• Orla C Sheehan, Christine S Ritchie, Roya Fathi, Sarah K Garrigues, Debra Saliba, and Bruce Leff.
• Center on Aging and Health, Division of Geriatric Medicine and Gerontology School of Medicine, Johns Hopkins University, Baltimore, Maryland.
• J Am Geriatr Soc. 2016 Dec 1; 64 (12): 2577-2584.

ObjectivesTo develop candidate quality indicators (QIs) for the quality standard of "addressing abuse and neglect" in the setting of home-based medical care.DesignSystematic literature review of both the peer-reviewed and gray literature.SettingHome-based primary and palliative care practices.ParticipantsHomebound community-dwelling older adults.MeasurementsArticles were identified to inform the development of candidate indicators of the quality by which home-based primary and palliative care practices addressed abuse and neglect. The literature guided the development of patient-level QIs and practice-level quality standards. A technical expert panel (TEP) representing exemplary home-based primary care and palliative care providers then participated in a modified Delphi process to assess the validity and feasibility of each measure and identify candidate QIs suitable for testing in the field.ResultsThe literature review yielded 4,371 titles and abstracts that were reviewed; 25 publications met final inclusion criteria and informed development of nine candidate QIs. The TEP rated all but one of the nine candidate indicators as having high validity and feasibility.ConclusionTranslating the complex problem of addressing abuse and neglect into QIs may ultimately serve to improve care delivered to vulnerable home-limited adults who receive home-based medical care.© 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

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