Abstract：
To find a consensus on clinicians\' and patients\' activities that underpin an ideal value-based outpatient specialty consultation, among clinicians.
A three-round online Delphi study was conducted. A purposive sample of nineteen clinicians from a Dutch university hospital judged activities on importance. Consensus was defined at 80% agreement. Activities were thematically analyzed to derive conceptual themes.
The expert panel agreed on 63 activities as being important for an ideal value-based outpatient specialty consultation and two activities as being unimportant. They failed to reach a consensus on 11 activities. Conceptual themes for activities that were considered important regard: 1) empowerment, 2) patient-reported biopsychosocial outcomes, 3) the patient as a person, 4) the patient\'s kin, 5) shared power and responsibility, 6) optimization, 7) coordination, 8) therapeutic relationships, and 9) resource-consciousness.
A value-based outpatient specialty consultation requires contextual decision-making, is person-centered, and focusses attention on care optimization and intelligent resource allocation. No importance is attributed to healthcare\'s societal burden and climate footprint. Disparities existed in various areas including the role of patient reported experience measures, \"patient-like-me\" data, and healthcare costs.
This study contributes a toolbox to guide and evaluate clinicians\' and patients\' behaviors in value-based outpatient specialty consultations and reveals opportunities to enhance facilitation.
A three-round online Delphi study was conducted. A purposive sample of nineteen clinicians from a Dutch university hospital judged activities on importance. Consensus was defined at 80% agreement. Activities were thematically analyzed to derive conceptual themes.
The expert panel agreed on 63 activities as being important for an ideal value-based outpatient specialty consultation and two activities as being unimportant. They failed to reach a consensus on 11 activities. Conceptual themes for activities that were considered important regard: 1) empowerment, 2) patient-reported biopsychosocial outcomes, 3) the patient as a person, 4) the patient\'s kin, 5) shared power and responsibility, 6) optimization, 7) coordination, 8) therapeutic relationships, and 9) resource-consciousness.
A value-based outpatient specialty consultation requires contextual decision-making, is person-centered, and focusses attention on care optimization and intelligent resource allocation. No importance is attributed to healthcare\'s societal burden and climate footprint. Disparities existed in various areas including the role of patient reported experience measures, \"patient-like-me\" data, and healthcare costs.
This study contributes a toolbox to guide and evaluate clinicians\' and patients\' behaviors in value-based outpatient specialty consultations and reveals opportunities to enhance facilitation.
摘要：
目的：在临床医生和患者活动上达成共识，以支持理想的基于价值的门诊专科咨询，在临床医生中。
方法：进行了三轮在线Delphi研究。来自荷兰大学医院的19名临床医生的目的样本判断了活动的重要性。共识定义为80％的协议。对活动进行了主题分析，以得出概念主题。
结果：专家小组同意63项活动对于基于理想价值的门诊专科咨询很重要，两项活动不重要。他们未能就11项活动达成共识。被认为重要的活动的概念主题：1)赋权，2）患者报告的生物心理社会结果，3）患者作为一个人，4)病人的亲属，5）共同的权力和责任，6)优化,7)协调,8)治疗关系，9)资源意识。
结论：基于价值的门诊专科咨询需要上下文决策，以人为中心，并将注意力集中在护理优化和智能资源分配上。医疗保健的社会负担和气候足迹并不重要。在各个领域存在差异，包括患者报告经验措施的作用，“像我一样的病人”数据，和医疗费用。
结论：本研究提供了一个工具箱来指导和评估临床医生和患者在基于价值的门诊专科会诊中的行为，并揭示了加强便利的机会。
方法：进行了三轮在线Delphi研究。来自荷兰大学医院的19名临床医生的目的样本判断了活动的重要性。共识定义为80％的协议。对活动进行了主题分析，以得出概念主题。
结果：专家小组同意63项活动对于基于理想价值的门诊专科咨询很重要，两项活动不重要。他们未能就11项活动达成共识。被认为重要的活动的概念主题：1)赋权，2）患者报告的生物心理社会结果，3）患者作为一个人，4)病人的亲属，5）共同的权力和责任，6)优化,7)协调,8)治疗关系，9)资源意识。
结论：基于价值的门诊专科咨询需要上下文决策，以人为中心，并将注意力集中在护理优化和智能资源分配上。医疗保健的社会负担和气候足迹并不重要。在各个领域存在差异，包括患者报告经验措施的作用，“像我一样的病人”数据，和医疗费用。
结论：本研究提供了一个工具箱来指导和评估临床医生和患者在基于价值的门诊专科会诊中的行为，并揭示了加强便利的机会。
