Refining the referral criteria of persons who have been burned to palliative care: A modified Delphi approach

• Published in: Burns Vol. 50; no. 2; pp. 507 - 516
• Main Authors: Grossoehme, Daniel H., Friebert, Sarah, Brown, Carrie, Brown, Miraides, Lou, Richard, Teo, Esther, Khandelwal, Anjay
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-03-2024
• Subjects: Burn; Care delivery; Delphi method; Palliative care; Burn; Palliative care; PC; Care delivery; Delphi method; SPC
• ISSN: 0305-4179; 1879-1409; 1879-1409
• DOI: 10.1016/j.burns.2023.07.002

A paucity of evidence is available to guide integration of specialist palliative care into burn care. This study’s purpose was to develop consensus on referral criteria using a modified Delphi process. Content experts were defined as burn or palliative care providers in locations where the teams have collaborative history; published at least one manuscript or presented nationally on burn and palliative care collaboration; or nomination as having equivalent expertise. N = 202 eligible persons were identified; n = 43 participated in Iteration 1 and Iteration 3 retained 79%. Iteration 1 invited participants to rank published referral criteria on a 9-point Likert-style scale. Consensus was defined as an interquartile range ≤ 2. Consensus items with median scores ≤ 3 were dropped from further consideration. Consensus items with median scores ≥ 7 were considered to be important and excluded in Iteration 2. Iteration 2 which presented non-consensus items with their associated median (interquartile range) and the participant’s own ranking from Iteration 1. Iteration 3 presented three models; participants ranked in order of preference and suggested revisions. Consensus was achieved on a final set of criteria for specialist palliative care for persons who sustain burn injuries. Future research should prospectively evaluate the criteria against meaningful outcomes.
•Modified Delphi process to develop consensus on palliative care referral for burns.•Consensus was achieved on a final set of criteria for specialist palliative care.•Criteria segregated for mandatory consultation and discretionary consultation.