After creating scoring rules, Schnitker et al. used the SAEM QIs for cognitive assessment, in a geriatric ED population (N=277) and found that cognitive assessment and its documentation in medical records occurred in too few Doxorubicin patients such that scoring the majority of
the QIs was impracticable in this sample . The aim of this project is to determine predictors of quality of care of geriatric patients Inhibitors,research,lifescience,medical in EDs, and to develop a suite of QIs, including structural, process and outcome measures, that are feasible with minimal collection cost, whilst being reflective of true levels of quality delivered, for use in ED-care of the elderly. This will include the potential to propose a sub-set of QIs focused on the special needs of 1) older ED patients with cognitive impairment 2) those residing in nursing homes presenting Inhibitors,research,lifescience,medical to EDs, 3) and older ED patients with palliative care needs. Methods/design To ensure that a suite of quality indicators for the care of older persons in the ED is developed using an evidence-based approach that reflects the diversity of ED systems in developed nations, a three-phase mixed methods study was designed (Figure 1). The project will consist of: 1) a review of the scientific literature and expert panel input for the development of a preliminary suite of indicators;
2) field study of preliminary indicators Inhibitors,research,lifescience,medical at 8 Australian emergency services; 3) a facilitated panel discussion among key experts in emergency and geriatric medicine followed by a formal voting process, resulting in a final QI suite. The results of each phase will inform subsequent phases. Figure 1 Schematic of the study design. Ethics Inhibitors,research,lifescience,medical Research ethics board approval was received for
the project from Metro South Human Research Ethics Committee (HREC/11/QPAH/628); Australian Capital Territory (ACT) Government Health Human Research Inhibitors,research,lifescience,medical Ethics Committee Low Risk Sub-committee (ETHLR.12.097); The University of Queensland Behavioural & Social Sciences Ethical Review Committee (2012000631); and Melbourne Health Human Research Ethics Committee (2012.010). Site Specific Governance approval PAK6 was received for this project from Metro South Centres for Health Research Governance (SSA/11/QPAH/628; SSA/12/QPAH/211); Metro North Health Service District Research, Ethics and Governance Unit (SSA/12/QPCH/76); West Moreton Health Service District Human Research Ethics Committee & Research Governance Office (SSA/12/QWMS/23); and Northern Health Research Governance Office (SSA/12/NH/4). For the field study, research nurses will obtain informed written consent from participating patients at each site. Phase 1: Review of the literature Objective The purpose of this phase is to develop a preliminary QI set through a process of evaluation of available scientific literature, analysis of data collected from a pilot study , and finally, expert panel input. There will be a focus on utilising structural, process and outcome measures.