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“Older people aren’t my real patients”: qualitative evaluation of barriers and enablers to older person friendly hospitals
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  • Alison Mudge,
  • Adrienne Young,
  • Prue McRae,
  • Frederick Graham,
  • Elizabeth Whiting,
  • Ruth E. Hubbard
Alison Mudge
Royal Brisbane and Women's Hospital
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Adrienne Young
Royal Brisbane and Women's Hospital
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Prue McRae
Royal Brisbane and Women's Hospital
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Frederick Graham
Princess Alexandra Hospital
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Elizabeth Whiting
Metro North Hospital and Health Service
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Ruth E. Hubbard
The University of Queensland Faculty of Medicine
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Abstract

Background, aims and objectives: With ageing global populations, hospitals need to adapt to ensure high quality hospital care for older inpatients. Older person friendly hospital (OPFH) principles and practices to improve care for older people are recognised, but many remain poorly implemented in practice. The aim of this study was to understand barriers and enablers to achieving OPFH from the perspective of key informants within an academic health system. Methods: Interpretive phenonomenological study, using open-ended interviews conducted by a single researcher with experienced clinicians, managers, academics and consumers who had peer-recognised interest in care of older people. 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). Key elements of OPFH were: older people and their families are recognized and respected; 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 OPFH will require genuine partnerships between clinicians, consumers, health system managers, policy makers and academic organisations, and reframing the value of caring for older people in hospital.

Peer review status:POSTED

25 Jul 2020Submitted to Journal of Evaluation in Clinical Practice
27 Jul 2020Assigned to Editor
27 Jul 2020Submission Checks Completed