Development of an Electronic Interdisciplinary Chronic Obstructive Pulmonary Disease (COPD) Proforma (E-ICP) to Improve Interdisciplinary Guideline Adherence in the Emergency Department: Modified Delphi Study

Isaac, Hancy and Keijzers, Gerben and Yang, Ian A. and Lea, Jackie ORCID: https://orcid.org/0000-0003-3189-0950 and Taylor, Melissa ORCID: https://orcid.org/0000-0002-2255-3859 and Moloney, Clint ORCID: https://orcid.org/0000-0003-2520-1506 (2022) Development of an Electronic Interdisciplinary Chronic Obstructive Pulmonary Disease (COPD) Proforma (E-ICP) to Improve Interdisciplinary Guideline Adherence in the Emergency Department: Modified Delphi Study. International Journal of Chronic Obstructive Pulmonary Disease, 17. pp. 1089-1106. ISSN 1176-9106

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Abstract

Introduction: Chronic obstructive pulmonary disease guideline non-adherence is associated with a reduction in health-related quality of life in patients (HRQoL). Improving guideline adherence has the potential to mitigate fragmented care thereby sustaining pulmonary function, preventing acute exacerbations, reducing economic health burdens, and enhancing HRQoL. The development of an electronic proforma stemming from expert consensus, including digital guideline resources and direct interdisciplinary referrals is hypothesised to improve guideline adherence and patient outcomes for emergency department (ED) patients with COPD. Aim: The aim of this study was to develop consensus among ED and respiratory staff for the correct composition of a COPD electronic proforma that aids in guideline adherence and management in the ED. Methods: This study adopted a mixed-method design to develop the most important indicators of care in the ED. The study involved three phases: (1) a systematic literature review and qualitative interdisciplinary staff interviews to assess barriers and solutions for guideline adherence and qualitative interdisciplinary staff interviews, (2) a modified Delphi panel to select interventions for the proforma, and (3) a consensus process through three rounds of scoring through a quantitative survey (ED and Respiratory consensus) and qualitative thematic analysis on each indicator. Results: The electronic proforma achieved acceptable and good internal consistency through all iterations from national emergency department and respiratory department interdisciplinary experts. Cronbach’s alpha score for internal consistency (α) in iteration 1 emergency department cohort (EDC) (α = 0.80 [CI = 0.89%]), respiratory department cohort (RDC) (α = 0.95 [CI = 0.98%]). Iteration 2 reported EDC (α = 0.85 [CI = 0.97%]) and RDC (α = 0.86 [CI = 0.97%]). Iteration 3 revealed EDC (α = 0.73 [CI = 0.91%]) and RDC (α = 0.86 [CI = 0.95%]), respectively. Conclusion: Electronic proformas have the potential to facilitate direct referrals from the ED leading to reduced hospital admissions, reduced length of hospital stays, holistic care, improved health care and quality of life and improved interdisciplinary guideline adherence.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Faculty/School / Institute/Centre: Current - Faculty of Health, Engineering and Sciences - School of Nursing and Midwifery (1 Jan 2015 - )
Faculty/School / Institute/Centre: Current - Institute for Resilient Regions - Centre for Health Research (1 Apr 2020 -)
Date Deposited: 05 Jun 2022 23:03
Last Modified: 24 Oct 2022 01:19
Uncontrolled Keywords: COPD; COPD-X plan; electronic proforma; guideline adherence; interdisciplinary; modified Delphi study
Fields of Research (2020): 42 HEALTH SCIENCES > 4205 Nursing > 420501 Acute care
Socio-Economic Objectives (2020): 20 HEALTH > 2003 Provision of health and support services > 200304 Inpatient hospital care
20 HEALTH > 2003 Provision of health and support services > 200307 Nursing
20 HEALTH > 2002 Evaluation of health and support services > 200206 Health system performance (incl. effectiveness of programs)
Identification Number or DOI: https://doi.org/10.2147/COPD.S358254
URI: http://eprints.usq.edu.au/id/eprint/48709

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