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

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.