Determining the New Norm Elements in Emergency Departments in Malaysia During a Pandemic: A Fuzzy Delphi Method.

IF 1.1 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
Malaysian Journal of Medical Sciences Pub Date : 2024-10-01 Epub Date: 2024-10-08 DOI:10.21315/mjms2024.31.5.17
Jivanya Raj Selvaraju, Nik Ab Rahman Nik Hisamuddin
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引用次数: 0

Abstract

Background: Emergency departments (EDs) have had to cope with various pandemics, such as HIN1, Ebola and the currently ongoing COVID-19. This study aimed to determine the elements of the new norm that has introduced changes into healthcare systems, particularly EDs, during the COVID-19 pandemic and to obtain consensus from the experts, the Emergency physicians in EDs across Malaysia. No previous study has been conducted on this topic.

Methods: This study used the fuzzy Delphi method (FDM) to acquire expert consensus. There were two phases in this study. The first involved extracting the elements to be assessed by the selected experts from a literature review. Three major domains were considered: infrastructure, governance and human resources. A total of 35 items were identified and divided into the three domains. In the second phase, the selected items were sent to a group of 15 ED physicians, who were asked to rate the items on a Likert-type scale. The data were then analysed using FDM.

Results: A total of 35 items were identified as possible new norms from a literature search for the three domains (governance, infrastructure and human resources). The first step of the FDM analysis showed that 9 out of the 35 items did not fulfil the initial requirement of the FDM, since the threshold value (d) must be lower than 0.2 (d 75%. Regarding the third requirement for FDM, only 1 out of the 35 items did not meet the criteria of an average fuzzy number (A value) of > 0.5. Finally, 25 items fulfilled all three requirements of FDM, so these were retained and the remaining 10 items were discarded.

Conclusion: The FDM used in this study had identified 25 items achieved the required level of agreement by the chosen experts. The results of this study can be used to guide EDs in Malaysia to utilise the new norms items in mitigating major outbreak affecting the ED services.

确定大流行病期间马来西亚急诊科的新规范要素:模糊德尔菲法
背景:急诊科(ED)不得不应对各种大流行病,如 HIN1、埃博拉和目前正在发生的 COVID-19。本研究旨在确定在 COVID-19 大流行期间为医疗保健系统(尤其是急诊室)带来变化的新规范的要素,并从专家、马来西亚各地急诊室的急诊医生那里获得共识。此前还没有进行过这方面的研究:本研究采用模糊德尔菲法 (FDM) 获得专家共识。本研究分为两个阶段。第一阶段是由选定的专家从文献综述中提取需要评估的要素。考虑了三个主要领域:基础设施、治理和人力资源。共确定了 35 个项目,并将其分为三个领域。第二阶段,将选定的项目发送给 15 名急诊科医生,要求他们用李克特量表对项目进行评分。然后使用 FDM 对数据进行分析:结果:通过对三个领域(管理、基础设施和人力资源)的文献检索,共确定了 35 个可能的新规范项目。FDM 分析的第一步显示,35 个项目中有 9 个不符合 FDM 的初始要求,因为阈值(d)必须低于 0.2(d < 0.2)。在满足 "快速需求管理 "的第二个条件方面,35 个项目中有 25 个项目的专家共识度大于 75%。关于模糊度量管理的第三个条件,35 个项目中只有 1 个不符合平均模糊数(A 值)大于 0.5 的标准。最后,有 25 个项目满足了 FDM 的所有三项要求,因此这些项目被保留下来,剩下的 10 个项目被舍弃:本研究中使用的 FDM 已确定 25 个项目达到了所选专家要求的一致水平。本研究的结果可用于指导马来西亚的急诊室利用新的规范项目来缓解影响急诊室服务的重大突发事件。
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来源期刊
Malaysian Journal of Medical Sciences
Malaysian Journal of Medical Sciences MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
2.70
自引率
0.00%
发文量
89
审稿时长
9 weeks
期刊介绍: The Malaysian Journal of Medical Sciences (MJMS) is a peer-reviewed, open-access, fully online journal that is published at least six times a year. The journal’s scope encompasses all aspects of medical sciences including biomedical, allied health, clinical and social sciences. We accept high quality papers from basic to translational research especially from low & middle income countries, as classified by the United Nations & World Bank (https://datahelpdesk.worldbank.org/knowledgebase/ articles/906519), with the aim that published research will benefit back the bottom billion population from these countries. Manuscripts submitted from developed or high income countries to MJMS must contain data and information that will benefit the socio-health and bio-medical sciences of these low and middle income countries. The MJMS editorial board consists of internationally regarded clinicians and scientists from low and middle income countries.
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