Grant: Knowledge Synthesis Grant

<html> <body> <p>Healthcare services for Canada&rsquo;s vulnerable older adult population are provided in a number of settings by a diverse group of healthcare providers, professions, and services. This type of care often necessitates care transitions, whereby older persons (&gt;65 years) move from one healthcare setting to the next (e.g. from their residential facility to the emergency department (ED)/hospital), during which they often experience poor quality care. During care transitions, long term care residents, the majority of whom have moderate to severe dementia,¹ often experience care that is fragmented, delayed, not evidence-based, and potentially unsafe.^2-5 In recent research, some care transitions between residential long term care facilities and EDs have led to increased hospital length of stay, provider and patient dissatisfaction, decreases in quality of healthcare, and adverse patient events.⁴^,^6-9 Furthermore, concerns about older persons&rsquo; transitions between acute care and community partners were noted in Alberta Health Services&rsquo; (AHS) recent accreditation review.¹⁰ Alberta Health Services&rsquo; decision-makers, knowledge users for this project, indicate that a set of validated and reliable measures of quality applicable across the care continuum, are needed in order to improve the healthcare for these frail older persons during care transitions.<br> <br> This project examines established quality of care measurements for the breadth of healthcare concerns these vulnerable older adults experience, across the series of transition settings: residential seniors facilities (long term care/nursing homes, assisted living facilities, independent living with home care support), emergency transport services, EDs, and, hospital inpatient settings. We aim to develop and validate a current, evidence-based, and ranked set of quality indicators (QIs) that can be used to evaluate the quality of care provided across the entire care transition. Our objectives are to:<br> <br> 1. Examine the current state of quality indicator knowledge for care transitions for older persons through a systematic literature review.<br> 2. Validate quality indicators for older persons&rsquo; care transitions.<br> 3. Evaluate the feasibility of implementing the full set of quality indicators across care transitions.<br> 4. Translate findings into practice through an integrated knowledge translation approach.<br> <br> This project will be completed in three phases using an integrated knowledge translation approach with existing partnerships between decision-makers and researchers. The first phase uses a recognized method of research, the systematic literature review, to identify, select, and evaluate relevant quality indicators, and to collect and analyze data from the relevant research literature. During phase 2 of this project, a Delphi process and panel of experts from diverse care settings and professions will evaluate and rank the relevance and importance of the quality indicators developed in phase 1. Phase 3 consists of the end of grant knowledge transfer efforts essential to disseminating our findings.<br> <br> Study deliverables include a validated set of multi-setting quality of care measures for the care transitions older adults experience across healthcare settings and providers. Researchers, funding agencies, policy makers, and both acute care and long term care administrators will be enabled to measure performance, establish benchmarks, identify care gaps, and implement improvements in care delivery where most needed.</p> </body> </html>