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J Am Geriatr Soc. 2016 Dec;64(12):2577-2584. doi: 10.1111/jgs.14365. Epub 2016 Oct 27.

Development of Quality Indicators to Address Abuse and Neglect in Home-Based Primary Care and Palliative Care.

Author information

1
Center on Aging and Health, Division of Geriatric Medicine and Gerontology School of Medicine, Johns Hopkins University, Baltimore, Maryland.
2
Division of Geriatrics, University of California, San Francisco, California.
3
Veterans Affairs Quality Scholars Fellowship Program, San Francisco Veterans Affairs Medical Center, San Francisco, California.
4
University of California, Los Angeles and Jewish Home Borun Center; Veterans Affairs Geriatric Research, Educational and Clinical Center, Los Angeles, California.
5
Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.
6
Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
7
Department of Community and Public Health, School of Nursing, Johns Hopkins University, Baltimore, Maryland.

Abstract

OBJECTIVES:

To develop candidate quality indicators (QIs) 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 QIs 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 QIs 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 QIs. 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 QIs may ultimately serve to improve care delivered to vulnerable home-limited adults who receive home-based medical care.

KEYWORDS:

abuse; home-based palliative care; home-based primary care; neglect; quality indicators

PMID:
27787878
DOI:
10.1111/jgs.14365
[Indexed for MEDLINE]

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