The development of a modified comprehensive geriatric assessment for use in the emergency department using a RAND/UCLA appropriateness method

Taylor, Andrea; Broadbent, Marc; Gurung, Apil; Wallis, Marianne

doi:10.1016/j.ienj.2020.100847

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…One approach to measuring healthcare quality is utilising secondary (health administrative) data; 20 21 although examining indicators in practice are limited by the information sources available. Some appropriateness studies have established quality standards or priorities to improve care for older patients in different care settings, [22][23][24][25][26][27] but none have reported a measurable indicator set. Few quality indicator sets are based on readily collected data or have been developed by referencing health administrative data holdings, thereby affecting their efficacy to assess performance.…”

Section: Open Accessmentioning

confidence: 99%

Development of practice-based quality indicators for the primary care of older adults: a RAND/UCLA Appropriateness Method study protocol

Correia,

Siu,

Vanstone

et al. 2023

BMJ Open

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IntroductionOlder adults have high rates of primary care utilisation, and quality primary care has the potential to address their complex medical needs. Family physicians have different levels of knowledge and skills in caring for older patients, which may influence the quality of care delivery and resulting health outcomes. In this study, we aim to establish consensus on practice-based metrics that characterise quality of care for older primary care patients and can be examined using secondary, administrative data.Methods and analysisWe describe a two-round RAND/UCLA Appropriateness Method (RAM) study to assess the consensus of a technical expert panel. We will recruit pan-Canadian experts who demonstrate excellence in clinical practice or scholarship related to the primary care of older adults. A literature review will generate a candidate list of practice-based quality indicators. The first round aims to evaluate the appropriateness and importance of candidate indicators through an online questionnaire. We will then develop technical definitions for each endorsed indicator using ICES data holdings. Panellists will offer feedback on the technical definitions in a virtual synchronous meeting and provide ratings on the same criteria in a second questionnaire.Ethics and disseminationOur study has been approved by the Hamilton Integrated Research Ethics Board (Project ID #15545). Findings will be disseminated via manuscripts, presentations and the lead author’s thesis.Trial registration numberISRCTN17074347

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Section: Open Accessmentioning

confidence: 99%

Development of practice-based quality indicators for the primary care of older adults: a RAND/UCLA Appropriateness Method study protocol

Correia,

Siu,

Vanstone

et al. 2023

BMJ Open

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A whole-of-health system approach to improving care of frail older persons

et al. 2022

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The population is aging, with frailty emerging as a significant risk factor for poor outcomes for older people who become acutely ill. We describe the development and implementation of the Frail Older Persons’ Collaborative Program, which aims to optimise the care of frail older adults across healthcare systems in Queensland. Priority areas were identified at a co-design workshop involving key stakeholders, including consumers, multidisciplinary clinicians, senior Queensland Health staff and representatives from community providers and residential aged care facilities. Locally developed, evidence-based interventions were selected by workshop participants for each priority area: a Residential Aged Care Facility acute care Support Service (RaSS); improved early identification and management of frail older persons presenting to hospital emergency departments (GEDI); optimisation of inpatient care (Eat Walk Engage); and enhancement of advance care planning. These interventions have been implemented across metropolitan and regional areas, and their impact is currently being evaluated through process measures and system-level outcomes. In this narrative paper, we conceptualise the healthcare organisation as a complex adaptive system to explain some of the difficulties in achieving change within a diverse and dynamic healthcare environment. The Frail Older Persons’ Collaborative Program demonstrates that translating research into practice and effecting change can occur rapidly and at scale if clinician commitment, high-level leadership, and adequate resources are forthcoming.

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The development of a modified comprehensive geriatric assessment for use in the emergency department using a RAND/UCLA appropriateness method

Cited by 2 publications

References 27 publications

Development of practice-based quality indicators for the primary care of older adults: a RAND/UCLA Appropriateness Method study protocol

Development of practice-based quality indicators for the primary care of older adults: a RAND/UCLA Appropriateness Method study protocol

A whole-of-health system approach to improving care of frail older persons

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