title: Development of Quality Indicators to Address Abuse and Neglect in Home-Based Primary Care and Palliative Care.
abstract: To develop candidate quality indicators (QIs) for the quality standard of "addressing abuse and neglect" in the setting of home-based medical care.
  
  
  
  Systematic literature review of both the peer-reviewed and gray literature.
  
  
  
  Home-based primary and palliative care practices.
  
  
  
  Homebound community-dwelling older adults.
  
  
  
  Articles were identified to inform the development of candidate indicators of the quality by which home-based primary and palliative care practices addressed abuse and neglect. The literature guided the development of patient-level QIs and practice-level quality standards. A technical expert panel (TEP) representing exemplary home-based primary care and palliative care providers then participated in a modified Delphi process to assess the validity and feasibility of each measure and identify candidate QIs suitable for testing in the field.
  
  
  
  The literature review yielded 4,371 titles and abstracts that were reviewed; 25 publications met final inclusion criteria and informed development of nine candidate QIs. The TEP rated all but one of the nine candidate indicators as having high validity and feasibility.
  
  
  
  Translating the complex problem of addressing abuse and neglect into QIs may ultimately serve to improve care delivered to vulnerable home-limited adults who receive home-based medical care.
authors: Center on Aging and Health, Division of Geriatric Medicine and Gerontology School of Medicine, Johns Hopkins University, Baltimore, Maryland.
authors: Orla C
authors: OC
authors: Sheehan
authors: Division of Geriatrics, University of California, San Francisco, California.
authors: Christine S
authors: CS
authors: Ritchie
authors: Division of Geriatrics, University of California, San Francisco, California.|Veterans Affairs Quality Scholars Fellowship Program, San Francisco Veterans Affairs Medical Center, San Francisco, California.
authors: Roya
authors: R
authors: Fathi
authors: Division of Geriatrics, University of California, San Francisco, California.
authors: Sarah K
authors: SK
authors: Garrigues
authors: University of California, Los Angeles and Jewish Home Borun Center; Veterans Affairs Geriatric Research, Educational and Clinical Center, Los Angeles, California.
authors: Debra
authors: D
authors: Saliba
authors: Division of Geriatric Medicine and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, Maryland.|Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.|Department of Community and Public Health, School of Nursing, Johns Hopkins University, Baltimore, Maryland.
authors: Bruce
authors: B
authors: Leff
mesh_terms: D000368:Aged; D003697:Delphi Technique; D004552:Elder Abuse / Q000175:diagnosis*; D006699:Home Care Services / Q000592:standards*; D018577:Homebound Persons; D006801:Humans; D010166:Palliative Care / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D019984:Quality Indicators, Health Care
keywords: abuse; home-based palliative care; home-based primary care; neglect; quality indicators