Quality indicators in the care of older persons in the emergency department: A systematic review of the literature

Australas J Ageing. 2017 Dec;36(4):286-298. doi: 10.1111/ajag.12451. Epub 2017 Jul 31.

Abstract

Objective: A systematic review of the literature was undertaken to assess the methodological quality of existing quality indicators (QIs) for the emergency department (ED) care of older persons.

Methods: MEDLINE, CINAHL, EMBASE and grey literature were searched. Articles were included if they addressed ED care of persons aged ≥65 years and defined a QI amenable to influence by ED providers. The methodological quality of QIs was assessed using relevant items from the Appraisal of Indicators through Research and Evaluation and the QUALIFY tools.

Results: Sixty-one articles were included in the review, with identification of 50 QIs meeting predefined inclusion criteria. Thirty-six of fifty ED QIs for older persons were process indicators. The appraisal instruments' total ratings ranged from 39 to 67%, with only 18 QIs scoring 50% or more for all five domains.

Conclusion: There is a need for a balanced, methodologically robust set of QIs for care of older persons in the ED.

Keywords: emergency medical services; geriatrics; healthcare; quality indicators.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Aged
  • Emergency Service, Hospital / standards*
  • Evidence-Based Medicine / standards*
  • Female
  • Geriatric Assessment
  • Geriatrics / standards*
  • Healthcare Disparities / standards
  • Humans
  • Male
  • Practice Guidelines as Topic / standards
  • Process Assessment, Health Care / standards*
  • Quality Indicators, Health Care / standards*
  • Time Factors
  • Treatment Outcome