Abstract
Background: Robust quality indicators (QIs) are essential for monitoring and improving the quality of care and learning from good practice. We aimed to identify and assess available QIs for the care of older people and people with dementia who are nearing the end of life and recommend QIs available to use with routinely collected electronic data across care settings.
Methods: Systematic review, including five databases and reference chaining. Studies describing development of QIs for care of older people and those with dementia nearing the end of life were included. QIs were categorised as relating to processes or outcomes and mapped against six care domains. The psychometric properties (acceptability, evidence base, definition, feasibility, reliability, and validity) of each QI were assessed; QIs were categorised as robust, moderate or poor.
Results: From 12,980 titles and abstracts screened, 37 papers and 976 QIs were included. Process and outcome QIs accounted for 780 (79.7%) and 196 (20.3%) of all QIs, respectively. Many of the QIs concerned physical aspects of care (n=492, 50.4%), and fewest concerned spiritual and cultural aspects of care (n=19, 1.9%). 315 (32.3%) QIs were robust and of those 220 were available for use with routinely collected electronic data. The final shortlist of 71 QIs came from seven studies.
Conclusions: Of numerous QIs developed for care of older adults and those with dementia nearing the end of life, most had poor or moderate psychometric properties or were not designed for use with routinely collected electronic datasets. Infrastructure for data availability, combined with use of robust QIs, is important for enhancing understanding of care provided to this population, identifying unmet needs, and improving service provision.
Methods: Systematic review, including five databases and reference chaining. Studies describing development of QIs for care of older people and those with dementia nearing the end of life were included. QIs were categorised as relating to processes or outcomes and mapped against six care domains. The psychometric properties (acceptability, evidence base, definition, feasibility, reliability, and validity) of each QI were assessed; QIs were categorised as robust, moderate or poor.
Results: From 12,980 titles and abstracts screened, 37 papers and 976 QIs were included. Process and outcome QIs accounted for 780 (79.7%) and 196 (20.3%) of all QIs, respectively. Many of the QIs concerned physical aspects of care (n=492, 50.4%), and fewest concerned spiritual and cultural aspects of care (n=19, 1.9%). 315 (32.3%) QIs were robust and of those 220 were available for use with routinely collected electronic data. The final shortlist of 71 QIs came from seven studies.
Conclusions: Of numerous QIs developed for care of older adults and those with dementia nearing the end of life, most had poor or moderate psychometric properties or were not designed for use with routinely collected electronic datasets. Infrastructure for data availability, combined with use of robust QIs, is important for enhancing understanding of care provided to this population, identifying unmet needs, and improving service provision.
| Original language | English |
|---|---|
| Journal | Journal of the American Geriatrics Society |
| Early online date | 31 Jul 2021 |
| DOIs | |
| Publication status | E-pub ahead of print - 31 Jul 2021 |
Keywords
- End-of-life care, quality indicators, healthcare, dementia, geriatrics