Criteria For Agreement When Conducting Local Consensus Discussions: A Qualitative Study.

Purpose: Healthcare is a complex, multi-layered team environment where effective change often requires reaching consensus among relatively autonomous stakeholders. Although conducting informal consensus discussions is a frequently used implementation strategy in real-world clinical settings, limited...

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Publicado en:Journal of Healthcare Leadership Vol. 17; pp. 159 - 173
Autores principales: Pagano, Lisa, Long, Janet C, Francis-Auton, Emilie, Hirschhorn, Andrew, Braithwaite, Jeffrey, Arnolda, Gaston, Sarkies, Mitchell N
Formato: research tables/charts Journal Article
Publicado: Dove Medical Press Ltd May2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2025
      vid: 17
      pid: 45064
      pub: Dove Medical Press Ltd
      place: Auckland, <Blank>
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        10.2147/JHL.S522784
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        atl: Criteria For Agreement When Conducting Local Consensus Discussions: A Qualitative Study.
      aug:
        au:
          Pagano, Lisa
          Long, Janet C
          Francis-Auton, Emilie
          Hirschhorn, Andrew
          Braithwaite, Jeffrey
          Arnolda, Gaston
          Sarkies, Mitchell N
      sug:
        subj:
          Personnel, Health Facility Psychosocial Factors
          Consensus
          Discussion
          Conceptual Framework
          Decision Making
          Perioperative Care Standards
          Health Personnel Psychosocial Factors
          Health Facility Administrators Psychosocial Factors
          Leadership
          Human
          Male
          Female
          Australia
          Hospitals, Private
          Qualitative Studies
          Grounded Theory
          Convenience Sample
          Semi-Structured Interview
          Thematic Analysis
          Funding Source
          Implementation Science
          Accountability
          Collaboration
          Male
          Female
      ab: Purpose: Healthcare is a complex, multi-layered team environment where effective change often requires reaching consensus among relatively autonomous stakeholders. Although conducting informal consensus discussions is a frequently used implementation strategy in real-world clinical settings, limited information exists about what defines consensus when using these methods. Specifying the criteria for consensus is important, as it can shape the design of consensus-building strategies. This study aimed to identify and define the key domains of consensus used in local consensus discussions to standardise healthcare practices. Patients and Methods: A qualitative study was conducted in one private hospital in Australia using a modified, grounded theory methodology. Clinical, non-clinical and leadership staff involved in developing standardised perioperative pathways using informal consensus discussions were recruited. Data were collected via semi-structured interviews and naturalistic participant observations between February 2023 and May 2024. Data collection and analysis occurred concurrently until theoretical saturation was achieved. Data were analysed using open coding with constant comparison, focussed and theoretical coding to develop theoretical concepts. Results: Sixteen hours of observations with 31 participants and nine semi-structured interviews were conducted. Analysis identified four distinct consensus criteria: i) unanimous consensus, ii) delegated consensus, iii) assumed consensus and iv) concessional consensus. While unanimity was the preferred outcome, other consensus types emerged as viable alternatives when unanimous agreement was challenging to achieve. Each criterion had differing factors and mechanisms which influenced reaching the consensus criterion, underpinning assumptions, and considerations for practice, which formed four domains of consensus. Conclusion: These domains provide a structured framework for classifying consensus criteria when conducting local consensus discussions in healthcare. The findings broaden our understanding of consensus in local healthcare discussions, moving beyond a singular focus on unanimity. By clearly defining consensus types, organisations can strategically select consensus methods that best support decision-making and intervention implementation.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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