions. Consensus-based KPIs that can be used in capturing the impact of evidence-based CAM and pharmaceutical care of patients in healthcare facilities that employ integrative medicine paradigm were developed. Future studies are still needed to investigate if implementing these KPIs might promote evidence-based CAM and pharmaceutical care in healthcare facilities that employ the integrative medicine paradigm.

“…1). The Analytic Hierarchy Process is a powerful tool that has been extensively used in multi-criteria decision analysis, notably, in healthcare [83–85]. The Analytic Hierarchy Process allows addressing and facilitating making decisions on complex problems with multi-criteria.…”

Section: Methodsmentioning

confidence: 99%

Merits, features, and desiderata to be considered when developing electronic health records with embedded clinical decision support systems in Palestinian hospitals: a consensus study

BMC Med Inform Decis Mak

2019

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BackgroundElectronic health records (EHRs) with embedded clinical decision support systems (CDSSs) have the potential to improve healthcare delivery. This study was conducted to explore merits, features, and desiderata to be considered when planning for, designing, developing, implementing, piloting, evaluating, maintaining, upgrading, and/or using EHRs with CDSSs.MethodsA mixed-method combining the Delphi technique and Analytic Hierarchy Process was used. Potentially important items were collected after a thorough search of the literature and from interviews with key contact experts (n = 19). Opinions and views of the 76 panelists on the use of EHRs were also explored. Iterative Delphi rounds were conducted to achieve consensus on 122 potentially important items by a panel of 76 participants. Items on which consensus was achieved were ranked in the order of their importance using the Analytic Hierarchy Process.ResultsOf the 122 potentially important items presented to the panelists in the Delphi rounds, consensus was achieved on 110 (90.2%) items. Of these, 16 (14.5%) items were related to the demographic characteristics of the patient, 16 (14.5%) were related to prescribing medications, 16 (14.5%) were related to checking prescriptions and alerts, 14 (12.7%) items were related to the patient’s identity, 13 (11.8%) items were related to patient assessment, 12 (10.9%) items were related to the quality of alerts, 11 (10%) items were related to admission and discharge of the patient, 9 (8.2%) items were general features, and 3 (2.7%) items were related to diseases and making diagnosis.ConclusionsIn this study, merits, features, and desiderata to be considered when planning for, designing, developing, implementing, piloting, evaluating, maintaining, upgrading, and/or using EHRs with CDSSs were explored. Considering items on which consensus was achieved might promote congruence and safe use of EHRs. Further studies are still needed to determine if these recommendations can improve patient safety and outcomes in Palestinian hospitals.