Table 3: Quality indicator scores of the acute geriatric unit and the palliative care unit

QI	Description	AGU^2 % (n)	PCU^3 % (n)	p
A. Physical domain
Pain
1	IF a patient is admitted to a hospital, THEN there should be screening for the presence or absence of pain within 48 hours of admission. This should be documented in the patient chart.	45.6 (26/57)	98.3 (58/59)	<.001
2	For patients who screened positive for pain, the percent who had a reduction or relief of pain within the 48 hours of admission (a pain score of 3 or less on a 10-point scale is considered equivalent to relief or reduction).	42.1 (8/19)	77.8 (28/36)	.008
3	IF a vulnerable elder (VE) with end-stage metastatic cancer is treated with opiates for pain, THEN the medical record should document a plan for management of worsening or emergent pain.	62.5 (5/8)	98.0 (49/50)	.007
Dyspnoea
4	IF a patient has dyspnoea on admission, THEN s/he should be offered symptomatic management or treatment directed at an underlying cause within 24 hours.	92.9 (26/28)	86.7 (13/15)	.602
Gastrointestinal tract
5	IF a patient is admitted to a hospital with affected gastrointestinal (GI) tract or abdomen, THEN the presence or absence of nausea or vomiting should be assessed within 24 hours.	60.0 (6/10)	84.2 (16/19)	.193
6	IF a VE has obstructive GI symptoms, THEN the medical record should document a plan for management of worsening or emergent nausea and vomiting.	100 (1/1)	100 (4/4)	-
7	IF a VE with persistent pain is treated with opioids, THEN one of the following should be prescribed or noted: (1) stool softener or laxative; (2) increased fibre, stool-softening foods; (3) documentation of the potential for constipation or why bowel treatment is not needed	55.6 (15/27)	66.0 (33/50)	.367
Other
8	Percent of patients for whom the observation and if necessary the oral health care was documented.	60.3 (35/58)	98.3 (58/59)	<.001
9	Percent of patients for whom the presence or absence of delirium or agitation was documented.	0.0 (0/57)	0.0 (0/59)	-
B. Psychological domain
10	IF a patient is admitted to a hospital, THEN the chart should document the presence or absence of anxiety.	29.8 (17/57)	83.1 (49/59)	<.001
11	For patients who screened positive for anxiety, the percent who received treatment within 24 hours of diagnosis.	94.4 (17/18)	75.8 (25/33)	.134
C. Spiritual domain
12	IF a VE who was conscious during the last 3 days of life died an expected death, THEN the medical record should contain documentation about spirituality or how the patient was dealing with death or religious feelings.	43.9 (25/57)	54.5 (30/55)	.258
D. Domain ‘information and care planning’
13	IF a patient is admitted to a hospital, THEN the chart should document that the goals of care were discussed with the patient.	44.9 (22/49)	43.9 (25/57)	.915
14	IF a patient is admitted to a hospital, THEN the chart should document that there has been phone contact with theGP about the care planning.	19.0 (11/58)	1.7 (1/59)	.002
E. Domain ‘family care’
15	IF a patient is admitted to a hospital, THEN the chart should document that the goals of care were discussed with the family.	80.7 (46/57)	51.7 (30/58)	.001
16	IF a patient is admitted to a hospital, THEN the chart should have documentation of a meeting during the first week of hospital stay between patient/family and members of the healthcare team to discuss the patient’s treatment preferences or the plans for discharge disposition.	35.1 (20/57)	22.4 (13/58)	.135
17	IF a patient is expected to die, THEN the chart should document that the family had been explained about the impending death of the patient.	91.4 (53/58)	96.6 (57/59)	.272

2 Acute Geriatric Unit

3 Palliative Care Unit

Significance level: p<.05

QI 1, QI 9 and QI 10 were not applicable for one patient at the AGU because this patient was unconscious within 48 hours of admission.
QI 12 was not applicable for one patient at the AGU and for four patients at the PCU because they were unconscious during the last three days of life.
QI 13 was not applicable for nine patients at the AGU and for two patients at the PCU because they were unconscious or refused to discuss the goals of care.
QI 15 and QI 16werenot applicable for one patient at the AGU and for one patient at the PCU because they didn’t want their health status and goals of care to be discussed with their family.