Table 3 Cross-referencing of Delphi best-practice rheumatology service statements to themes from patient data, and generation of new statements and overarching principles to themes without a match
Subthemes | Mapped to Delphi best practice statement (No or number of statement) | Statement or principle encompassing patient views derived from data |
|---|---|---|
Value individuals and their experiences | No | New principle 1: A rheumatology service should value individuals and their experiences through positive interpersonal interactions, supportive relationships and within a health system organised with the patients’ needs at the centre |
System | No | |
Interpersonal | No | |
Relationship with professionals is supportive | No | |
Importance of relationships with professionals in the rheumatology service | No | New statement 23: Patients should have specific rheumatologist(s) responsible for their care and be provided with the names and roles of other medical, nursing, allied health and administrative staff who may be involved in their care |
Rheumatologists | No | |
Nurses | No | |
Support/admin staff organising appointments | No | |
Supporting self-management | No | New principle 2: Healthcare professionals in a rheumatology service actively support patients to participate in decision-making and self-management |
Supporting active participation in decision-making and care | No | |
Education requirements met | 5 | New principle 3: Healthcare professionals in a rheumatology service should ensure patients’ education requirements about their rheumatic condition are met; including appropriate communication, content, and framed to support patients’ active involvement in shared decision-making |
Right language for effective communication | No | |
About condition and management | No | |
To make informed decisions | No | |
Rheumatology specialist care | 4, 16 | |
Timeliness | 2, 3, 16 | |
Of diagnosis | 2,3,16 | |
Appointments (including appointment certainty) | No | Carer—Outside of rheumatology—primary/community health provision |
Appropriately responsive care access mechanisms | 8, 16, 21 | |
Patient-factors related to access | 20 | |
Telehealth | 20 | |
Funding | No | Funding for allied health—Outside of rheumatology—primary/community health provision |
Mobility pass | No | Mobility pass—Outside of rheumatology—primary/community health provision |
Access to rheumatology nurses is highly important | 3, 5, 6, 7, 8 | NEW STATEMENT 24: A public rheumatology service should involve at least one full time equivalent (FTE) rheumatologist nurse per FTE rheumatologist |
Between appointments | 7 | |
Nurse phone line | 6, 7 | |
Access to Pain MDT—Outside of rheumatology—Other DHB service | ||
Co-ordinated care and other aspects of care | 15 | |
Between specialists | 15 | |
Between DHBs | No | DHB/service communication Outside of rheumatology—whole of DHB |
Across disciplines (non-specialist) | No | DHB/service communication Outside of rheumatology—whole of DHB |
Allied health | 9, 10, 11, 15 | |
Physiotherapy | 11 | |
Occupational therapy | 9 | |
Personal trainer | No | Personal trainer—Outside of rheumatology—primary/community health provision |
Carer | No | Carer—Outside of rheumatology—primary/community health provision |
Orthotics/podiatrist | 10 | |
Pharmacy | No | Pharmacist—Outside of rheumatology—primary/community health provision |
Oral hygienist | No | Dental hygienist—Outside of rheumatology—primary/community health provision |
Access to specialist multidisciplinary care when relevant | 13 | |
Pain | 13 | |
System navigation | No | New statement 25: Rheumatology services should actively provide information to patients with rheumatic diseases about outside services or providers that provide social, emotional or practical support |
Support groups | No | |
Other services | No | |
Access to personal health information | No | Access to personal health information—Outside of rheumatology—whole of DHB |