Reporting System of Patients' Safety Management Established By the Delphi Method about Psychological Evaluation, Intervention and the Psychological Critical Value

  Objective  To explore the feasibility of establishing a reporting system of patients' safety management by the Delphi method about psychological evaluation, intervention and the psychological critical value.

  Methods  Based on literature review, we used the modified delphi method to study 14 indexes of safety management of patients in terms of psychological evaluation and intervention. Questionnaires were sent to 43 experts to solicit the opinions about patients' safety management regarding psychological assessment dimensions, suggestions on quantitative score, assessment method, assessment grading, and assessment principles of each dimension. According to the experts' opinion, the average value and the coefficient of variation of each index were calculated to form the preliminary construction of a reporting system of patients' safety management in terms of psychological evaluation, intervention and psychological critical value, and the feasibility of the system was discussed.

  Results  After six rounds of discussion of the experts, 43 questionnaires were sent to experts, and 35 ones (81.4%) were returned. In the evaluation of the importance and urgency of the 14 assessment indicators, the coefficient of experts' participation was 0.97; the Kendall W coefficient of importance was 0.241 (P < 0.001), the coefficient of the urgency was 0.283 (P < 0.001). The authority coefficient of experts ranged from 0.68 to 0.74. After the discussion of the experts, 12 indicators were approved to be included in the psychological evaluation system about patients' safety management: suicide risk, depression, anxiety, excessive treatment expectation, expectation of doctor-patient relationship, agitation, hallucination, delusion, delirium, alcohol addiction, drug abuse and occupational exhaustion. The evaluation method should include patients' self-evaluation and medical observation. According to the consulting meeting of the experts, graded intervention should be performed in the results of psychological assessment of patients' safety management, and the highest warning level should be measured and set according to the standard of the critical value. The expert-group considered that it is feasible to establish psychological evaluation indexes and corresponding intervention measures.

  Conclusions  The system framework of indicators of psychological assessment and hierarchical intervention system for the management of patients' safety has been established by the delphi method. On this basis, detailed methods and tools can be further formulated and trial practice can be carried out.