Table 1 The nominal group process

Introduction

The purpose of the study and nominal group process was explained, and the value of each participant’s opinion(s) was reinforced.

Silent generation

Participants were encouraged to record, in silence, as many broad or specific ideas as possible in five minutes, to the following research question: Imagine an ideal healthcare service several years into the future, what should this service look like? The aim of this open ended question was to allow participants to think in-depth, about the healthcare they wanted in the future. Participants who had difficulty writing were encouraged to silently think about their answers, or a facilitator assisted them with writing their ideas down.

Round robin

Participant ideas were elicited in a round robin fashion, i.e. everyone had an opportunity to contribute one idea at a time, until all ideas were exhausted. One researcher recorded the ideas verbatim on a whiteboard in front of all participants. Some new ideas were also generated during this process; however, discussion was kept to a minimum to ensure each person felt comfortable to share their idea.

Clarification

In this phase, the group was asked to clarify ambiguous ideas to ensure that the meaning was clearly understood by all participants. The group facilitators remained neutral to the group’s discussion. Similar ideas were then grouped together if there was consensus, and a letter was allocated to each idea for ranking purposes.

Ranking

Participants were asked to individually select their top five ideas, and then rank them in terms of priority, with five marks allocated to their top, and one mark to their lowest, priority.

Discussion

Individual votes for the group were collated for feedback purposes, thus allowing participants the opportunity to discuss their priorities as a group. This final procedure ensured face validity of the healthcare priorities.