Table 2 Final components with ≥80% agreement from Delphi panelists
From: Early supported hospital discharge for foot disease: a co-design study
Component | Specific component | % agreement |
|---|---|---|
New personnel requirements | A full time nurse care co-ordinator | 87% |
In home podiatry 1 day per week for wound debridement | 87% | |
Inpatient process components | Identify who needs to be involved in patient’s care on admission and alert the relevant teams | 87% |
Early referral to treating team (endocrinology, and seen within 24–48 h | 87% | |
Shared care between consultants allowing vascular consultants to make decisions or change management as required on other team members behalf | 93% | |
All lower limb wound patients co-located on the same inpatient ward | 87% | |
Multidisciplinary ward round including vascular, infectious diseases, endocrinology and allied health representation from dietetics, physiotherapy and occupational therapy | 80% | |
Orthotist review within 24 h of admission (24 h if not admitted late on Friday)a | 80% | |
Dedicated multidisciplinary foot unit to include input from dietetics, physiotherapy and occupational therapy hours | 80% | |
Discharge process components | Comprehensive management plan in place for patient prior to discharge | 100% |
Information provided to GPs around contacts and referral point of access | 93% | |
Referrals in place for hospital in the home support for patients prior to discharge | 86% | |
Patients appointed a care-coordinator to make contact prior to discharge to support and co-ordinate discharge process | 80% | |
Offloading requirements in place prior to discharge | 86% | |
Outpatient process components | Full time nurse care coordinator to act as a single point of contact for patients and GP’s, co-ordinating discharge, following up patients at home and providing reminder for appointments and managing failures to attend | 86% |
Appropriate care of the wound in the home in place (could be hospital in the home, district nursing, allied health home visit, or hospital outpatient visits dependent on patient needs and preferences) | 86% | |
Exclusion criteria | Cognitive impairment | 93% |
Less than 3 days wait for inpatient angiogram and/or angioplasty | 93% |