Elder-Friendly Emergency Department: Development and Validation of a Quality Assessment Tool.

OBJECTIVES: To develop and validate a comprehensive quality assessment tool for emergency department (ED) geriatric care.

DESIGN: Four-step study: (1) Content development of tool by a multidisciplinary panel, (2) survey of ED lead physicians and nurses, (3) development of subscales using principal component analysis and clinical judgment, (4) reliability and validity assessment.

SETTING: Province of Quebec, Canada.

PARTICIPANTS: Lead ED nurses and physicians at 76 Quebec EDs who participated in a 2013/14 survey (66% of 116 adult nonpsychiatric EDs in the province).

MEASUREMENTS: Geriatric care items (n = 62) grouped into seven preliminary content areas (screening and assessment, clinical protocols, discharge planning, staffing, physical environment, continuing education, quality assessment), lead nurse and physician perceptions of the quality of ED geriatric care, institutional prioritization of geriatric care, and ED type.

RESULTS: Thirteen subscales were developed; most were associated with ED type and quality indicators.

CONCLUSION: Thirteen subscales for geriatric ED services are proposed for evaluation in various ED settings.