TY - JOUR
T1 - Quality indicators for dementia and older people nearing the end of life
T2 - A systematic review
AU - Yorganci, Emel
AU - Sampson, Elizabeth L.
AU - Gillam, Juliet
AU - Aworinde, Jesutofunmi
AU - Leniz, Javiera
AU - Williamson, Lesley E.
AU - Cripps, Rachel L.
AU - Stewart, Robert
AU - Sleeman, Katherine E.
N1 - Funding Information:
Cicely Saunders International; Kirby Laing Foundation; National Institute for Health Research (NIHR) and Economic and Social Research Council (ESRC) ESRC/NIHR dementia initiative 2018, Grant/Award Number: ES/S010327/1; NIHR Clinician Scientist Fellowship, Grant/Award Number: CS‐2015‐15‐005 Funding information
Funding Information:
This project is funded by the National Institute for Health Research (NIHR) and Economic and Social Research Council (ESRC) ESRC/NIHR dementia initiative 2018 (Grant Reference Number ES/S010327/1). Katherine E. Sleeman is funded by an NIHR Clinician Scientist Fellowship (CS‐2015‐15‐005), and is the Laing Galazka Chair in palliative care at King's College London, funded by an endowment from Cicely Saunders International and the Kirby Laing Foundation. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
Publisher Copyright:
© 2021 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.
PY - 2021/12
Y1 - 2021/12
N2 - 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 QIs for the care of older people and people with dementia who are nearing the end of life and recommend QIs for use with routinely collected electronic data across care settings. Methods: A systematic review was conducted, including five databases and reference chaining. Studies describing the development of QIs for care of older people and those with dementia nearing the end of life were included. QIs were categorized 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 categorized 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 very few concerned spiritual and cultural aspects of care (n = 19, 1.9%). Three hundred and fifteen (32.3%) QIs were robust and of those 220 were measurable using routinely collected electronic data. The final shortlist of 71 QIs came from seven studies. Conclusions: Of the 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.
AB - 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 QIs for the care of older people and people with dementia who are nearing the end of life and recommend QIs for use with routinely collected electronic data across care settings. Methods: A systematic review was conducted, including five databases and reference chaining. Studies describing the development of QIs for care of older people and those with dementia nearing the end of life were included. QIs were categorized 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 categorized 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 very few concerned spiritual and cultural aspects of care (n = 19, 1.9%). Three hundred and fifteen (32.3%) QIs were robust and of those 220 were measurable using routinely collected electronic data. The final shortlist of 71 QIs came from seven studies. Conclusions: Of the 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.
KW - dementia
KW - end-of-life care
KW - geriatrics
KW - health care
KW - quality indicators
UR - http://www.scopus.com/inward/record.url?scp=85111658641&partnerID=8YFLogxK
U2 - 10.1111/jgs.17387
DO - 10.1111/jgs.17387
M3 - Review article
C2 - 34331704
AN - SCOPUS:85111658641
SN - 0002-8614
VL - 69
SP - 3650
EP - 3660
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 12
ER -