Delphi_Stage3_Form Research agenda 2 Email From which European Country are you? (Blank)AlbaniaAndorraArmeniaAustriaAzerbaijanBelarusBelgiumBosnia and HerzegovinaBulgariaCroatiaCyprusCzech RepublicDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHungaryIcelandIrelandItalyKazakhstanKosovoLatviaLiechtensteinLithuaniaLuxembourgMacedonia (FYROM)MaltaMoldovaMonacoMontenegroNetherlandsNorwayPolandPortugalRomaniaRussiaSan MarinoSerbiaSlovakiaSloveniaSpainSwedenSwitzerlandTurkeyUkraineUnited Kingdom (UK)Vatican City (Holy See)OtherOutside Europe What is your profession? (Blank)PhysiotherapistEmergency physician / acute medicineGeriatricianOther physicianED nurseGeriatric nurseOther nurseOccupational therapistGeneral practitioner What is your age? 1. Is assessment of frailty effective in reducing the number of unscheduled reattendance of older patients visiting the Emergency Department? 50 0 = NOT important ___________________________________________________ VERY important = 100 2. Are interventions led by a geriatric nurse effective in improving outcomes for older patients in the ED? 50 0 = NOT important ___________________________________________________ VERY important = 100 3. Does additional geriatric training of ED nurses improve patient outcomes in older ED patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 4. What are the perceptions of professionals throughout the healthcare chain on the feasibility and benefits of an integrated geriatric team assessment in the ED for older patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 5. Does assessment by occupational therapist or physiotherapist effectively identify the needs of care for older patients in the ED? 50 0 = NOT important ___________________________________________________ VERY important = 100 6. Is physiotherapy assessment in the ED effective and cost-effective for delivering better outcomes for the older patient? 50 0 = NOT important ___________________________________________________ VERY important = 100 7. Is ‘hospital at home’ effective and cost-effective in improving outcomes in older ED patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 8. Which elements of Comprehensive Geriatric Assessment (CGA), such as screening for frailty and geriatric interventions, are feasible in the ED? 50 0 = NOT important ____________________________________________________ VERY important = 100 9. Is implementation of elements of CGA, such as screening for frailty and geriatric interventions, effective in improving outcomes for older patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 10. Is delivering of elements of CGA in the ED cost-effective? 50 0 = NOT important ___________________________________________________ VERY important = 100 11. Which interventions in older ED patients are effective in reducing ED or hospital length of stay? 50 0 = NOT important ___________________________________________________ VERY important = 100 12. Does medication review in the ED affect treatment decisions, such as discharge disposition? 50 0 = NOT important ___________________________________________________ VERY important = 100 13. Are separate ED spaces tailored for older patients living with frailty effective and cost-effective in improving outcomes? 50 0 = NOT important ___________________________________________________ VERY important = 100 14. Is the teach-back method effective in improving understanding of and compliance to discharge instruction in older ED patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 15. Is fast-track assessment by a geriatrician effective and cost-effective in improving outcomes in older patients presenting to the ED with a fall? 50 0 = NOT important ___________________________________________________ VERY important = 100 16. Which alternative models of care outside the ED are safe and effective to deliver geriatric emergency medicine to older patients who would otherwise come to the ED? 50 0 = NOT important ___________________________________________________ VERY important = 100 17. Is the presence in the ED of a geriatrician or geriatric nurse effective in improving outcomes for older ED patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 18. Does care by a nurse with training in Geriatric Emergency Medcine in the nursing home result is similar outcomes compared to transferring the patient to the ED? 50 0 = NOT important ___________________________________________________ VERY important = 100 19. Is a “functional unit” in primary care effective in reducing (acute) hospital admissions in older patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 20. Is ambulatory care effective in diagnosing and managing delirium in older people at home? 50 0 = NOT important ___________________________________________________ VERY important = 100 21. What support do caregivers of older ED patients experience and what are their needs? 50 0 = NOT important ___________________________________________________ VERY important = 100 22. Is optimisation of the social network at home effective in improving patient satisfaction and unscheduled ED reattendence of (acutely) hospitalized older patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 23. Are ED-based vaccination programs effective and cost-effective in decreasing the rate of infectious disease related ED presentations, hospital admissions and mortality? 50 0 = NOT important ___________________________________________________ VERY important = 100 24. What interventions are effective in reducing ED visits of older adults? 50 0 = NOT important ___________________________________________________ VERY important = 100 25. What elements should be reported in the ED referral letter of primary care physicians? What are barriers and facilitators of reporting necessary elements in ED referral letters for primary care physicians? 50 0 = NOT important ___________________________________________________ VERY important = 100 26. What interventions can improve care transitions of older ED patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 27. What interventions might promote use of advance care planning policies in the ED? 50 0 = NOT important ___________________________________________________ VERY important = 100 28. What do older patients and their caregivers expect from conversations about goals of care or advance planning? 50 0 = NOT important ___________________________________________________ VERY important = 100 29. What are the barriers and facilitators for emergency departments which are implementing Geriatric Emergency Medicine principles? 50 0 = NOT important ___________________________________________________ VERY important = 100 30. Which interventions in the ED reduce unscheduled reattendances among older people? 50 0 = NOT important ___________________________________________________ VERY important = 100 31. Does ED crowding affect quality of care and patient experience for older people? 