Alison M Mudge1,2, Adrienne Young3, Prue McRae4, Frederick Graham5, Elizabeth Whiting6, Ruth E Hubbard7. 1. Department of Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Brisbane, Australia. Alison.Mudge@health.qld.gov.au. 2. University of Queensland School of Clinical Medicine, Brisbane, Australia. Alison.Mudge@health.qld.gov.au. 3. Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Brisbane, Australia. 4. Department of Internal Medicine and Aged Care, Royal Brisbane and Women's Hospital, Brisbane, Australia. 5. Department of Internal Medicine, Princess Alexandra Hospital, Brisbane, Australia. 6. Metro North Hospital and Health Services, Brisbane, Australia. 7. Centre for Research in Geriatric Medicine, The University of Queensland, Brisbane, Australia.
Abstract
BACKGROUND: With ageing global populations, hospitals need to adapt to ensure high quality hospital care for older inpatients. Age friendly hospitals (AFH) aim to establish systems and evidence-based practices which support high quality care for older people, but many of these practices remain poorly implemented. This study aimed to understand barriers and enablers to implementing AFH from the perspective of key stakeholders working within an Australian academic health system. METHODS: In this interpretive phenomenenological study, open-ended interviews were conducted with experienced clinicians, managers, academics and consumer representatives who had peer-recognised interest in improving care of older people in hospital. Initial coding was guided by the Promoting Action on Research Implementation in Health Services (PARIHS) framework. Coding and charting was cross checked by three researchers, and themes validated by an expert reference group. Reporting was guided by COREQ guidelines. RESULTS: Twenty interviews were completed (8 clinicians, 7 academics, 4 clinical managers, 1 consumer representative). Key elements of AFH were that older people and their families are recognized and valued in care; skilled compassionate staff work in effective teams; and care models and environments support older people across the system. Valuing care of older people underpinned three other key enablers: empowering local leadership, investing in implementation and monitoring, and training and supporting a skilled workforce. CONCLUSIONS: Progress towards AFH will require collaborative action from health system managers, clinicians, consumer representatives, policy makers and academic organisations, and reframing the value of caring for older people in hospital.
BACKGROUND: With ageing global populations, hospitals need to adapt to ensure high quality hospital care for older inpatients. Age friendly hospitals (AFH) aim to establish systems and evidence-based practices which support high quality care for older people, but many of these practices remain poorly implemented. This study aimed to understand barriers and enablers to implementing AFH from the perspective of key stakeholders working within an Australian academic health system. METHODS: In this interpretive phenomenenological study, open-ended interviews were conducted with experienced clinicians, managers, academics and consumer representatives who had peer-recognised interest in improving care of older people in hospital. Initial coding was guided by the Promoting Action on Research Implementation in Health Services (PARIHS) framework. Coding and charting was cross checked by three researchers, and themes validated by an expert reference group. Reporting was guided by COREQ guidelines. RESULTS: Twenty interviews were completed (8 clinicians, 7 academics, 4 clinical managers, 1 consumer representative). Key elements of AFH were that older people and their families are recognized and valued in care; skilled compassionate staff work in effective teams; and care models and environments support older people across the system. Valuing care of older people underpinned three other key enablers: empowering local leadership, investing in implementation and monitoring, and training and supporting a skilled workforce. CONCLUSIONS: Progress towards AFH will require collaborative action from health system managers, clinicians, consumer representatives, policy makers and academic organisations, and reframing the value of caring for older people in hospital.
Entities:
Keywords:
Capacity building; Health services; Health workforce; Patient care team; Quality of health care
Authors: Alison M Mudge; Prue McRae; Ruth E Hubbard; Nancye M Peel; Wen Kwang Lim; Adrian G Barnett; Sharon K Inouye Journal: J Am Geriatr Soc Date: 2018-11-13 Impact factor: 5.562