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.