Quality indicators for geriatric emergency care.

Abstract

OBJECTIVES:

Emergency departments (EDs), similar to other health care environments, are concerned with improving the quality of patient care. Older patients comprise a large, growing, and particularly vulnerable subset of ED users. The project objective was to develop ED-specific quality indicators for older patients to help practitioners identify quality gaps and focus quality improvement efforts.

METHODS:

The Society for Academic Emergency Medicine (SAEM) Geriatric Task Force, including members representing the American College of Emergency Physicians (ACEP), selected three conditions where there are quality gaps in the care of older patients: cognitive assessment, pain management, and transitional care in both directions between nursing homes and EDs. For each condition, a content expert created potential quality indicators based on a systematic review of the literature, supplemented with expert opinion when necessary. The original candidate quality indicators were modified in response to evaluation by four groups: the Task Force, the SAEM Geriatric Interest Group, and audiences at the 2007 SAEM Annual Meeting and the 2008 American Geriatrics Society Annual Meeting.

RESULTS:

The authors offer 6 quality indicators for cognitive assessment, 6 for pain management, and 11 for transitions between nursing homes and EDs.

CONCLUSIONS:

These quality indicators will help researchers and clinicians target quality improvement efforts. The next steps will be to test the feasibility of capturing the quality indicators in existing medical records and to measure the extent to which each quality indicator is successfully met in current emergency practice.

• Authors: Kevin M Terrell, Fredric M Hustey, Ula Hwang, Lowell W Gerson, Neil S Wenger, Douglas K Miller, Society for Academic Emergency Medicine (SAEM) Geriatric Task Force
• Journal: Academic emergency medicine : official journal of the Society for Academic Emergency Medicine (Acad Emerg Med) Vol. 16 Issue 5 Pg. 441-9 (May 2009) ISSN: 1553-2712 [Electronic] United States
• PMID: 19344452 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Aged, 80 and over
• Cognition Disorders (diagnosis)
• Emergency Service, Hospital (standards)
• Emergency Treatment (standards)
• Evaluation Studies as Topic
• Geriatric Assessment (methods)
• Geriatrics
• Health Services Research (methods)
• Health Services for the Aged (organization & administration, standards)
• Humans
• Pain Management
• Quality Indicators, Health Care
• United States