They Will Come, You Must Build It: A Modified Delphi Process Applied to Preparing Acute Care Facilities Infrastructure for High-Consequence Infectious Diseases.

IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Health Security Pub Date : 2024-09-01 DOI:10.1089/hs.2024.0013
Justin Chan, Eileen F Searle, Dmitry Khodyakov, Logan Denson, Andrea Echeverri, Edward M Browne, Yvonne Chiarelli, Linda L Dickey, Douglas S Erickson, Jonathan Flannery, Lewis J Kaplan, Sarah Markovitz, Saskia V Popescu, Erica S Shenoy
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Abstract

Patients with suspected or confirmed high-consequence infectious diseases (HCIDs) may present for care at any acute care facility. However, there are limited data to inform recommendations for the design, maintenance, and operation of isolation spaces for patients with suspected or confirmed HCIDs. To address this gap, we developed consensus statements by convening a group of 29 subject matter experts to participate in a modified Delphi process facilitated by a validated tool (the RAND-developed ExpertLens system). The subject matter experts participated in 3 consensus rounds, providing feedback and rating the appropriateness of 36 draft consensus statements. These draft statements were then revised based on their feedback. As a result, we developed 36 consensus statements addressing 5 domains: (1) patient room physical space, (2) doors and windows, (3) air handling, (4) electrical and plumbing, and (5) soiled utility rooms and waste management. These statements could inform the approaches of frontline acute care facilities when building new spaces or modifying existing spaces to enable appropriate HCID patient isolation and care.

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他们会来,你必须建造:改良德尔菲法应用于急症护理设施基础设施应对高发传染病的准备工作。
疑似或确诊高危传染病(HCID)患者可在任何急症护理机构接受治疗。然而,对于疑似或确诊高危传染病患者隔离空间的设计、维护和操作建议,可参考的数据非常有限。为了弥补这一不足,我们召集了 29 位主题专家,在经过验证的工具(兰德公司开发的 ExpertLens 系统)的协助下,参与修改后的德尔菲流程,从而制定了共识声明。主题专家参与了 3 轮共识讨论,提供了反馈意见,并对 36 份共识声明草案的适当性进行了评级。然后根据他们的反馈意见对这些声明草案进行了修订。最终,我们制定了 36 项共识声明,涉及 5 个领域:(1) 病房物理空间;(2) 门窗;(3) 空气处理;(4) 电气和管道;(5) 污物杂物间和废物管理。这些声明可为前线急症护理机构在建造新空间或改造现有空间时提供参考,以实现适当的 HCID 患者隔离和护理。
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来源期刊
Health Security
Health Security PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
4.80
自引率
6.10%
发文量
70
期刊介绍: Health Security is a peer-reviewed journal providing research and essential guidance for the protection of people’s health before and after epidemics or disasters and for ensuring that communities are resilient to major challenges. The Journal explores the issues posed by disease outbreaks and epidemics; natural disasters; biological, chemical, and nuclear accidents or deliberate threats; foodborne outbreaks; and other health emergencies. It offers important insight into how to develop the systems needed to meet these challenges. Taking an interdisciplinary approach, Health Security covers research, innovations, methods, challenges, and ethical and legal dilemmas facing scientific, military, and health organizations. The Journal is a key resource for practitioners in these fields, policymakers, scientific experts, and government officials.
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