“Older people aren’t my real patients”: qualitative evaluation of
barriers and enablers to older person friendly hospitals
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.