Tate K, Lee S, Rowe B, Holroyd Leduc J, Estabrooks C, Reid RC, Cummings GE, Anderson C, Cummings GG. (2018). Development of Quality Indicators for Older Persons Transitions in Care (OPTIC QI) Participants’ Report. Faculty of Nursing, University of Alberta.
At a Glance
The purpose of the Developing Quality Indicators for Older Persons’ Transitions in Care (OPTIC QI) study was to:
- Examine the current state of quality indicator knowledge for care transitions for older persons through systematic literature review
- Validate quality indicators for older persons’ care transitions
- Evaluate feasibility of implementing quality indicators across care transitions
- Translate findings into practice using an integrated knowledge translation approach
We used an integrated knowledge translation approach to build on partnerships between decision-makers, stakeholders and researchers.
Phase 1. In the first phase of the study, we conducted a systematic literature review to identify quality of care indicators applying to any setting that an older person may experience during a care transition. We coded identified indicators based on care setting, the Institute of Medicine’s (IOM) quality domain framework and the Donabedian framework domain (structure, process, outcome).
Phase 2. In Phase II the Delphi process was used, whereby identified indicators were reviewed by an expert panel in two rounds of electronic surveys. Experts were asked to rate each quality indicator on a 5-point Likert scales for each of the following: scientific soundness, validity, feasibility, relevance, importance to improving transfers and importance to improving them or their work. We determined if and how easily current Canadian administrative databases capture data for each retained indicator through a feasibility review.
The findings of this study have led to four main contributions. Systematic review of the relevant literature identified candidate quality indicators across all settings included in a care transition and highlighted a lack of standardized QI development and reporting. Expert panelists reviewed candidate indicators through the Delphi process, and the subsequent feasibility review was conducted by our research team Steering Committee. This process resulted in a total of 38 quality indicators deemed scientifically sound, important to improving transitions and feasible to capture in practice, using current Canadian administrative databases. This study identified critical knowledge gaps and gaps in care related to: a lack of indicators specific to care transitions in settings such as emergency transport and domains such as equity; a lack of appropriate, well-documented assessments of older persons during transitions; and a lack of
Download file below