Studies pertaining to the ACOVE quality criteria: a systematic review

To identify and uniformly describe studies employing the Assessing Care Of Vulnerable Elders (ACOVE) quality indicators within a comprehensive thematic model that reflects how the indicators were used. A systematic search of MEDLINE, EMBASE and CINAHL was conducted. English-language studies meeting our criteria published prior to January 2010. Included studies were analyzed and described by two independent researchers. A total of 41 articles met our selection criteria. Studies were classified into the themes ‘Application of indicators’ (32 studies) and ‘Analysis and development of indicators’ (13 studies). ‘Application’ studies included assessing quality of care, influencing behavior of health professionals and examining the association of quality of care with other factors. ‘Analysis and development’ included studies developing new indicator sets, and those adapting and validating the original quality indicators to new settings. The indicators were used in a wide range of applications with two main foci: the assessment of quality of care for elderly patients, and investigating the feasibility of similar indicators and their adaptation to new settings. Very few of the studies published to date have addressed the goal of care improvement. We foresee an important role for application of indicators that proactively help health-care professionals to deliver the right care at the right time, for example by resorting to decision support systems.