Delphi Study to Develop Consensus for the Quality Improvement of Prehospital Care

Ahn, Ki Ok; Shin, Sang Do; Song, Kyoung Jun; Park, Ju Ok; Lee, Jin Seok; Suh, Gil Joon

Abstract

PURPOSE: To develop consensus opinion for quality improvement in pre-hospital emergency care, the Delphi study was performed in Korea.
METHODS
Consensus was developed through several rounds of assessment between August, 2006 and October, 2006. Physicians in emergency center and the specialized emergency center were chosen as Delphi experts. The Delphi questionnaire collected data in the following categories; 1) Dispatcher, 2) Ambulance Station and Operation, 3) Advanced Life Support (ALS) for prehospital care, 4) Tiered response system, 5) Medical control, 6) Triage and transport, and 7) Desirable (Emergency medical system) EMS model. Respondents were asked to indicate their level of agreement with questionnaire statements on a scale from 0 to 9 (0 indicating total disagreement and 9 indicating total agreement). A score of 1-3 was classified as disagreement, 4-6 as medium agreement, and 7-9 as agreement. Consensus was considered to be defined when the respond rate was more than 2/3 in each section.
RESULTS
Response rate was 68.2% for the first round and 75.6% for the second round. Paramedics were the consensus choice as dispatchers and providers for prehospital ALS, and there were general desire for an increased number of physicians working rescue in order to improve the medical direction, triage, and transport. The rate of formation of consensus was fairly low (24.1%). Consensus was not achieved in recommending a desirable EMS model.