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

Orla C. Sheehan · Christine Seel Ritchie · Roya Fathi · Sarah K. Garrigues · Debra Saliba · Bruce A. Leff

16 citations0/0 files storedJournal of the American Geriatrics Society

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Elder Abuse and Neglect Geriatric Care and Nursing Homes Primary Care and Health Outcomes

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.

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2009Prevalence and Correlates of Emotional, Physical, Sexual, and Financial Abuse and Potential Neglect in the United States: The National Elder Mistreatment Study 2013Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America 2004Elder abuse 2011Health Care Professionals' Perspectives on Barriers to Elder Abuse Detection and Reporting in Primary Care Settings 2006Mandatory Reporting of Elder Abuse: Between a Rock and a Hard Place 1996Reporting Mistreatment of Older Adults: The Role of Physicians 2005Elder abuse and neglect: the experience, knowledge, and attitudes of primary care physicians.2013Elder Abuse: Research, Practice, and Health Policy. The 2012 GSA Maxwell Pollack Award Lecture

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