Construction of reference criteria to admit patients to intermediate care units in France: A Delphi survey of intensivists, anaesthesiologists and emergency medicine practitioners (first part of the UNISURC project)
Adult intensive & critical care; Hospitalization; PUBLIC HEALTH; Delphi Technique; Emergency Medicine; Humans; Intensive Care Units; Prospective Studies; Surveys and Questionnaires; Medicine (all)
Abstract :
[en] Objectives No consensus criteria describe the medical eligibility of the patients to intermediate care units (IMCUs). In this first part of the UNISURC project, we aimed to develop criteria based on a consensus of physicians from the main specialties involved in IMCU admission decisions. Design We selected criteria from IMCU literature, scoring systems and intensive care unit nursing workload. We submitted these criteria to a panel of experts in a Delphi survey. We used a two-round Delphi survey procedure to assess the validity and feasibility of each criterion. Setting Medical practitioners in either public or private French institutions and proposed by the national scientific societies of anaesthesiology, emergency medicine and intensive care. The Delphi rounds took place in 2015-2016. Outcome measures Validity and feasibility of the proposed criteria; uniformity of the judgement across the primary specialty and the hospital category of the responders. Results The criteria submitted to vote were classified as one of: chronic factor (CF); acute factor (AF); specific pathway (SP); nursing activity (NA) and hospital environment (HE). Of 189 experts invited, 81 (41%) responded to the first round and 62 of them (76%) responded to the second round. A definite selection of 63 items was made, distributed across 6 CF, 18 AF, 31 SP, 3 NA and 5 HE. Validity and feasibility were influenced by the specialty or the public/private status of the institution of the responders for a few items. Conclusion We created a set of 63 consensus criteria with acceptable validity and feasibility to assess the medical eligibility of the patients to IMCUs. The second part of the UNISURC project will assess the distribution of each criterion in a prospective multicentre national cohort. Trial registration number NCT02590172.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Misset, Benoît ; Université de Liège - ULiège > Département des sciences cliniques > Soins intensifs ; Department of Intensive Care, Groupe Hospitalier Paris Saint-Joseph, Paris, France ; Paris University, Paris, France ; University of Rouen Normandie, Rouen, France
Aegerter, Philippe; Epidemiology and Public Health Service, Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicetre, France ; University of Versailles Saint-Quentin, Versailles, France ; INSERM CESP U1018, Université Paris-Saclay, Le Kremlin-Bicêtre, France
Boulkedid, Rym; Unité d'Epidémiologie Clinique, INSERM CIC 1426, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France
Alberti, Corinne; Unité d'Epidémiologie Clinique, AP-HP, Paris, France
Baillard, Christophe; Paris University, Paris, France ; Department of Anesthesia and Intensive Care, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Paris, France
Guidet, Bertrand; Department of Intensive Care, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
Beaussier, Marc ; Anesthesiology, Institut Mutualiste Montsouris, Paris, France
Language :
English
Title :
Construction of reference criteria to admit patients to intermediate care units in France: A Delphi survey of intensivists, anaesthesiologists and emergency medicine practitioners (first part of the UNISURC project)
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