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Development of Quality Indicators to Address Abuse and Neglect in Home‐Based Primary Care and Palliative Care
Author(s) -
Sheehan Orla C.,
Ritchie Christine S.,
Fathi Roya,
Garrigues Sarah K.,
Saliba Debra,
Leff Bruce
Publication year - 2016
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14365
Subject(s) - neglect , medicine , delphi method , palliative care , elder abuse , nursing , inclusion (mineral) , family medicine , poison control , suicide prevention , medical emergency , psychology , social psychology , statistics , mathematics
Objectives To develop candidate quality indicators ( QI s) for the quality standard of “addressing abuse and neglect” in the setting of home‐based medical care. Design Systematic literature review of both the peer‐reviewed and gray literature. Setting Home‐based primary and palliative care practices. Participants Homebound community‐dwelling older adults. Measurements Articles were identified to inform the development of candidate indicators of the quality by which home‐based primary and palliative care practices addressed abuse and neglect. The literature guided the development of patient‐level QI s and practice‐level quality standards. A technical expert panel ( TEP ) representing exemplary home‐based primary care and palliative care providers then participated in a modified Delphi process to assess the validity and feasibility of each measure and identify candidate QI s suitable for testing in the field. Results The literature review yielded 4,371 titles and abstracts that were reviewed; 25 publications met final inclusion criteria and informed development of nine candidate QI s. The TEP rated all but one of the nine candidate indicators as having high validity and feasibility. Conclusion Translating the complex problem of addressing abuse and neglect into QI s may ultimately serve to improve care delivered to vulnerable home‐limited adults who receive home‐based medical care.