A Quality Measurement Framework for Emergency Department Care of Psychiatric Emergencies - 19/04/23
, Kirstin W. Scott, MD, PhD b, Arjun K. Venkatesh, MD, MBA c, Luis F. Lobon, MD, MS a, David S. Kroll, MD d, Elizabeth A. Samuels, MD, MPH e, Michael P. Wilson, MD, PhD f, Scott Zeller, MD g, Leslie S. Zun, MD, MBA h, Kathleen C. Clifford, BS a, Kori S. Zachrison, MD, MSc iAbstract |
As a primary access point for crisis psychiatric care, the emergency department (ED) is uniquely positioned to improve the quality of care and outcomes for patients with psychiatric emergencies. Quality measurement is the first key step in understanding the gaps and variations in emergency psychiatric care to guide quality improvement initiatives. Our objective was to develop a quality measurement framework informed by a comprehensive review and gap analysis of quality measures for ED psychiatric care. We conducted a systematic literature review and convened an expert panel in emergency medicine, psychiatry, and quality improvement to consider if and how existing quality measures evaluate the delivery of emergency psychiatric care in the ED setting. The expert panel reviewed 48 measures, of which 5 were standardized, and 3 had active National Quality Forum endorsement. Drawing from the measure appraisal, we developed a quality measurement framework with specific structural, process, and outcome measures across the ED care continuum. This framework can help shape an emergency medicine roadmap for future clinical quality improvement initiatives, research, and advocacy work designed to improve outcomes for patients presenting with psychiatric emergencies.
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| Supervising editor: Daniel A. Handel, MD, MBA. Specific detailed information about possible conflict of interest for individual editors is available at editors. |
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| Authorship: All authors attest to meeting the four ICMJE.org authorship criteria: (1) Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND (2) Drafting the work or revising it critically for important intellectual content; AND (3) Final approval of the version to be published; AND (4) Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. |
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| Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.icmje.org/). The authors have stated that no such relationships exist. This work was supported by Emergency Medicine Foundation/EMRA Research Grant, 2019-20. |
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| Publication dates: Received for publication July 2, 2022. Revision received September 10, 2022. Accepted for publication September 14, 2022. |
Vol 81 - N° 5
P. 592-605 - mai 2023 Retour au numéro
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