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Quality Indicators for Musculoskeletal Injury Management in the Emergency Department: a Systematic Review
Author(s) -
Strudwick Kirsten,
Nelson Mark,
MartinKhan Melinda,
Bourke Michael,
Bell Anthony,
Russell Trevor
Publication year - 2015
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.12591
Subject(s) - medicine , cinahl , medline , emergency department , critical appraisal , data extraction , health care , systematic review , quality management , musculoskeletal injury , physical therapy , alternative medicine , psychological intervention , nursing , pathology , management system , political science , law , economics , economic growth , management
Objectives There is increasing importance placed on quality of health care for musculoskeletal injuries in emergency departments ( ED s). This systematic review aimed to identify existing musculoskeletal quality indicators ( QI s) developed for ED use and to critically evaluate their methodological quality. Methods MEDLINE , EMBASE , CINAHL , and the gray literature, including relevant organizational websites, were searched in 2013. English‐language articles were included that described the development of at least one QI related to the ED care of musculoskeletal injuries. Data extraction of each included article was conducted. A quality assessment was then performed by rating each relevant QI against the Appraisal of Indicators through Research and Evaluation ( AIRE ) Instrument. QI s with similar definitions were grouped together and categorized according to the health care quality frameworks of Donabedian and the Institute of Medicine. Results The search revealed 1,805 potentially relevant articles, of which 15 were finally included in the review. The number of relevant QI s per article ranged from one to 11, resulting in a total of 71 QI s overall. Pain ( n = 17) and fracture management ( n = 13) QI s were predominant. Ten QI s scored at least 50% across all AIRE Instrument domains, and these related to pain management and appropriate imaging of the spine. Conclusions Methodological quality of the development of most QI s is poor. Recommendations for a core set of QI s that address the complete spectrum of musculoskeletal injury management in emergency medicine is not possible, and more work is needed. Currently, QI s with highest methodological quality are in the areas of pain management and medical imaging.