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A Modified Delphi Process to Develop Consensus Definitions of Time-Dependent Care by Paramedic Services Systems.

Luc de Montigny^1,2, Ryan Lee³, Eddy S Lang^4,5

¹Urgences-Santé, Montreal, Quebec, Canada.

Prehospital and Disaster Medicine

|November 19, 2025

Summary

This summary is machine-generated.

Researchers defined time-dependent care in paramedicine to improve patient outcomes. A consensus definition and list of 17 time-dependent interventions were established to enhance prehospital care quality.

Keywords:

Emergency Medical Services ambulance paramedicine time factor triage

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Area of Science:

Paramedicine and Emergency Medical Services
Clinical Intervention Research
Healthcare Quality Improvement

Background:

Accurate differentiation of patient acuity is crucial for effective prehospital care and research.
Current vital-sign-based instruments for assessing patient acuity have limitations.
A need exists to complement existing methods with a definition of time-dependent care and interventions.

Purpose of the Study:

To establish a consensus definition of time-dependent care in paramedicine.
To identify and categorize time-dependent interventions in prehospital settings.
To develop a tool for improving prehospital care and system performance.

Main Methods:

A Delphi approach involving four rounds of voting was employed.
A bi-provincial panel of 22 Canadian experts participated, including first responders, paramedics, and physicians.
The panel first agreed on a definition of time-dependent care, then categorized clinical and pharmacological interventions.

Main Results:

A consensus definition was reached: 'A majority of patients who should receive the intervention, according to provincial protocols, would suffer a direct prejudice to their health or safety if the intervention, provided on its own, was not performed within eight minutes of the initial call.'
Consensus was achieved on 52 out of 63 interventions (82.5%).
Seventeen interventions (32.7%) were identified as time-dependent, comprising 11 clinical and 6 pharmacological interventions.

Conclusions:

A consensus definition for time-dependent care in paramedicine was successfully established.
The identified list of time-dependent interventions can serve as a valuable instrument.
This work aims to enhance the quality of prehospital care and overall system performance.