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Health services research
Research
Scoping review of potential quality indicators for hip fracture patient care
  1. Kristen B Pitzul1,
  2. Sarah E P Munce2,
  3. Laure Perrier3,
  4. Lauren Beaupre4,5,
  5. Suzanne N Morin6,
  6. Rhona McGlasson7,
  7. Susan B Jaglal1,2,8
  1. 1Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
  2. 2Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
  3. 3Gerstein Science Information Centre, University of Toronto, Toronto, Ontario, Canada
  4. 4Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
  5. 5Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
  6. 6Department of Medicine, McGill University, Montreal, Quebec, Canada
  7. 7Bone and Joint Canada, Toronto, Ontario, Canada
  8. 8Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Kristen B Pitzul; kristen.pitzul{at}mail.utoronto.ca

Abstract

Objective The purpose of this study is to identify existing or potential quality of care indicators (ie, current indicators as well as process and outcome measures) in the acute or postacute period, or across the continuum of care for older adults with hip fracture.

Design Scoping review.

Setting All care settings.

Search strategy English peer-reviewed studies published from January 2000 to January 2016 were included. Literature search strategies were developed, and the search was peer-reviewed. Two reviewers independently piloted all forms, and all articles were screened in duplicate.

Results The search yielded 2729 unique articles, of which 302 articles were included (11.1%). When indicators (eg, in-hospital mortality, acute care length of stay) and potential indicators (eg, comorbidities developed in hospital, walking ability) were grouped by the outcome or process construct they were trying to measure, the most common constructs were measures of mortality (outcome), length of stay (process) and time-sensitive measures (process). There was heterogeneity in definitions within constructs between studies. There was also a paucity of indicators and potential indicators in the postacute period.

Conclusions To improve quality of care for patients with hip fracture and create a more efficient healthcare system, mechanisms for the measurement of quality of care across the entire continuum, not just during the acute period, are required. Future research should focus on decreasing the heterogeneity in definitions of quality indicators and the development and implementation of quality indicators for the postacute period.

  • HEALTH SERVICES ADMINISTRATION & MANAGEMENT
  • REHABILITATION MEDICINE

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-014769

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    Footnotes

    • Contributors KBP involved in writing protocol, screening for all levels, extraction, synthesis and writing of manuscripts and was the project coordinator. SEPM involved in editing of protocol, screening for all levels, extraction, synthesis and editing manuscripts. LP involved in editing of protocol, search strategy and editing manuscripts. LB contributed to editing of protocol, content expert input (rehabilitation), partial screening level 1 and editing manuscripts. SNM involved in editing of protocol, content expert input (clinical), partial screening level 1 and editing manuscripts. RM contributed to editing of protocol, stakeholder input (BJC), partial screening level 1 and editing manuscripts. SBJ involved in project conception, editing of protocol, partial screening level 1 and editing manuscripts and was the senior responsible investigator.

    • Funding This work was supported by a Technology Evaluation in the Elderly Network Knowledge Synthesis Grant # 2013–07, which is funded federally through the National Centers of Excellence.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Further details on studies included in this scoping review can be retrieved by contacting the corresponding author at kristen.pitzul@mail.utoronto.ca.