Methodology for developing quality indicators for the care of older people in the Emergency Department
1 Centre for Research in Geriatric Medicine, Level 2, Building 33, Princess Alexandra Hospital, The University of Queensland, Ipswich Road, Woolloongabba QLD 4102, Australia
2 Centre for Online Health, Level 3, Foundation Building, royal Children’s Hospital, The University of Queensland, Herston QLD 4029, Australia
3 Emergency Department, Princess Alexandra Hospital, Queensland Health, Ipswich Road, Woolloongabba QLD 4102, Australia
4 Hebrew SeniorLife, Institute for Aging Research, Beth Israel Deaconess Medical Centre, Harvard Medical School, Cambridge, 1200 Centre Street, Boston, MA 02131, USA
BMC Emergency Medicine 2013, 13:23 doi:10.1186/1471-227X-13-23Published: 6 December 2013
Compared with younger people, older people have a higher risk of adverse health outcomes when presenting to emergency departments. As the population ages, older people will make up an increasing proportion of the emergency department population. Therefore it is timely that consideration be given to the quality of care received by older persons in emergency departments, and to consideration of those older people with special needs. Particular attention will be focused on important groups of older people, such as patients with cognitive impairment, residents of long term care and patients with palliative care needs. This project will develop a suite of quality indicators focused on the care of older persons in the emergency department.
Following input from an expert panel, an initial set of structural, process, and outcome indicators will be developed based on thorough systematic search in the scientific literature. All initial indicators will be tested in eight emergency departments for their validity and feasibility. Results of the data from the field studies will be presented to the expert panel at a second meeting. A suite of Quality Indicators for the older emergency department population will be finalised following a formal voting process.
The predicted burgeoning in the number of older persons presenting to emergency departments combined with the recognised quality deficiencies in emergency department care delivery to this population, highlight the need for a quality framework for the care of older persons in emergency departments. Additionally, high quality of care is associated with improved survival & health outcomes of elderly patients. The development of well-selected, validated and economical quality indicators will allow appropriate targeting of resources (financial, education or quality management) to improve quality in areas with maximum potential for improvement.