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Criteria For Agreement When Conducting Local Consensus Discussions: A Qualitative Study.

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Summary

This study identified four consensus criteria—unanimous, delegated, assumed, and concessional—used in healthcare settings. Understanding these criteria helps organizations select appropriate consensus methods for better decision-making and implementation.

Keywords:
consensus-buildingdecision-makinghealthcareimplementation scienceperioperative pathwaysqualitative research

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Area of Science:

  • Healthcare management
  • Organizational behavior
  • Clinical practice standardization

Background:

  • Healthcare settings are complex team environments requiring consensus among autonomous stakeholders for effective change.
  • Informal consensus discussions are common implementation strategies, but criteria for consensus are often undefined.
  • Defining consensus criteria is crucial for designing effective consensus-building strategies.

Purpose of the Study:

  • To identify and define key domains of consensus in local consensus discussions.
  • To standardize healthcare practices through a better understanding of consensus criteria.
  • To move beyond a singular focus on unanimity in healthcare decision-making.

Main Methods:

  • Qualitative study using modified grounded theory in an Australian private hospital.
  • Recruited clinical, non-clinical, and leadership staff involved in standardizing perioperative pathways.
  • Data collected via semi-structured interviews and participant observation; analyzed concurrently using coding techniques.

Main Results:

  • Identified four distinct consensus criteria: unanimous, delegated, assumed, and concessional consensus.
  • Unanimity was preferred, but other types emerged as viable alternatives.
  • Each criterion involved unique factors, mechanisms, assumptions, and practice considerations, forming four domains of consensus.

Conclusions:

  • Developed a structured framework for classifying consensus criteria in healthcare.
  • Broadened understanding of consensus beyond unanimity in local healthcare discussions.
  • Enables organizations to strategically select consensus methods for improved decision-making and implementation.