G298(P) A delphi-consensus study to identify the core clinical information required for neonatal inter-hospital transport in a resource-limited setting

Abstract

Aims Neonates who require transfer to a higher level of care need optimal sharing of clinical information to maintain adequate continuity of care at the receiving hospital. Therefore, we sought to identify the core clinical information (CCI) that should be provided to a referral center when transferring a neonate in a resource-limited setting. Methods A three-round modified Delphi-consensus study. Participants were clinicians with experience in neonatal care in resource-limited settings. Results In Round-1, a literature and internet search identified 16 pre-existing Neonatal Referral Forms (NRFs). These 16 NRFs contained a total of 101 individual items. Ten items were removed as they were not relevant to our setting (e.g. cooling). Ninety-one items met the pre-defined consensus, of being present in two or more NRFs, and were therefore included in Round-2. Each NRF contained a mean of 34 items (min=11, max=52). Thirty-three were present in more than half of the 16 NRFs demonstrating the need for consensus.For Round-2 and Round-3, there was a response rate of 32 (25%) and 33 (27%) participants, respectively. Participants were clinicians from East Africa, USA, and the UK. In Round-2, 6 of 12 new suggested items met the pre-defined consensus. None of these items were specific to the resource-limited setting. 57 items, grouped into eight domains, met the final consensus criteria (Table 1). Conclusion Our CCI of 57 items is larger than the range of 11-52 items that were present in the 16 NRFs of Round-1. This CCI can now be used to create a standardized Neonatal Referral Form tailored to use in resource-limited settings.Abstract G298(P) Table 1 Delphi-rounds for CCI items