The ACOVE-3 QI set is an updated and expanded set of QIs including five new conditions: COPD, colorectal cancer, breast cancer, sleep. The original studies regarding the development of the ACOVE quality indicators ( sets 1–3), opinion papers, editorials and letters were excluded. Measuring Medical Care Provided to Vulnerable Elders: The Assessing Care of Vulnerable Elders‐3 (ACOVE‐3) Quality Indicators.

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Important future work consists of attempting to switch from using quality indicators solely as an assessment instrument, to using quality indicators as the basis for change of care delivery by providing timely and proactive feedback to the care givers. Articles were included if they used the original ACOVE quality indicators or adaptations, acovs or extensions thereof. Email acpve New issue alert.

Most research originated from the ACOVE group itself but there are some translational efforts to other countries.

Introduction to the assessing care of vulnerable elders-3 quality indicator measurement set.

Acovf these 18 studies, 4 studies focused on nursing home residents [ 17182632 ], 5 on managed care plans [ 51928—30 ], 2 on hospitalized patients [ 2231 ] and 5 on primary care patients [ 2023252733 ].

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This could be due to the difficulty of identifying who is vulnerable the VES considers age, self-rated health, limitations in physical function and functional disabilities. Unlike subjective methods, objective methods consist of explicitly specified assessment instruments and are often based on literature review and expert consensus, and are therefore more reliable [ 12 ]. Our systematic literature search was designed to give a complete overview of the studies pertaining to the Acovve quality indicators.

Care for elderly patients is complex and not yet well understood [ 6 ]. J Am Geriatr Soc. First, only one study developed a completely original indicator set that consisted of quality indicators with content not based on ACOVE indicators. Four studies had a more indirect approach to examine an association with the quality of care: High quality of care did not imply increased hospital acoge nationwide cohort study among hip acoev patients.


Two studies assessed the quality of care with interviews only [ 2425 ], two studies by medical records only [ 2131 ] and three studies utilized administrative data [ 232732 ]. In the 12 above-mentioned studies between acpve and quality indicators were used.

The Acvoe Committee evaluated the coherence of the complete set of QIs that the expert panels rated as valid. The effects of multimorbidity, polypharmacy and the overall quality of care have been investigated [ 1—5 ]. Only seven studies explicitly mentioned that the population consisted of vulnerable elderly patients, all of which used the Vulnerable Elders Survey VES to identify vulnerability. Eight articles pertained to the assessment of care for a specific condition: In sum, the ACOVE quality indicator set has formed the basis for many studies inspiring various applications and it holds promise of forming a common ground for aligning diverse research efforts.

These sub-categories were then organized into larger categories and put into a thematic conceptual model.

These QIs can be applied to identify areas of care in need of improvement and can form the basis of interventions to improve care. Three studies assessed the quality of care using only medical records [ 373845 ].

View large Download slide. Computerized clinical decision support systems may play an important role in this vision. Ten studies focused on specific domain s of care aacove overall quality: Citing articles via Web of Science 6.

Introduction to the assessing care of vulnerable elders-3 quality indicator measurement set.

Twelve studies were classified into this category [ 19263148—56 ]. The source of data used to evaluate the quality indicators was in most cases a combination of medical record data and interviews with caregivers and patients.

Only few studies used automated data extraction methods, because the required data are often unavailable, hard to access or difficult to standardize. The quality of medical care provided to vulnerable older patients with chronic pain. The effect of a quality improvement initiative on the quality of other aspects of health care: Based on the ACOVE project’s intended objectives [ 9 ], the studies were provisionally organized into two main themes: All QIs also apply to community-dwelling patients aged 75 and older.


Beyond the initial indicators: One study used a combination of medical records, direct observation and electronic measurement [ 26 ]. ACOVEquality indicatorsquality of careelderlyvulnerable eldersclinical decision support systems. The patient population in these studies mainly consisted of patients aged 65 or older defined by a threshold age range of minimal 50 to maximum 75 years.

Due to these properties, the ACOVE quality indicator set has a unique place amidst screening and assessment methods for measuring the quality of care of elders, especially the vulnerable ones. Feasibility of quality indicators for the management of geriatric syndromes in nursing home residents.

Simply translating and adapting the comprehensive ACOVE quality indicators may prove sufficient in the same patient group. Close mobile search navigation Article navigation. Two studies focused on nursing home residents, seven on community-dwelling patients [ 343637 avove, 39—42 ], one on hospitalized patients [ 35 ] and two studies focused on patients in primary care [ 3845 ].

Studies have shown that elderly patients often do not receive care appropriate to their age and conditions [ 58 ]. This is shown in the thematic conceptual model Fig. Measuring quality in arthritis care: We believe that by decoupling assessment from improvement, crucial opportunities to improve care at the right qcove and the right place may be missed.

Documentation and evaluation of cognitive impairment in elderly primary care patients. The authors declare that they have no conflicts of interest. The majority of the studies did not assess the reliability of the medical record review; however, most of them reported the acovee reliability of assessing the pass rates of quality indicators. One investigator screened citations to identify additional possible candidate articles. In recent years many studies have been dedicated to the care of elderly aclve.