Mayo Clinic Children's Center, Rochester, Minnesota;
Mayo Clinic Children's Center, Rochester, Minnesota.
Pediatrics. 2018 Mar;141(3). doi: 10.1542/peds.2017-1701. Epub 2018 Feb 7.
Aerodigestive programs provide coordinated interdisciplinary care to pediatric patients with complex congenital or acquired conditions affecting breathing, swallowing, and growth. Although there has been a proliferation of programs, as well as national meetings, interest groups and early research activity, there is, as of yet, no consensus definition of an aerodigestive patient, standardized structure, and functions of an aerodigestive program or a blueprint for research prioritization. The Delphi method was used by a multidisciplinary and multi-institutional panel of aerodigestive providers to obtain consensus on 4 broad content areas related to aerodigestive care: (1) definition of an aerodigestive patient, (2) essential construct and functions of an aerodigestive program, (3) identification of aerodigestive research priorities, and (4) evaluation and recognition of aerodigestive programs and future directions. After 3 iterations of survey, consensus was obtained by either a supermajority of 75% or stability in median ranking on 33 of 36 items. This included a standard definition of an aerodigestive patient, level of participation of specific pediatric disciplines in a program, essential components of the care cycle and functions of the program, feeding and swallowing assessment and therapy, procedural scope and volume, research priorities and outcome measures, certification, coding, and funding. We propose the first consensus definition of the aerodigestive care model with specific recommendations regarding associated personnel, infrastructure, research, and outcome measures. We hope that this may provide an initial framework to further standardize care, develop clinical guidelines, and improve outcomes for aerodigestive patients.
航空消化计划为患有影响呼吸、吞咽和生长的复杂先天性或后天性疾病的儿科患者提供协调的跨学科护理。尽管航空消化计划已经激增，以及全国性会议、利益集团和早期研究活动，但迄今为止，还没有航空消化患者的共识定义、航空消化计划的标准化结构和功能，以及研究优先级的蓝图。多学科和多机构的航空消化提供者小组使用 Delphi 方法就与航空消化护理相关的 4 个广泛内容领域达成共识：（1）航空消化患者的定义，（2）航空消化计划的基本结构和功能，（3）确定航空消化研究重点，以及（4）航空消化计划的评估和认可以及未来方向。在进行了 3 次迭代调查后，通过 75%的超级多数或在 36 项中的 33 项的中位数排名稳定来获得共识。这包括航空消化患者的标准定义、特定儿科专业在计划中的参与程度、护理周期的基本组成部分和计划的功能、喂养和吞咽评估和治疗、程序范围和数量、研究重点和结果衡量标准、认证、编码和资金。我们提出了航空消化护理模式的第一个共识定义，并提出了有关相关人员、基础设施、研究和结果衡量标准的具体建议。我们希望这可以为进一步规范护理、制定临床指南和改善航空消化患者的结果提供初步框架。
