Developing consensus for definitions of key veterinary-specific quality improvement (QI) terms using an eDelphi-study method.

BACKGROUND: Quality improvement (QI) methods are a continuous process of iterative tests to improve the quality of a service or product. Using common language has been linked to the successful implementation of QI in human healthcare. This study aimed to assimilate and achieve consensus on veterinary-specific definitions for terms associated with quality care and QI methods in UK veterinary practice. METHODS: A four-round modified eDelphi process with a panel of 50 UK veterinary practice stakeholders was used to generate consensus. The panel selected or suggested the definition they best felt 'fitted' each term. Consensus was reached if there was >70% agreement, and terms were eliminated if there was <15% selection. RESULTS: Thirty-one panellists completed all three rounds of eDelphi; eight participants completed an optional feedback round. From 14 terms, 10 reached consensus, leaving four unresolved definitions. CONCLUSIONS: A majority of terms reached consensus; 90% were new or amended definitions proposed by panel members. Utilising plain English refined by stakeholders will allow successful implementation of QI in veterinary healthcare. Not all terms achieved consensus, highlighting a need for further research to enable successful integration of QI principles as seen in human healthcare.

Quantitative Outcomes of a One Health approach to Study Global Health Challenges.

Having gained momentum in the last decade, the One Health initiative promotes a holistic approach to address complex global health issues. Before recommending its adoption to stakeholders, however, it is paramount to first compile quantitative evidence of the benefit of such an approach. The aim of this scoping review was to identify and summarize primary research that describes monetary and non-monetary outcomes following adoption of a One Health approach. An extensive literature search yielded a total of 42,167 references, of which 85 were included in the final analysis. The top two biotic health issues addressed in these studies were rabies and malaria; the top abiotic health issue was air pollution. Most studies described collaborations between human and animal (n = 42), or human and environmental disciplines (n = 41); commonly reported interventions included vector control and animal vaccination. Monetary outcomes were commonly expressed as cost-benefit or cost-utility ratios; non-monetary outcomes were described using disease frequency or disease burden measurements. The majority of the studies reported positive or partially positive outcomes. This paper illustrates the variety of health challenges that can be addressed using a One Health approach, and provides tangible quantitative measures that can be used to evaluate future implementations of the One Health approach.