P-19: Development of a theoretical framework for assessment of quality of primary care medical service trips
Dainton, C*, Gorman, C, Chu, CH, Cherniak, W.
Objective: Short-term, primary care medical service trips (MSTs) are increasingly common among
medical professionals and trainees. We aimed to generate expert consensus on an objective, evidence based tool for assessing the quality of volunteer MSTs operating in low resource settings in low and middle income countries (LMICs).
Methods: We constructed a preliminary framework based on the relevant literature on best practices for MSTs, and organized the relevant items into 6 major quality domains (Preparedness, Impact and safety, Efficiency, Cost-effectiveness, Sustainability, and Education), with 32 corresponding minor factors. Structured eDelphi feedback was solicited from 26 MST experts and stakeholders from across North America, recruited from four categories: public health/academics, medical professionals (clinicians, nurses, pharmacists), MST program coordinators, and non-medical MST volunteers. Levels of agreement with prompts based on the minor factors were assessed on a 7-point Likert scale, and scores >2 (moderate agreement or worse) were re-distributed to panelists in Round 2 and 3 for further discussion.
Results: There was strong agreement (mean score 1-2) on 14 of the core best practice elements of a quality MST, and moderate agreement (mean score 2-3) on a further 16 elements. Elements related to Impact and safety, and Cost effectiveness generated the most controversy.
Conclusion: Evaluation of core best practice elements may be broadly useful to medical professionals
and trainees selecting a high quality short-term volunteer opportunity that adheres to consensus ethical
standards. Future research should solicit feedback from host communities and local clinicians, and assess adherence to these principles by actual MST-sending organizations.