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Can Fam Physician
Vol. 53, No. 11, November 2007, pp.1944 - 1952
Copyright © 2007 by The College of Family Physicians of Canada
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Validation d’indicateurs de la prise en charge des atteintes des fonctions cognitives dans les unités d’évaluation gériatrique

Isabelle Payot, MD, Judith Latour, MD FRCPC CSPQ, Fadi Massoud, MD FRCPC CSPQ and Marie-Jeanne Kergoat, MD CCFP FCFP CSPQ
Dre Payot, Dre Latour, Dr Massoud et Dre Kergoat enseignent la gériatrie à la faculté de médecine de l’Université de Montréal au Québec. Dre Kergoat est chercheuse au centre de recherche de l’Institut universitaire de gériatrie de Montréal.

Correspondance à: Dre Marie-Jeanne Kergoat, Centre de recherche, Institut universitaire de gériatrie de Montréal, 4565, ch. Queen-Mary, Montréal, QC H3W 1W5; téléphone 514 340-3515; télécopieur 514 340-2832; courriel marie-jeanne.kergoat@umontreal.ca

OBJECTIVE To analyze and adapt a set of quality indicators for assessment and management of patients with cognitive disorders, which are seen very frequently in geriatric assessment units in Quebec.

DESIGN Modified Delphi technique.

SETTING Province of Quebec.

PARTICIPANTS Seven clinicians from 3 different medical faculties in Quebecwere selected for their expertise in dementia and geriatric care.

METHOD From among the indicators developed in 2001 using the RAND method, 22 items selected for their relevance to evaluation and management of cognitive disorders were adapted to clinical practice in the Quebec hospital system. These indicators, along with evidence from the literature, were submitted by mail to a panel of experts. The experts were asked to rate, on a scale of 1 to 9, their level of agreement with the indicators in terms of their validity and quality and the need for them to be recorded in patients’ medical charts. For an indicator to be retained, it had to be accepted according to itsmedian value, to be rated in the upper third of the scale, and to be approved by the panelists. Indicators not accepted at first were modified according to experts’ comments and then resubmitted to the same panel for a second round.

RESULTS Of 22 indicators submitted in the first round, 21 were validated. They covered assessment, investigation, evaluation, treatment, and follow-up. The indicator found questionable was modified and then accepted during the second round.

CONCLUSION This study identified 22 indicators relevant to assessment and management of patients with cognitive disorders in geriatric assessment units. These indicators will serve as a basis for evaluation of dementia in a larger study of the quality of care in all short-term geriatric assessment units in Quebec.






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