Planning a coordinated local health care system response to a pandemic using an accelerated Delphi technique: Phase 1

Abstract

Objectives: To coordinate local responsibilities and identify options to enhance local health system capacity during a pandemic. The purpose of this paper is to illustrate the application of a Delphi exercise in an Ontario Public Health Unit as a first step in this complex planning task. Its strengths and weaknesses are presented. Participants: Stakeholders representing nine categories of health care organizations. Setting: Public Health facilitated the Delphi process. Intervention: The exercise occurred in three rounds. In round 1, stakeholders identified a series of questions pertaining to the subject. Round 2 involved formulation of issue-related statements outlining possible strategies or solutions. Level of agreement regarding the statements by panel members were indicated. In round 3, a facilitated face-to-face meeting allowed statements to be fed back to the panel, enabling discussion of their own and other panel members' previous statement views. Outcomes: Statements were formulated from questions generated by the expert panel, collated into categories and sent to all panel members. A total of 72 unique statements were developed. Agreement was obtained for 56 of the statements. Conclusion: The Delphi exercise proved to be an effective approach to commence planning a coordinated local health system response to a pandemic. This process permitted advancement of the planning exercise to Phase 2 which aimed to develop operational plans for primary assessment centres, alternate care sites and hospital surge capacity.