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

ObjectivesTo develop and validate a comprehensive quality assessment tool for emergency department (ED) geriatric care. DesignFour-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. SettingProvince of Quebec, Canada. ParticipantsLead ED nurses and physicians at 76 Quebec EDs who participated in a 2013/14 survey (66% of 116 adult nonpsychiatric EDs in the province). MeasurementsGeriatric 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. ResultsThirteen subscales were developed; most were associated with ED type and quality indicators. ConclusionThirteen subscales for geriatric ED services are proposed for evaluation in various ED settings.