50 0 = NOT important ___________________________________________________ VERY important = 100 32. What knowledge and competencies of Geriatric Medicine are trainees in Emergency Medicine across Europe receiving training in and what are the gaps? 50 0 = NOT important ___________________________________________________ VERY important = 100 33. What knowledge and competencies of Emergency Medicine are trainees in Geriatric Medicine across Europe receiving training in and what are the gaps? 50 0 = NOT important ___________________________________________________ VERY important = 100 34. Do education and training interventions focusing on geriatric syndromes of ED staff improve outcomes for older patients in the ED? 50 0 = NOT important ___________________________________________________ VERY important = 100 35. What needs or preferences are specific to older patients in the emergency setting, and which interventions are effective in increasing emergency care professional’s awareness and knowledge of these? 50 0 = NOT important ___________________________________________________ VERY important = 100 36. What is the added value of formal screening for geriatric impairments over and above clinical gestalt to predict adverse outcomes in older ED patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 37. Is measuring functional ability in the pre-hospital setting effective in predicting and reducing ED contact and acute hospital admission? 50 0 = NOT important ___________________________________________________ VERY important = 100 38. What are predictors of Patient Reported Outcome Meusures (PROMs) in older patients in the ED? 50 0 = NOT important ___________________________________________________ VERY important = 100 39. What symptoms or signs predict prolonged hospitalisation in older patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 40. In which patients is screening most effective in improving outcomes in older ED patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 41. In initial triage and assessment how do older patients differ from younger patients in the ED? 50 0 = NOT important ___________________________________________________ VERY important = 100 42. Is goal directed fluid resuscitation until signs of organ failure have disappeared effective in improving patient outcomes, more than restoration of blood pressure, in older patients with non-cardiogenic shock? 50 0 = NOT important ___________________________________________________ VERY important = 100 43. Is management of acute decompensation in older patients with focus on co-morbidities and comfort effective in improving outcomes in older ED patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 44. What is the effect on outcomes of interprofessional discussion with patient and caregiver in the management of acute-on-chronic organ failure in older patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 45. Do older ED patients benefit more from Non-Invasive Ventilation than younger ED patients in term of intubation rate, ICU admission, quality of life? 50 0 = NOT important ___________________________________________________ VERY important = 100 46. Are the proposed algorithms from European Society of Cardiology equally adequate for the assessment and management of syncope and transient loss of consciousness in older patients living with frailty? 50 0 = NOT important ___________________________________________________ VERY important = 100 47. What is the effectiveness and cost-effectiveness of medication review and prescription assistance in older patients in the ED? 50 0 = NOT important ___________________________________________________ VERY important = 100 48. What is the association between vital signs (respiratory rate, heart rate, blood pressure, temperature), or standard blood tests (Hb, creatinine, urea, lactate) and relevant clinical outcomes (in-hospital mortality, ICU admission, hospital length of stay) in different age strata (<70, 70-85 years, >85 years)? 50 0 = NOT important ___________________________________________________ VERY important = 100 49. Is muscle mass a predictor of outcomes in older patients who are acutely hospitalised? 50 0 = NOT important ___________________________________________________ VERY important = 100 50. Is a structured interview with caregiver (i.e. IQCODE or Short IQCODE) of confused patient useful to indicate a preexisting cognitive impairment? 50 0 = NOT important ___________________________________________________ VERY important = 100 51. What interventions in the ED are effective and cost-effective in preventing (progression of) delirium in acutely ill older patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 52. Are alternative resuscitation strategies than those used in younger patients more effective in older adults? 50 0 = NOT important ___________________________________________________ VERY important = 100 53. Are patients with dementia presenting with signs of sepsis under-diagnosed in the ED? 50 0 = NOT important ___________________________________________________ VERY important = 100 54. What are the indicators of quality ED care that are important to older patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 55. What is the effect of implementation of Quality Indicators in the ED on outcomes relevant to older patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 56. Which care-plans are most effective for positive patient-related outcomes? 50 0 = NOT important ___________________________________________________ VERY important = 100 57. What Patient Reported Outcome Measure (PROM) for older patients is relevant, usable and valid in the acute care setting? 50 0 = NOT important ___________________________________________________ VERY important = 100 58. What are the outcomes that matter in the ED and post-ED phase for all older people with cognitive impairment and their carers? 50 0 = NOT important ___________________________________________________ VERY important = 100 59. What are effective strategies of (alternative) disposition to improve outcomes (functional status, quality of life) in older ED patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 60. Is age or level of frailty an adequate modifier of triage or treatment strategy in cardiac resuscitation? 50 0 = NOT important ___________________________________________________ VERY important = 100 61. What are the barriers and facilitators (practical, legal, ethical, financial) of successful implementation of a living will in older ED patients? 50 0 = NOT important ___________________________________________________ VERY important = 100 Thank you very much for taking the time to fill in this questionnaire! If you have any remarks, please leave them here and procede to submit the form. reCAPTCHA Submit Δ
