Faculty of Nursing, University of Alberta, Edmonton, Alberta.
Department of Emergency Medicine, University of Alberta, Edmonton, Alberta.
Can J Aging. 2022 Mar;41(1):40-54. doi: 10.1017/S0714980820000446. Epub 2021 Jun 3.
We identified quality indicators (QIs) for care during transitions of older persons (≥ 65 years of age). Through systematic literature review, we catalogued QIs related to older persons' transitions in care among continuing care settings and between continuing care and acute care settings and back. Through two Delphi survey rounds, experts ranked relevance, feasibility, and scientific soundness of QIs. A steering committee reviewed QIs for their feasible capture in Canadian administrative databases. Our search yielded 326 QIs from 53 sources. A final set of 38 feasible indicators to measure in current practice was included. The highest proportions of indicators were for the emergency department (47%) and the Institute of Medicine (IOM) quality domain of effectiveness (39.5%). Most feasible indicators were outcome indicators. Our work highlights a lack of standardized transition QI development in practice, and the limitations of current free-text documentation systems in capturing relevant and consistent data.
我们确定了老年人（≥65 岁）在护理过渡期的质量指标（QIs）。通过系统的文献回顾，我们编目了与连续护理环境以及连续护理与急性护理环境之间以及返回连续护理环境的老年人过渡相关的 QIs。通过两轮 Delphi 调查，专家对 QIs 的相关性、可行性和科学合理性进行了排名。指导委员会审查了在加拿大管理数据库中可行捕获 QIs 的情况。我们的搜索从 53 个来源中产生了 326 个 QIs。最终纳入了一套 38 个可行的指标，用于当前实践中的测量。指标比例最高的是急诊科（47%）和美国医学研究所（IOM）的效果质量域（39.5%）。大多数可行的指标是结果指标。我们的工作强调了实践中缺乏标准化的过渡 QI 开发，以及当前自由文本文档系统在捕获相关和一致数据方面的局限性。
