Quality indicators in the care of older persons in the emergency department: A systematic review of the literature

ObjectiveA systematic review of the literature was undertaken to assess the methodological quality of existing quality indicators (QIs) for the emergency department (ED) care of older persons. MethodsMEDLINE, CINAHL, EMBASE and grey literature were searched. Articles were included if they addressed ED care of persons aged 65 years and defined a QI amenable to influence by ED providers. The methodological quality of QIs was assessed using relevant items from the Appraisal of Indicators through Research and Evaluation and the QUALIFY tools. ResultsSixty-one articles were included in the review, with identification of 50 QIs meeting predefined inclusion criteria. Thirty-six of fifty ED QIs for older persons were process indicators. The appraisal instruments' total ratings ranged from 39 to 67%, with only 18 QIs scoring 50% or more for all five domains. ConclusionThere is a need for a balanced, methodologically robust set of QIs for care of older persons in the ED.