There is a paucity of literature evaluating mass casualty systems and no clear 'gold standard' for measuring the efficacy of information decision support systems or triage systems that can be used in mass casualty events. The purpose of this research was the preliminary validation of a comprehensive conceptual model for a mass casualty continuum of care. This research examined key relationships among entities/factors needed to provide real-time visibility of data that track patients, personnel, resources and potential hazards that influence outcomes of care during mass casualty events.A modified Delphi technique was used to validate the proposed model using a panel of experts. The four research questions measured the extent to which experts agreed that the: 1) ten constructs represent appropriate predictors of outcomes of care during mass casualty events; 2) proposed relationships among the constructs provide valid representations of mass casualty triage; 3) proposed indicators for each construct represent appropriate measurements for the constructs; and 4) the proposed model is seen as useful to the further study of information and technology requirements during mass casualty events. The usefulness of the online Delphi process was also evaluated.A purposeful sample of 18 experts who work in the field of emergency preparedness/response was selected from across the United States. Computer, Internet and email applications were used to facilitate a modified Delphi technique through which experts provided initial validation for the proposed conceptual model. Two rounds of the Delphi process were needed to satisfy the criteria for consensus and/or stability related to the constructs, relationships and indicators in the model. Experts viewed the proposed model as relatively useful (Mean = 5.3 on a 7-point scale). Experts rated the online Delphi process favorably.Constructs, relationships and indicators presented in this model are viewed as preliminary. Future research is needed to develop the tools to measure the constructs and then test the model as a framework for studying effects and outcomes of mass casualty events. This study provides a foundation for understanding the complex context in which mass casualty events take place and the factors that influence outcomes of care.

The study examines the relationship between professional players and their motivations in profession gaming. With the theoretical framework of Bartle's Quotient and the ERG theory, the study indicates and clarifies the motivations of professional gamers through Delphi Process. Tournament prizes, money, approval by others, competition, sense of accomplishments, and self-actualization are the critical motivations that grant these professionals the encouragement to excel. Such essential information could be very useful for game developers to create a competitive game with a friendly environment for professional gamers.

Organizational readiness for implementation (ORI) is a critical barrier to successfully implementing evidence-based practices (EBPs) that support the recovery of people with severe mental illnesses (SMI). Despite the importance of ORI, to date, no approach for enhancing readiness across an organization has been developed. The two studies conducted as part of this dissertation aimed to identify, organize, and confirm potential strategies to support ORI enhancement in community mental health (CMH) services. Study findings may inform the development of practices to increase ORI, and thus optimize implementation of evidence-based practices in the CMH services. The first study aimed to develop a typology of pre-implementation strategies focused on ORI enhancement. A panel of implementation experts participated in a modified Delphi process to classify pre-implementation strategies into stages of organizational readiness. The experts selected strategies from a well-accepted compilation of 73 implementation strategies, developed as part of the Expert Recommendations for Implementing Change (ERIC) project. The Transtheoretical Model of behavioral change guided the experts in choosing strategies relevant during pre-implementation and classifying them into three readiness stages: Pre-contemplation, Contemplation, and Preparation. The experts identified 48 of the ERIC strategies as relevant to pre-implementation readiness enhancement and agreed on their classification into the three ORI stages. Several strategies were identified as relevant to more than one stage. The purpose of the second study was to confirm and expand the expert-based typology based on empirical data relevant to the implementation of mental health evidence-based practices. The study employed qualitative methods to learn about the experiences of various CMH stakeholders who participated in a recent implementation project. Participants’ feedback about the use of different ORI strategies was compared with the expert-based typology to identify consistencies and discrepancies. Two-thirds of the strategies and their ORI stage designation suggested by the experts were congruent with the second study participants' experiences. Participants also assigned several strategies to different stages than those indicated by the experts and mentioned additional strategies not included in the expert-based typology. The second study highlighted the applicability of the expert-based typology to the CMH field and offered suggestions for potential expansions. Together, these two studies provide an essential step towards conceptualizing and operationalizing the construct of ORI and the strategies for enhancing it in the CMH context. The high congruence between experts and implementers suggests the applicability of the Transtheoretical model for organizing the strategies associated with each stage. This dissertation provides a promising foundation for the future development of a systematic approach to ORI enhancement at various levels of readiness for a practice change. Direct targeting of ORI enhancement could increase the uptake of EBPs and ensure that more people with SMI benefit from state-of-the-art interventions supporting their recovery. / 2023-05-14T00:00:00Z

The medical laboratory science (MLS) profession is in need for published molecular diagnostics competency-based standards and curriculum. To assess their expectations of new MLS graduates, professionals performing and supervising performance of clinical molecular assays were surveyed to rate the importance of relevant cognitive and psychomotor learning objectives. A modified, asynchronous, iterative online Delphi process was utilized for assessment of consensus on the importance of the objectives. The survey was delivered through online REDCap application. Program directors of 221 MLS programs accredited by the National Accrediting Agency for Clinical Laboratory Science (NAACLS) were asked to forward the first Delphi survey to target participants at their affiliated clinical sites. Ninety-four experts submitted complete surveys, including 88 who provided email addresses, indicating agreement to participate in future Delphi rounds. Most of the participants were certified by ASCP or NCA (81.9%), had over 10 years of laboratory experience (76.6%), and worked in a hospital setting (43.6%). The reliability of the surveys, assessed using Cronbach’s alpha, was 0.96 and 0.97. In the second survey, the objectives assigned low importance by the majority were removed; and others, assigned high importance were expanded. Respondents were given the opportunity to confirm or change their opinion on the objectives after reviewing quantitative results and narrative comments collected in the preceding survey. Upon completion of the Delphi process, 25 essential items were identified as necessary for inclusion in the entry-level MLS curriculum. These concepts and objectives focused on basic molecular biology principles and general molecular laboratory operations, including practical knowledge of techniques designed to maintain specimen integrity and intense theoretical background of the polymerase chain reaction, as well as comprehension of the principles of laboratory assays designed for pathogens most commonly tested for using molecular methods. In this study, the investigator also provided information on the preferred number of contact hours devoted to each group of the identified essential items. The goal of creating the list of essential concepts and objectives was to share it with MLS educators, the NAACLS and the provider of MLS certification exam, the American Society for Clinical Pathology Board of Certification (ASCP-BOC), to contribute to the existing exam content guidelines.

The problem of this study was the description of two year college instructional and vocational-technical administrators' expectations concerning the enrollment of adults over thirty years of age in two-year colleges and the colleges' need to respond to this population. Ninety of 125 Texas administrators eligible to participate and the Delphi process developed a consensus of opinion. The Delphi process consists of a series of three rounds of solicitation of opinion from panelists through responses to questionnaires and controlled feedback to the panelists of information relevant to the issue in the form of a group statistical response.