Quality Indicators for Behavioral and Psychological Symptoms of Dementia: A Qualitative Study on Available Measures and Key Factors for Implementation in Acute Care.

BACKGROUND

Behavioral and psychological symptoms of dementia (BPSD) are common in hospitalized older people and challenge acute care delivery.

OBJECTIVE

This study sought to identify available quality indicators (QIs) for BPSD, establish priorities, and explore perceived facilitators and barriers to their use.

METHODS

We conducted a cross-sectional electronic survey among physicians, nurses, and administrators in Quebec acute care hospitals (January-February 2025). The survey included open-ended questions analysed using Donabedian's structure-process-outcome model.

FINDINGS: Fifty-five respondents generated 677 responses, yielding 59 themes, 44 deemed priorities. Key QIs included delirium screening, restraint and antipsychotic use, length of stay, adverse events, and resource availability. Participants emphasized the need for standardized, clinically meaningful QIs. Reported barriers included staffing shortages, fragmented technological systems, and limited institutional prioritization, while facilitators included leadership commitment, interdisciplinary support, and structured training.

DISCUSSION: Embedding standardized QIs into electronic health records may enhance benchmarking, guide improvement, and promote safer dementia care.