Developing a set of emergency department performance measures to evaluate delirium care quality for older adults: a modified e-Delphi study

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dc.contributor.authorFiliatreault, Sarah
dc.contributor.authorKreindler, Sara A.
dc.contributor.authorGrimshaw, Jeremy M.
dc.contributor.authorChochinov, Alecs
dc.contributor.authorDoupe, Malcolm B.
dc.date.accessioned2024-03-06T17:55:50Z
dc.date.available2024-03-06T17:55:50Z
dc.date.issued2024-02-15
dc.date.updated2024-03-01T04:34:38Z
dc.description.abstractBackground Older adults are at high risk of developing delirium in the emergency department (ED); however, it is under-recognized in routine clinical care. Lack of detection and treatment is associated with poor outcomes, such as mortality. Performance measures (PMs) are needed to identify variations in quality care to help guide improvement strategies. The purpose of this study is to gain consensus on a set of quality statements and PMs that can be used to evaluate delirium care quality for older ED patients. Methods A 3-round modified e-Delphi study was conducted with ED clinical experts. In each round, participants rated quality statements according to the concepts of importance and actionability, then their associated PMs according to the concept of necessity (1–9 Likert scales), with the ability to comment on each. Consensus and stability were evaluated using a priori criteria using descriptive statistics. Qualitative data was examined to identify themes within and across quality statements and PMs, which went through a participant validation exercise in the final round. Results Twenty-two experts participated, 95.5% were from west or central Canada. From 10 quality statements and 24 PMs, consensus was achieved for six quality statements and 22 PMs. Qualitative data supported justification for including three quality statements and one PM that achieved consensus slightly below a priori criteria. Three overarching themes emerged from the qualitative data related to quality statement actionability. Nine quality statements, nine structure PMs, and 14 process PMs are included in the final set, addressing four areas of delirium care: screening, diagnosis, risk reduction and management. Conclusion Results provide a set of quality statements and PMs that are important, actionable, and necessary to a diverse group of clinical experts. To our knowledge, this is the first known study to develop a de novo set of guideline-based quality statements and PMs to evaluate the quality of delirium care older adults receive in the ED setting.
dc.identifier.citationBMC Emergency Medicine. 2024 Feb 15;24(1):28
dc.identifier.doi10.1186/s12873-024-00947-6
dc.identifier.urihttp://hdl.handle.net/1993/38046
dc.language.isoeng
dc.language.rfc3066en
dc.publisherBMC
dc.rightsopen accessen_US
dc.rights.holderThe Author(s)
dc.subjectDelphi technique
dc.subjectPerformance measures
dc.subjectEmergency services (hospital)
dc.subjectDelirium
dc.subjectOlder adults
dc.subjectProcess assessment (health care)
dc.subjectQuality indicators (health care)
dc.titleDeveloping a set of emergency department performance measures to evaluate delirium care quality for older adults: a modified e-Delphi study
dc.typeJournal Article
local.author.affiliationRady Faculty of Health Sciences::Max Rady College of Medicine::Department of Community Health Sciences
oaire.citation.issue28
oaire.citation.titleBMC Emergency Medicine
oaire.citation.volume24
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