Building Timely Consensus Among Diverse Stakeholders: An Adapted Nominal Group Technique.

Abstract

Building timely consensus among diverse stakeholders is important in primary health care research. Consensus can be obtained using the nominal group technique which includes 5 steps: (1) introduction and explanation; (2) silent generation of ideas; (3) sharing ideas; (4) discussion; and (5) voting and ranking. The main challenges in using this technique are a lack of representation of different stakeholder opinions and the amount of time taken to reach consensus. In this paper, we demonstrate how to effectively achieve consensus using an adapted nominal group technique that mitigates the challenges. This project aimed to reach consensus on the priority care domains for individuals aged 65 or older, using an adapted nominal group technique with 4 strategies: (1) recruit 4 stakeholders groups (older people, clinicians, managers, decision makers) by using maximum variation and snowballing sampling approaches; (2) use remote tools to ensure high participation; (3) add an individual pre-elicitation activity to increase effectiveness; and (4) adapt discussions to the stakeholders' preferences for meaningful engagement. In total, 28 diverse stakeholders participated. After the pre-elicitation activity and 1 round of group discussion, we reached consensus on a priority domain called symptoms, functioning, and quality of care. Adaptive group discussions and remote tools were the most effective strategies. All participants strongly agreed that they were able to express their views freely. Some perceived a need for emphasizing the alignment between the research objectives and anticipated practice and policy implications. This adapted nominal group technique is an effective and enriching method when timely consensus is needed among diverse stakeholders. Health care researchers in various fields can benefit from using this research methodology.