Table 3.
Survey Items That Achieved Consensus After 3 Rounds of the Delphi Exercise, and Their Delphi Rating
| Item | Consensus | Delphi Rating |
|---|---|---|
| The importance of the following groups targeted in academic detailing | ||
| 1. Clinicians | Critical | Essential 83%; Very important 17% |
| 2. Patients | Not critical | Somewhat important 67%; Not at all important 17% |
| The importance of the following factors in selecting providers for academic detailing | ||
| 1. Geographic | Critical | Essential 11%; Very important 83% |
| 2. Specialty or specific setting | Critical | Essential 22%; Very important 72% |
| 3. Patient population | Critical | Essential 12%; Very important 71% |
| 4. Pattern of care | Critical | Essential 6%; Very important 82% |
| The importance of the following components in academic detailing interventions | ||
| 1. Clinician education | Critical | Essential 79%; Very important 16% |
| 2. Feedback about clinical performance | Critical | Essential 11%; Very important 78% |
| 3. Recommendations about practice change | Critical | Essential 61%; Very important 39% |
| 4. Opinion leaders | Critical | Essential 6%; Very important 78% |
| 5. Commitment to change | Critical | Essential 28%; Very important 67% |
| 6. Best practices | Critical | Essential 28%; Very important 67% |
| 7. Decision support | Critical | Essential 82%; Very important 0% |
| 8. Patient education | Not critical | Somewhat important 72%; Not at all important 6% |
| 9. Patient reminders | Not critical | Somewhat important 67%; Not at all important 22% |
| 10. Patient care equipment | Not critical | Somewhat important 78%; Not at all important 11% |
| 11. Financial and other incentives | Not critical | Somewhat important 72% Not at all important 11% |
| 12. Practice facilitation | Not critical | Somewhat important 71%; Not at all important 0% |
| 13. Technical and other assistance | Not critical | Somewhat important 82%; Not at all important 0% |
| 14. Patient resources | Not critical | Somewhat important 71%; Not at all important 0% |
| 15. Community resources | Not critical | Somewhat important 88%; Not at all important 0% |
| 16. Documentation tools for clinicians | Not critical | Somewhat important 82%; Not at all important 0% |
| 17. Care coordination | Not critical | Somewhat important 59%; Not at all important 26% |
| 18. Continuing education guidance | Not critical | Somewhat important 77%; Not at all important 12% |
| 19. Social marketing | Not critical | Somewhat important 65%; Not at all important 18% |
| The importance of the following outcomes in evaluating academic detailing interventions | ||
| 1. Clinician behavior or performance | Critical | Essential 83%; Very important 17% |
| 2. Patient outcomes | Critical | Essential 6%; Very important 72% |
| 3. Clinician knowledge or awareness | Critical | Essential 28%; Very important 56% |
| 4. Resource utilization | Critical | Essential 6%; Very important 84% |
| 5. Clinician attitude | Critical | Essential 12%; Very important 71% |
| 6. Clinician skill | Not critical | Somewhat important 72%; Not at all important 0% |
| 7. Care intensity | Not critical | Somewhat important 78%; Not at all important 6% |
| 8. Changes in educational activities | Not critical | Somewhat important 73%; Not at all important 11% |
| 9. Changes in workflow | Not critical | Somewhat important 89%; Not at all important 6% |
| 10. Family satisfaction | Not critical | Somewhat important 61%; Not at all important 28% |
| 11. Prevalence of condition or disease | Not critical | Somewhat important 77%; Not at all important 0% |
| The importance of the following qualifications for academic detailers | ||
| 1. Physician | Critical | Essential 12%; Very important 71% |
| 2. Pharmacist | Critical | Essential 6%; Very important 77% |
| 3. Clinical or health educator | Not critical | Somewhat important 88%; Not at all important 0% |
| 4. Quality improvement expert | Not critical | Somewhat important 53%; Not at all important 35% |
| 5. Public health practitioner | Not critical | Somewhat important 67%; Not at all important 22% |
| 6. Pharmaceutical industry representative | Not critical | Somewhat important 11%; Not at all important 89% |
| 7. Nurse | Not critical | Somewhat important 72%; Not at all important 6% |
| The importance of the following elements of information in academic detailing interventions | ||
| 1. Discussion: barriers and solutions | Critical | Essential 83%; Very important 17% |
| 2. Discussion: challenging cases | Critical | Essential 11%; Very important 78% |
| 3. Discussion: feasibility | Critical | Essential 33%; Very important 61% |
| 4. Discussion: context | Critical | Essential 29%; Very important 65% |
| 5. Discussion: quality improvement approach, strategies, interventions | Critical | Essential 53%; Very important 35% |
| 6. Ad hoc visits, resources, and support upon request | Critical | Essential 18%; Very important 71% |
| 7. Discussion: general progress | Critical | Essential 65%; Very important 18% |
| 8. Model of discussion or teaching technique | Not critical | Somewhat important 83%; Not at all important 6% |
| 9. Role playing | Not critical | Somewhat important 67%; Not at all important 17% |
| 10. Meetings with peers and specialists facilitated | Not critical | Somewhat important 88%; Not at all important 0% |
| 11. Ongoing needs assessment | Not critical | Somewhat important 71%; Not at all important 0% |
| The importance of training in the following areas for academic detailers | ||
| 1. Academic detailing process | Critical | Essential 94%; Very important 0% |
| 2. Anticipated barriers | Critical | Essential 89%; Very important 11% |
| 3. Behavior change and persuasion | Critical | Essential 83%; Very important 11% |
| 4. Communication and interpersonal skills | Critical | Essential 94%; Very important 6% |
| 5. Content of study | Critical | Essential 83%; Very important 11% |
| 6. Debriefing on visits | Critical | Essential 17%; Very important 72% |
| 7. Education | Critical | Essential 17%; Very important 83% |
| 8. Supervising observations | Critical | Essential 0%; Very important 77% |
| 9. Rehearsals/role playing | Critical | Essential 72%; Very important 17% |
| 10. Resources and interventions being offered | Critical | Essential 56%; Very important 39% |