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

Published online by Cambridge University Press:  20 April 2026

Philippe Desmarais ,
Aline Bolduc ,
Miguel Conant ,
Madeleine Asselin ,
Julia Chabot ,
Géraldine Clerjuste ,
Alexandra Constant ,
Julie Décary ,
Katherine Desforges  and
Annie Fortier
...Show all authors
Philippe Desmarais*
Affiliation:
Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Canada Centre Hospitalier de l’Universite de Montreal, Canada Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Canada
Aline Bolduc
Affiliation:
Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Canada
Miguel Conant
Affiliation:
Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Canada
Madeleine Asselin
Affiliation:
Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Canada
Julia Chabot
Affiliation:
St Mary’s Hospital Center, Canada
Géraldine Clerjuste
Affiliation:
Centre Hospitalier de l’Universite de Montreal, Canada
Alexandra Constant
Affiliation:
Centre Hospitalier de l’Universite de Montreal, Canada
Julie Décary
Affiliation:
Centre Intégré de Santé et de Services Sociaux de la Montérégie-Est du Québec, Canada
Katherine Desforges
Affiliation:
Université de Montréal Faculté de Pharmacie, Canada
Annie Fortier
Affiliation:
Centre Intégré de Santé et de Services Sociaux de Laval du Québec, Canada
Sandra Gauthier
Affiliation:
Centre Intégré de Santé et de Services Sociaux des Laurentides du Québec, Canada
Marie-Jeanne Kergoat
Affiliation:
Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Canada
Jennifer Kistchouk
Affiliation:
Centre Hospitalier de l’Universite de Montreal, Canada
Joseph Di Lalla
Affiliation:
CIUSSS Centre-Sud-de-l’Ile-de-Montreal, Canada
Sonia Mailhot
Affiliation:
Centre Intégré de Santé et de Services Sociaux des Laurentides du Québec, Canada
Marie-Pier Mandeville
Affiliation:
Centre Intégré de Santé et de Services Sociaux de la Montérégie-Est du Québec, Canada
Quoc Dinh Nguyen
Affiliation:
Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Canada Centre Hospitalier de l’Universite de Montreal, Canada
Marie-Claude Patry
Affiliation:
CIUSSS Centre-Sud-de-l’Ile-de-Montreal, Canada
*
Corresponding author: La correspondance et les demandes de tirés-à-part doivent être adressées à:/Correspondence and requests for offprints should be sent to: Philippe Desmarais, Division of Geriatrics, Department of Medicine, Centre Hospitalier de l’Université de Montréal, 1000 Rue St-Denis, Pavillon B - 12e étage - B12-8091, Montréal, QC H2X 0C1, Canada (philippe.desmarais.1@umontreal.ca)
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Abstract

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.

Résumé

RésuméContexte

Les symptômes comportementaux et psychologiques en démence (SCPD) sont fréquents chez les personnes âgées hospitalisées et représentent un défi pour les soins aigus.

Objectif

Cette étude visait à recenser les indicateurs de qualité (IQ) disponibles pour les SCPD, établir les priorités et explorer les facilitateurs et obstacles perçus à leur utilisation.

Méthodes

Nous avons mené un sondage électronique transversal auprès de médecins, infirmières et administrateurs des hôpitaux de soins aigus du Québec (janvier–février 2025). Le questionnaire comportait des questions ouvertes analysées selon le modèle structure–processus–résultats de Donabedian.

Résultats

Cinquante-cinq répondants ont généré 677 réponses, dont 59 thèmes, 44 jugés prioritaires. Les principaux IQ incluaient le dépistage du délirium, l’utilisation de contentions et d’antipsychotiques, la durée de séjour, les événements indésirables et la disponibilité des ressources. Les participants ont souligné l’importance d’IQ standardisés et cliniquement pertinents.

Discussion

L’intégration d’IQ standardisés dans les dossiers électroniques pourrait améliorer les comparaisons, orienter l’amélioration et favoriser des soins plus sécuritaires et centrés sur la personne.

Keywords

acute careagingbehavioral and psychological symptoms in dementiadementiahealth care qualityolder peoplequality indicatorsSoins aigusSymptômes comportementaux et psychologiques en démenceTrouble neurocognitifQualité des soins médicauxPersonnes âgéesIndicateurs de qualitéVieillissement

Information

Type
Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , First View , pp. 1 - 10
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Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of The Canadian Association on Gerontology

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