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Establishing primary care physician commitment in Canadian long-term care homes: a protocol for a modified e-Delphi

Darly Dash1, Maya Potter2, Henry Yu-Hin Siu3

  • 1Department of Health Research Methods, Evidence, and Impact, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada.

BMJ Open
|February 7, 2025
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Summary

Establishing a Canadian standard for primary care physician commitment in long-term care homes is crucial for improving resident care quality. This study aims to reach consensus on defining physician commitment in this setting.

Keywords:
Delphi TechniqueNursing HomesPhysiciansPrimary Care

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Area of Science:

  • Healthcare delivery
  • Geriatric medicine
  • Medical practice management

Background:

  • Primary care physician (PCP) commitment in Canadian long-term care (LTC) homes is inconsistent.
  • A lack of standardized expectations for PCP involvement may impact the quality of care and resident health outcomes.
  • Defining PCP commitment is theorized by practice proportion, resident load, and time per encounter.

Purpose of the Study:

  • To establish consensus on the expectations for primary care physician commitment in Canadian long-term care settings.
  • To develop a Canadian standard for PCP engagement in LTC homes.
  • To inform best practices for medical care delivery in LTC.

Main Methods:

  • A modified two-round e-Delphi study protocol guided by RAND and ACCORD methodologies.
  • Recruitment of pan-Canadian experts in LTC medical care delivery.
  • Literature review to generate candidate statements on PCP commitment, followed by online questionnaires and a virtual synchronous meeting.

Main Results:

  • The study protocol outlines a rigorous consensus-building process.
  • Expert panel input will be gathered through iterative questionnaires and discussions.
  • The findings will lead to a defined set of consensus-based expectations for PCP commitment.

Conclusions:

  • Consensus on PCP commitment expectations is essential for standardizing care in Canadian LTC homes.
  • This research will contribute to improved quality of care and health outcomes for LTC residents.
  • The established consensus will provide a foundation for future policy and practice guidelines.