Hip fractures (HF) are one of the most common injuries seen in emergency departments among the elderly, but quality care measures for hip fractures are lacking. To that end, a recent report sought to identify optimal quality indicators (QI) for clinical use, but researchers found gaps that need to be addressed.
Hip fractures (HF) are one of the most common injuries seen in emergency departments among the elderly, but quality care measures for hip fractures are lacking. To that end, a recent report sought to identify optimal quality indicators (QI) for clinical use, and found gaps that need to be addressed.
After a literature search, researchers were unable to find evidence for the quality indicators that are currently in use, despite the various QIs available relating to structure, process, and outcome, they wrote. They recommended additional study on the predictive validity of QIs on outcomes that are meaningful to patients as well as healthcare administrators.Researchers defined Qs structure, process, and outcome indicators as follows:
A good QI must meet 4 criteria: clinically relevant, scientifically acceptable, feasible, and usable, and to be scientifically acceptable, a QI has to be reliable and valid. In order to meet these criteria, a high-quality QI should undergo a well-described methodological development process, the report said.
In this review, researchers used the Appraisal of Indicators through Research and Evaluation (AIRE) instrument. However, since detailed methodological information about the indicators was lacking, the AIRE instrument could not be applied.
Sixteen publications, 9 audits, and 5 guidelines were included. In total, 97 unique QIs were found: 9 structure, 63 process, and 25 outcome indicators.
Because of the lack of methodological quality, the researchers created a list of 9 QIs that they recommend for further study. They selected these indicators if they were described in at least 2 articles and were used in at least 2 existing audits/guidelines. The 9 indicators are made up of of 1 structure indicator, 6 process indicators, and 2 outcome indicators. The list includes:
The researchers described these as a starting point for additional research.
Voeten SC, Krijnen P, Voeten DM, Hegeman JH, Wouters MWJM, Schipper IB. Quality indicators for hip fracture care, a systematic review. Osteoporos Int. 2018;29(9):1963-1985. https://doi.org/10.1007/s00198-018-4558-x.