The Elder-Friendly Emergency Department Assessment Tool: Development of a Quality Assessment Tool for Emergency Department–Based Geriatric Care

Authors

  • Jane McCusker MD, DrPH,

    Corresponding author
    1. St. Mary's Research Centre, Montreal, Quebec, Canada
    • Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
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  • Josée Verdon MD, MSc, FRCPC,

    1. Division of Geriatrics, Department of Medicine, McGill University, Montreal, Quebec, Canada
    2. McGill University Health Centre, Montreal, Quebec, Canada
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  • Alain Vadeboncoeur MD,

    1. Emergency Medicine Services, Montreal Institute of Cardiology, Montreal, Quebec, Canada
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  • Jean-Frédéric Lévesque MD, PhD,

    1. Centre de Recherche du, Centre Hôspitalier de l'Université de Montréal et, Institut National de Santé Publique du Québec, Montreal, Quebec, Canada
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  • Samir K. Sinha MD, DPhil, FRCPC,

    1. Department of Medicine, Mount Sinai and University Health Network Hospitals, University of Toronto, Toronto, Ontario, Canada
    2. Division of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada
    3. School of Medicine, Johns Hopkins University, Baltimore, Maryland
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  • Katherine Y. Kim BSc,

    1. St. Mary's Research Centre, Montreal, Quebec, Canada
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  • Eric Belzile MSc

    1. St. Mary's Research Centre, Montreal, Quebec, Canada
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Address correspondence to Jane McCusker, St. Mary's Research Centre, Hayes Pavilion, Suite 3734, 3830 Avenue Lacombe, Montreal, QC H3T 1M5, Canada. E-mail: jane.mccusker@mcgill.ca

Abstract

Objectives

To develop and conduct a preliminary validation of selected subscales of an elder-friendly emergency department (ED) assessment tool.

Design

Content validation of tool by an international panel. Construct validation using care ratings of ED lead physicians and nurses.

Setting

Quebec, Canada.

Participants

The international panel comprised 34 clinicians, administrators, and researchers. The construct validation was based on a 2006 survey of ED lead physicians and nurses at all 103 EDs in the province, of whom 68 (66%) supplied complete data.

Measurements

The initial tool included five subscales: ED staffing, screening and assessment, discharge planning, community services, and care philosophy. Differences in subscale scores were examined according to ED size, and of these scores were correlated with care ratings made by lead physicians and nurses.

Results

The average scores for three subscales (ED staffing, discharge planning, and community services) varied according to ED size. After adjustment for ED size, three subscales (screening and assessment, discharge planning, and community services) were correlated with ED nurse or physician care ratings. A preliminary tool, taking into account all factors, is proposed.

Conclusion

This study provides preliminary evidence of the validity of three subscales of the proposed elder-friendly ED assessment tool. Results suggest that ED size should be considered in interpreting these subscales. Further evaluation and validation of the proposed tool will be needed to further its utility in helping to focus the quality improvement efforts of clinicians, managers, and administrators related to the care they provide older adults.

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