@article{
 title = {Structural quality indicators to support quality of care for older people with cognitive impairment in emergency departments},
 type = {article},
 year = {2015},
 identifiers = {[object Object]},
 keywords = {Aged,Caregivers,Cognition Disorders/therapy,Delirium/diagnosis,Emergency Service, Hospital/organization & adminis,Humans,Policy,Quality Indicators, Health Care,Quality of Health Care/organization & administrati,Risk Factors},
 pages = {273-284},
 volume = {22},
 month = {3},
 publisher = {by the Society for Academic Emergency Medicine},
 city = {The Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Australia.},
 id = {9f445fd4-ac2c-3a18-8265-37e3b791c3b0},
 created = {2016-08-21T22:18:55.000Z},
 file_attached = {false},
 profile_id = {217ced55-4c79-38dc-838b-4b5ea8df5597},
 group_id = {408d37d9-5f1b-3398-a9f5-5c1a487116d4},
 last_modified = {2017-03-14T09:54:45.334Z},
 read = {false},
 starred = {false},
 authored = {false},
 confirmed = {true},
 hidden = {false},
 source_type = {JOUR},
 notes = {CI: (c) 2015; JID: 9418450; CIN: Acad Emerg Med. 2015 Mar;22(3):362-4. PMID: 25716708; 2014/05/18 [received]; 2014/08/25 [revised]; 2014/10/09 [revised]; 2014/10/15 [accepted]; ppublish},
 folder_uuids = {9f7543f9-a98f-45fc-84f1-3d497af5c9b1},
 private_publication = {false},
 abstract = {OBJECTIVES: The purpose of this study was to identify the structural quality of care domains and to establish a set of structural quality indicators (SQIs) for the assessment of care of older people with cognitive impairment in emergency departments (EDs). METHODS: A structured approach to SQI development was undertaken including: 1) a comprehensive search of peer-reviewed and gray literature focusing on identification of evidence-based interventions targeting structure of care of older patients with cognitive impairment and existing SQIs; 2) a consultative process engaging experts in the care of older people and epidemiologic methods (i.e., advisory panel) leading to development of a draft set of SQIs; 3) field testing of drafted SQIs in eight EDs, leading to refinement of the SQI set; and 4) an independent voting process among the panelists for SQI inclusion in a final set, using preestablished inclusion and exclusion criteria. RESULTS: At the conclusion of the process, five SQIs targeting the management of older ED patients with cognitive impairment were developed: 1) the ED has a policy outlining the management of older people with cognitive impairment during the ED episode of care; 2) the ED has a policy outlining issues relevant to carers of older people with cognitive impairment, encompassing the need to include the (family) carer in the ED episode of care; 3) the ED has a policy outlining the assessment and management of behavioral symptoms, with specific reference to older people with cognitive impairment; 4) the ED has a policy outlining delirium prevention strategies, including the assessment of patients' delirium risk factors; and 5) the ED has a policy outlining pain assessment and management for older people with cognitive impairment. CONCLUSIONS: This article presents a set of SQIs for the evaluation of performance in caring for older people with cognitive impairment in EDs.},
 bibtype = {article},
 author = {Schnitker, L M and Martin-Khan, M and Burkett, E and Brand, C A and Beattie, E R and Jones, R N and Gray, L C and Panel, Research Collaboration for Quality Care of Older Persons: Emergency Care},
 journal = {Academic emergency medicine : official journal of the Society for Academic Emergency Medicine},
 number = {3}
}

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METHODS: A structured approach to SQI development was undertaken including: 1) a comprehensive search of peer-reviewed and gray literature focusing on identification of evidence-based interventions targeting structure of care of older patients with cognitive impairment and existing SQIs; 2) a consultative process engaging experts in the care of older people and epidemiologic methods (i.e., advisory panel) leading to development of a draft set of SQIs; 3) field testing of drafted SQIs in eight EDs, leading to refinement of the SQI set; and 4) an independent voting process among the panelists for SQI inclusion in a final set, using preestablished inclusion and exclusion criteria. RESULTS: At the conclusion of the process, five SQIs targeting the management of older ED patients with cognitive impairment were developed: 1) the ED has a policy outlining the management of older people with cognitive impairment during the ED episode of care; 2) the ED has a policy outlining issues relevant to carers of older people with cognitive impairment, encompassing the need to include the (family) carer in the ED episode of care; 3) the ED has a policy outlining the assessment and management of behavioral symptoms, with specific reference to older people with cognitive impairment; 4) the ED has a policy outlining delirium prevention strategies, including the assessment of patients' delirium risk factors; and 5) the ED has a policy outlining pain assessment and management for older people with cognitive impairment. 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