[Development of decision support guidance of people in loss of autonomy in the care system in the Canton of Geneva's healthcare system].

Aim: The objective of this study is to use Iso-SMAF functional autonomy profiles (SMAF: French acronym for Functional autonomy measurement system) and other clinical and sociodemographic characteristics to develop algorithms that would support decision-making in orienting disabled people that would be adapted to current and future options available to a healthcare system in the Canton of Geneva.

Methods: A modified Delphi expert consultation, including the RAND/UCLA method, was used. After two rounds of consultations in which the experts responded to Web-based questionnaires, a nominal group completed the study.

Results: A total of 108 experts took part in the online consultation during the two rounds of consultation; 13 took part in the nominal group. In addition to belonging to various disciplines, the participants came from the different care structures within the Canton of Geneva. The findings made it possible to develop 14 decision-making algorithms, eight of which received consensus support in the first round of consultation. The second round and nominal group achieved consensus for others. The profiles with moderate to severe cognitive impairment were those for which the orientation options required several rounds of voting.

Conclusion: Since the orientation choices suggested by the algorithms were relatively standardized, they constitute recommendations that can guide professionals in orienting people.