The resultant preliminary indicators will aim to encompass assessment of emergency department structure (including the physical environment and the policies related to the care of older persons), process and outcomes. Data
collection Throughout the meeting, three scribes will record decisions and concepts resulting from the discussion; and each panel member will informally rate potential QIs based on three criteria, including validity, significance, and responsibility. These ratings will be recorded on individual data collection sheets. This will be used as an additional Inhibitors,research,lifescience,medical resource to ensure that the scribes captured all relevant discussion points. Inhibitors,research,lifescience,medical Data compilation After completion of the first expert panel meeting, three investigators (EB, LS, MMK) will review all the preliminary indicators. A working manual for each indicator set will be established (structural, process, outcome). Each preliminary QI will be defined – this includes
detailed Inhibitors,research,lifescience,medical specification of the numerator, denominator, exclusion characteristics and any factors that will be significant for risk adjustment. The feedback from the expert panel will be incorporated into the manual alongside each indicator. Any preliminary indicators rejected at the expert panel meeting as clearly unsuitable will be recorded, along with the justification for exclusion, in a separate manual, known as The Excluded Indicators Manual. Phase 2: Field study Objective The purpose of the field study is Inhibitors,research,lifescience,medical to test the DNA PK inhibitor feasibility and usefulness of each of the preliminary indicators suggested in Phase 1. This will be achieved by collecting data from a representative sample Inhibitors,research,lifescience,medical of older patients presenting for emergency department care. The assessment of potential QIs will include a complex analytic process that involves risk adjustment. Design
The study will be a multi-centre prospective observational cohort study of the validity and feasibility of the preliminary QIs developed by the study team, including any previously published relevant QIs . Working from the defined preliminary indicators Carnitine palmitoyltransferase II recorded in each of the working manuals, a matrix of data items and data collection methods will be created which ensures that, for each potential QI, the relevant data items have been identified and a collection method found (EB, LS, MMK). Based on the data matrix, the data collection tools will be designed. Wherever possible, existing, validated, tools will be used for the data collection. If a tool cannot be identified to collect specific data, then a data collection tool will be designed. The tool will be tested for feasibility at several sites at the beginning of the project and feedback from the research nurses will enable refinement of the tool.