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Standardized Screening and Assessment of Older Emergency Department Patients: A Survey of Implementation in Quebec*

Published online by Cambridge University Press:  31 March 2010

Jane McCusker ,
Josée Verdon ,
Nathalie Veillette ,
Katherine Berg ,
Tina Emond  and
Eric Belzile
Jane McCusker*
Affiliation:
Department of Clinical Epidemiology and Community Studies, St. Mary's Hospital Centre Department of Epidemiology, Biostatistics, and Occupational Health, McGill University
Josée Verdon
Affiliation:
McGill University Health Centre, Royal Victoria Hospital Division of Geriatrics, McGill University
Nathalie Veillette
Affiliation:
Institut universitaire de gériatrie de Montréal, Université de Montréal
Katherine Berg
Affiliation:
Department of Physical Therapy, University of Toronto
Tina Emond
Affiliation:
Department of Clinical Epidemiology and Community Studies, St. Mary's Hospital Centre
Eric Belzile
Affiliation:
Department of Clinical Epidemiology and Community Studies, St. Mary's Hospital Centre
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à: Jane McCusker, M.D., Dr.P.H., St. Mary's Hospital Centre, Department of Clinical Epidemiology and Community Studies, 3830 Lacombe Avenue Montreal, QC H3T 1M5. (jane.mccusker@mcgill.ca)
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Abstract

Cost-effective methods have been developed to help busy emergency department (ED) staff cope with the growing number of older patients, including quick screening and assessment tools to identify those at high risk and note their specific needs. This survey, from a sample of key informants from all EDs (n=111) in the province of Quebec (participation rate of 88.2%), investigated the implementation of these tools and barriers to implementation. Questionnaires (administered either by telephone or by self-completion) included characteristics of the ED, characteristics of the respondent, use of tools, and method of implementation. Barriers to the implementation of these tools included lack of resources for screening and follow-up, misunderstandings of the difference between screening and assessment tools, and need for adaptation of the tools to the local context. Education of staff and pre-implementation adaptation and testing are needed for successful implementation.

Résumé

Des méthodes efficientes ont été développées pour aider le personnel des départements d'urgence (DU) à s'ajuster au nombre croissant de patients âgés, leur procurant des outils de dépistage et d'évaluation permettant d'identifier les patients plus à risque ainsi que les besoins spécifiques à ceux-ci. Ce sondage des informateurs-clé de tous les départements d'urgence (n=111) de la province de Québec porte sur l'implantation de ces outils ainsi que sur les barrières à leur implantation. Les questionnaires (complétés soit par téléphone ou auto-administrés) incluaient : les caractéristiques du département d'urgence (DU), les caractéristiques des répondants, l'utilisation d'outils ainsi que le mode d'implantation. Les barrières à l'implantation de ces outils sont : le manque de ressources pour dépister et faire le suivi, la méconnaissance de la différence entre outils de dépistage et d'évaluation et enfin, la nécessité d'adapter les outils aux contextes locaux. La formation des intervenants et des essais préalables sont nécessaires à l'implantation fructueuse.

Keywords

agingscreeningemergency departmentimplementationsurveyvieillissementdépistageservice des urgencesmise en oeuvresondage
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 26 , Issue 1 , Spring/Printemps 2007 , pp. 49 - 57
Copyright
Copyright © Canadian Association on Gerontology 2007

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Footnotes

*

The authors are grateful to Dr. Alain Vadeboncoeur and Sylvie Berger of the Quebec Ministry of Health and Social Services, for making the working documents on the ED classification available to us. We also appreciate the assistance provided by Karine St-Denis in the data collection. This study was funded by a grant from the Inter-University Group on Emergency Research (Groupe interuniversitaire de recherche sur les urgences—GIRU).

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