Fernando Rangika L, Inacio Maria C, Sluggett Janet K, Ward Stephanie A, Beattie Elizabeth, Khadka Jyoti, Caughey Gillian E
Registry of Senior Australians Research Centre, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia; Registry of Senior Australians Research Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia, Australia.
Registry of Senior Australians Research Centre, Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia; Registry of Senior Australians Research Centre, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia.
J Am Med Dir Assoc. 2025 Mar;26(3):105424. doi: 10.1016/j.jamda.2024.105424. Epub 2025 Jan 22.
To identify quality and safety indicators routinely used to monitor, evaluate, and improve care transitions for older adults globally.
A scoping literature review.
This review identified indicators used internationally to monitor and evaluate the quality and safety of care transitions by older adults. Care transitions were defined as the transfer of health care at least once between care settings.
A search of academic and gray literature identified indicators that were publicly available, used routinely at the population level, and reported on since 2012. Indicators were summarized by care domain (ie, hospitalization, consumer experience, access/waiting times, communication, follow-up, and medication-related), type (structure, process, outcome), quality dimension (patient centeredness, timeliness, effectiveness, efficiency, safety, and equity), data collection approach, reporting strategies, and care settings involved.
The review identified 361 quality indicators from 89 programs across 12 countries. Care domains included hospitalization (n = 112; 31.0%), consumer experience (n = 82; 22.7%), access/waiting times (n = 63; 17.5%), communication (n = 40; 11.1%), follow-up (n = 40; 11.1%), and medication-related (n = 24; 6.6%). Indicators measured outcomes (n = 227; 62.9%) or processes (n = 134; 37.1%) and represented the dimensions of patient centeredness (n = 155, 42.9%), timeliness (n = 91; 25.2%), and effectiveness (n = 87; 24.1%), efficiency (n = 18; 5.0%) and safety (n = 10; 2.8%). Most indicators were constructed from survey (n = 160; 44.3%) or administrative data (n = 138; 38.2%); 69% (n = 249) were publicly reported and 80% (n = 287) measured transitions related to acute settings.
Eighty-nine international programs routinely monitor the quality and safety of care transitions, and focus on the domains of hospitalization, access and waiting times, and communication. Considering the vulnerability of older adults as they transition across settings and providers, it is important to ensure holistic measurement of the quality of these care transitions to identify sub-optimal transitions, inform quality improvement, and ultimately improve outcomes for older adults.
确定全球范围内用于监测、评估和改善老年人护理转接质量与安全的常规指标。
一项范围综述。
本综述确定了国际上用于监测和评估老年人护理转接质量与安全的指标。护理转接定义为在不同护理机构之间至少进行一次医疗保健转移。
检索学术文献和灰色文献，确定自2012年以来公开可用、在人群层面常规使用并报告的指标。指标按护理领域（即住院治疗、消费者体验、就诊/等待时间、沟通、随访和药物相关）、类型（结构、过程、结果）、质量维度（以患者为中心、及时性、有效性、效率、安全性和平等性）、数据收集方法、报告策略以及涉及的护理机构进行汇总。
该综述从12个国家的89个项目中确定了361个质量指标。护理领域包括住院治疗（n = 112；31.0%）、消费者体验（n = 82；22.7%）、就诊/等待时间（n = 63；17.5%）、沟通（n = 40；11.1%）、随访（n = 40；11.1%）和药物相关（n = 24；6.6%）。指标测量结果（n = 227；62.9%）或过程（n = 134；37.1%），并代表以患者为中心（n = 155，42.9%）、及时性（n = 91；25.2%）、有效性（n = 87；24.1%）、效率（n = 18；5.0%）和安全性（n = 10；2.8%）等维度。大多数指标由调查（n = 160；44.3%）或行政数据（n = 138；38.2%）构建；69%（n = 249）为公开报告，80%（n = 287）测量与急性护理机构相关的转接。
89个国际项目常规监测护理转接的质量与安全，并关注住院治疗、就诊和等待时间以及沟通等领域。鉴于老年人在不同护理机构和提供者之间转接时的脆弱性，确保对这些护理转接质量进行全面测量以识别次优转接、为质量改进提供信息并最终改善老年人的结局非常重要。
