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Quality Improvement / The Basics

Quality Improvement Metrics

If you can’t measure it, you can’t change it!

Quality Improvement Metrics

Here are some outcome measures you might want to consider in tracking your quality improvement activities relating to senior-friendly care.
The ED should track metrics for structures, processes, and outcomes related to the following criteria:

  1. Numbers of older adults with repeat ED visits
  2. Numbers of older adults with repeat ED admissions
  3. Number of older adults staying >8 hours in the ED
  4. Mortality data for patients according to designated diagnosis
  5. Numbers of older adults admitted to the hospital with specific chief complaints and admitting diagnosis
  6. Numbers of older adults discharged to home, long-term care, rehabilitation with ED diagnosis and chief complaints
  7. Numbers of patients screening positively on applicable screen(s) (e.g. delirium, functional decline, falls, elder abuse)
  8. Numbers of patients accessing a referral pathway for positively screened patients
(e.g. assessment by an in-department assessment team or referral to a Falls or Memory Clinic)
  9. Percentage of eligible positively screened patients who are referred appropriately
  10. Percentage of eligible positively screened patients who complete the referral
  11. Outcomes of such referral

References and Resources

  • Terrell KM, Hustey FM, Hwang U, et al. Quality indicators for geriatric emergency care. Acad Emerg Med. 2009 16: 441-449.
  • Carpenter CR, Heard K, Wilber ST, et al. Research priorities for high-quality geriatric emergency care: medication management, screening, and prevention and functional assessment. Acad Emerg Med. 2011;18: 644-654. 26.
  • Carpenter CR, Shah MN, Hustey FM, et al. High yield research opportunities in geriatric emergency medicine research: prehospital care, delirium, adverse drug events, and falls. J Gerontol Med Sci. 2011;66: 775-783.
  • Inouye SK, Studenski S, Tinetti ME, et al. Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Am Geratr Soc. 2007;55: 780-791.

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Profile photo of Don Melady
I am an Emergency Physician at Mount Sinai Hospital Toronto and the lead on this website project. I am also involved with the Geriatric ED Collaborative supported by the Hartford Foundation and the West Health Foundation. I am co-author on a textbook, Geriatric Emergencies: A Discussion-Based Review. Please follow me on Twitter: @Geri_EM

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