Personal and professional values of healthcare practitioners influence their clinical decisions. Understanding these values for individuals and across healthcare professions can help improve patient-centred decision-making by individual practitioners and interprofessional teams, respectively. We aimed to identify these values and integrate them into a single framework using Schwartz's values model. We searched Medline, Embase, PsycINFO, CINAHL and ERIC databases for articles on personal and professional values of healthcare practitioners and students. We extracted values from included papers and synthesized them into a single framework using Schwartz's values model. We summarised the framework within the context of healthcare practice. We identified 128 values from 50 included articles from doctors, nurses and allied health professionals. A new framework for the identified values established the following broad healthcare practitioner values, corresponding to Schwartz values (in parentheses): authority (power); capability (achievement); pleasure (hedonism); intellectual stimulation (stimulation); critical-thinking (self-direction); equality (universalism); altruism (benevolence); morality (tradition); professionalism (conformity); safety (security) and spirituality (spirituality). The most prominent values identified were altruism, equality and capability. This review identified a comprehensive set of personal and professional values of healthcare practitioners. We integrated these into a single framework derived from Schwartz's values model. This framework can be used to assess personal and professional values of healthcare practitioners across professional groups, and can help improve practitioners' awareness of their values so they can negotiate more patient-centred decisions. A common values framework across professional groups can support shared education strategies on values and help improve interprofessional teamwork and decision-making.

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Objective: The objective was to test the ability of the Brief Risk Identification for Geriatric Health Tool (BRIGHT) to identify older emergency department (ED) patients with functional and physical impairment.Methods: This was a cross-sectional study in which 139 persons ‡75 years, who presented to an urban New Zealand ED over a 12-week period, completed the 11-item BRIGHT case-finding tool. Then, within 10 days of their index ED visit, 114 persons completed a comprehensive geriatric assessment. A ''yes'' response to at least 3 of the 11 BRIGHT items was considered ''positive.'' Primary outcome measures were instrumental activities of daily living (IADL), cognitive performance scale (CPS), and activities of daily living (ADL).Results: The BRIGHT-identified IADL deficit (64% prevalence) with a sensitivity of 0.76, specificity of 0.79, and receiver operating characteristic (ROC) of 0.83 (95% confidence interval [CI] = 0.74 to 0.91, p < 0.01); cognitive deficit (35% prevalence) sensitivity of 0.78, specificity of 0.54, and ROC of 0.66 (95% CI = 0.55 to 0.76, p = 0.006); and ADL deficit (29% prevalence) sensitivity of 0.83, specificity of 0.53, and ROC of 0.64 (95% CI = 0.53 to 0.75, p = 0.020). Positive likelihood ratios (LR+) for the three outcomes of interest were 3.6, 1.7, and 1.8, respectively. Negative likelihood ratios (LR)) were 0.3, 0.4, and 0.3. Conclusions:The 11-item BRIGHT successfully identifies older adults in the ED with decreased function and may be useful in differentiating elder patients in need of comprehensive assessment. ACADEMIC EMERGENCY MEDICINE 2008; 15:598-606 ª 2008 by the Society for Academic Emergency MedicineKeywords: risk assessment, aged, emergency services, case finding, geriatric assessment O lder adult patients commonly present to the emergency department (ED) with a complex mix of health and psychosocial issues. Functional dependence at the time of ED admission is a risk factor for subsequent health and functional decline, ED and hospital readmission, institutionalization, and death.1-4 Other risk factors for adverse outcomes include living alone, lack of social support, multiple comorbidity, polypharmacy, and diagnoses such as cardiovascular disease, diabetes, cognitive impairment, and depression. 5,6 Research has demonstrated that systematic case-finding, assessment, and prompt intervention can forestall health and functional decline, decrease hospital length of stay and readmission, and decrease long-term care admission. 7,8 In the Discharge of Elderly from the Emergency Department (DEED) II trial, ED-based comprehensive geriatric assessment followed by multidisciplinary community outreach resulted in a lower rate of

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