From Consensus Through Prioritization: A Delphi Method, Clinical Audit, and Analytic Hierarchy Process…

StudyJournal of primary care & community health· 2026

From Consensus Through Prioritization: A Delphi Method, Clinical Audit, and Analytic Hierarchy Process Framework for Quality Improvement in Primary Diabetes Care.

Ansif Pallath Majeed, Niyaz Panakaje, Shajitha Thekke Veettil … Noora Jassim AlKubaisi

Family MedicineStudyClinical practiceQ1IF 2.6

Individualized HbA1c goal documentation was recorded in just 1.3% of diabetes records.

From Consensus Through Prioritization: A Delphi Method, Clinical Audit, and Analytic Hierarchy Process Framework for Quality Improvement in Primary Diabetes Care.

Ansif Pallath Majeed … Noora Jassim AlKubaisi

Journal of primary care & community health · 2026

Background

Type 2 diabetes mellitus (T2DM) affects approximately 17% of adults in Qatar, making improved primary care management a national health priority.

Methods

We conducted a mixed-methods, pre-implementation quality improvement study across 31 primary health care facilities in Qatar.

n = 450 adult

Results

individualized goals were almost never documented, far below the other targets

19.6%

ASCVD risk assessment

24%

Foot examinations

1.3%

Individualized HbA1c g

More results

The Delphi panel reached unanimous consensus on all 17 key performance indicators (median importance rating 5/5), covering preventive care, metabolic monitoring, therapy management, and patient education.

Key performance indicators adherence varied widely across centers (e.g., foot exam rates ranged from 0% to 95.6%).

More results

Analytic Hierarchy Process analysis identified five top-priority gaps accounting for 63% of total priority weight: ASCVD risk assessment (16%), foot examinations (16%), lifestyle education (12%), follow-up HbA1c testing (10%), and individualized HbA1c goal-setting(9%).

“

Conclusion · 1 of 3

This study highlights critical deficits in preventive and patient-centered diabetes care in primary care facilities.

Conclusion · 2 of 3

By integrating expert consensus, real-world performance data, and structured prioritization through the Delphi-AHP framework, we developed a robust, evidence-based model for quality improvement planning.

Conclusion · 3 of 3

Importantly, involving frontline clinicians in both key performance indicators selection and intervention prioritization fostered ownership, contextual relevance, and alignment with clinical realities.

From Consensus Through Prioritization: A Delphi Method, Clinical Audit, and Analytic Hierarchy Process Framework for Quality Improvement in Primary Diabetes Care.

From Consensus Through Prioritization: A Delphi Method, Clinical Audit, and Analytic Hierarchy Process Framework for Quality Improvement in Primary Diabetes Care.

Related papers