Abstract
IntroductionIn emergency care, geriatric requirements and risks are often not taken sufficiently into account. In addition, there are neither evidence-based recommendations nor scientifically developed quality indicators (QI) for geriatric emergency care in German emergency departments. As part of the GeriQ-ED© research project, quality indicators for geriatric emergency medicine in Germany have been developed using the QUALIFY-instruments.MethodsUsing a triangulation methodology, a) clinical experience-based quality aspects were identified and verified, b) research-based quality statements were formulated and assessed for relevance, and c) preliminary quality indicators were operationalized and evaluated in order to recommend a feasible set of final quality indicators.ResultsInitially, 41 quality statements were identified and assessed as relevant. Sixty-seven QI (33 process, 29 structure and 5 outcome indicators) were extrapolated and operationalised. In order to facilitate implementation into daily practice, the following five quality statements were defined as the GeriQ-ED© TOP 5: screening for delirium, taking a full medications history including an assessment of the indications, education of geriatric knowledge and skills to emergency staff, screening for patients with geriatric needs, and identification of patients with risk of falls/ recurrent falls.DiscussionQIs are regarded as gold standard to measure, benchmark and improve emergency care. GeriQ-ED© QI focused on clinical experience- and research-based recommendations and describe for the first time a standard for geriatric emergency care in Germany. GeriQ-ED© TOP 5 should be implemented as a minimum standard in geriatric emergency care.
Highlights
IntroductionGeriatric requirements and risks are often not taken sufficiently into account
In emergency care, geriatric requirements and risks are often not taken sufficiently into account
The aim of this paper is to describe the development process of quality indicators (QI) for the management of geriatric emergency patients and to provide a set of structure, process and outcome QIs (GeriQ-emergency department (ED)©)
Summary
Geriatric requirements and risks are often not taken sufficiently into account. In Australia and Europe, there are currently no consensus on which aspects of care to be included [7, 8, 12, 13] To bring together both disciplines, geriatrics and emergency medicine, a European curriculum in geriatric emergency medicine was developed and approved by the European Union of Medical Specialists (UEMS) [14]. A position paper by the German Society of Emergency Medicine (DGINA), the German Society of Geriatrics (DGG), the German Society of Gerontology and Geriatrics (DGGG), the Austrian Society of Geriatrics and Gerontology (ÖGGG) and the Swiss Society for Geriatrics (SFGG) have identified the need for further research and objective quality indicators (QIs) for geriatric emergency care [15]. Well-defined QIs will enable the assessment, benchmarking, and improvement of quality of care for geriatric emergency care patients [17]
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