Research has shown that the quality and outcomes of geriatric emergency department (ED) care can be improved by ED-based interventions that are linked to community-based services. Although many EDs are developing ways to apply these interventions, there are no tools or methods that have been proven to be effective in guiding quality improvement efforts. Using data from a 2006 survey, members of our team have developed a tool that can assess the extent to which EDs are elder-friendly. Some early statistical testing on the effectiveness of this tool has been done however further we need to do further testing, as well as revise, expand and develop the tool.
In this study, we will describe changes since 2006 in the implementation of elder-friendly services in Quebec EDs and describe how the components of our revised tool can be applied and how important these components are. We also aim to do statistical tests on the tool and study the links between scores on the tool and patient and provider views of the quality of ED care. And finally, we intend to find what factors prevent and aid in implementing elder-friendly ED services.
The study will include questionnaire surveys of chief physicians and head nurses at all Quebec, adult, non-psychiatric EDs. Then, from the results of the surveys, 4 EDs will be selected: 2 in Montreal and 2 in Quebec City. From those 4 EDs, a group of patients aged 75 and over or their family members will be surveyed to rate the care they received. We will also interview select patients and providers from those 4 EDs to obtain a deeper understanding of ED geriatric care and what prevents or aids in implementing elder-friendly ED services.