title: Achieving consensus in follow-up practice for routine ENT procedures: a Delphi exercise.
abstract: OBJECTIVE
  To generate consensus amongst faculty members regarding follow-up practice for well-defined clinical scenarios using a Delphi exercise and to identify whether disseminating the consensus guidelines changed follow-up practice.
  
  
  METHODS
  Generation of consensus using a Delphi exercise and an audit of follow-up practice before and after dissemination of the resultant guidelines.
  
  
  METHODS
  The department of Otorhinolaryngology-Head and Neck Surgery at the Freeman Hospital, Newcastle upon Tyne, UK.
  
  
  METHODS
  Panel members for this exercise included 11 consultants and two associate specialists and one co-ordinator. We identified clinical scenarios where ≥ 80% agreement existed that routine follow-up appointments should not be made and subsequently disseminated guidelines widely to all medical staff. The follow-up rates for the scenarios where consensus existed regarding follow-up practice were audited from clinic letters before and after the guidelines were disseminated.
  
  
  METHODS
  Agreement on scenarios where routine follow-up appointments should not be made was assessed using a Likert scale (1-5).
  
  
  RESULTS
  Of 13 faculty members, 12 responded to rounds one and two, and 11 responded to round three. The Delphi exercise identified 18 clinical scenarios where there was ≥ 80% agreement on patients not routinely being followed up. Comparison of the follow-up practice prior to and after the Delphi exercise identified a reduction in follow-up for all 18 scenarios of 48%.
  
  
  CONCLUSIONS
  Consensus regarding routine follow-up can be reached by using the Delphi process in ENT practice. This can translate into a real change in clinical practice. Furthermore, this process could be applied for consensus building in other related areas.
authors.affiliation: The Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Road, Newcastle upon Tyne, NE7 7DN, UK.
authors.forename: J
authors.initials: J
authors.lastname: Powell
authors.forename: H
authors.initials: H
authors.lastname: El Dean
authors.forename: S
authors.initials: S
authors.lastname: Carrie
authors.forename: J A
authors.initials: JA
authors.lastname: Wilson
authors.forename: V
authors.initials: V
authors.lastname: Paleri
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D032921:Consensus; D003695:Delivery of Health Care / Q000592:standards*; D003697:Delphi Technique; D005500:Follow-Up Studies; D006801:Humans; D010036:Otolaryngology / Q000592:standards*; D013517:Otorhinolaryngologic Surgical Procedures / Q000592:standards*; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires; D006113:United Kingdom