Qualifying Outcome Measures For Evaluating The Impact Of User Involvement On Culture Change. Using A Modified Delphi Method And Nominal Group Technique - Info and Reading Options

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The purpose of this study is to qualify previously identified outcomes from a scoping review (n=134) through reaching consensus on core outcomes. The outcomes are culture-related outcomes that are relevant for evaluating the impact of user involvement on culture change. A modified delphi method is used to anonymously capture diverse stakeholder input over multiple delphi rounds, followed by a Nominal Group Technique (NGT) session to facilitate a structured discussion on missing outcomes from the literature as well as finalize the consensus process. The modification is thus the NGT following a priori set of 3 delphi rounds. Including both methods ensures a rigorous and inclusive consensus process that leverages the strengths of individual reflection as well as interative group deliberation. The NGT is primarily utilized for bringing forward, discussing, and ranking new outcomes not captured in the literature. Since most of the included literature from the scoping review did not explicitly aim to assess the impact of user involvement on culture change, it is likely that relevant outcomes may have been overlooked. The NGT allows the multi-stakeholder group to introduce and validate these additional outcomes through structured discussion and ranking. Furthermore, a pilot test was conducted with the full panel using a forced-ranking prioritization system, where panelists were asked to rank outcomes relative to each other within thematic categories. Based on participant feedback and methodological reflection, we concluded that a Likert scale would be more appropriate for the 3 formal delphi rounds. Participants will be a multistakeholder expert panel (n=19), including patients, relatives, nurses, doctors, healthcare developmental staff, researchers, and leaders. The same expert panel conducted the pilot test. We adhere to Recommendations for the Conducting and REporting of DElphi Studies (CREDES) to ensure a high quality consensus study. This framework consists of 11 recommendations relating to rationale, planning and design, study conduct, and reporting. Noteworthy recommendations are a clear rationale for doing the study, the use of an a priori defintion of consensus, pre-specification of number of rounds, feedback strategy, analysis plan and reporting plan. Generally, we aim to cover everything that we plan to do and stick to it. However, we are currently unsure on whether to conduct a qualitative analysis of the NGT discussion.

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