| Sumario: | Background: Older adults frequently present to the Emergency Department (ED). In response, a Swiss university hospital introduced age‐friendly interventions and achieved Geriatric Emergency Department Accreditation (GEDA) by the American College of Emergency Physicians (ACEP). However, the impact of previously introduced interventions and the reasons behind emergency clinicians' varying uptake or lack of continued use remain unclear. To further improve patient outcomes, conducting a contextual analysis to identify implementation barriers and facilitators is crucial, followed by the development of tailored implementation strategies supporting the sustainable uptake of all age‐friendly program elements. The project's overall aim is to systematically promote the uptake and sustainable re‐implementation of the existing age‐friendly ED program. The first study phase outlined in this protocol ("Phase A") focuses on 2 key objectives: (1) to assess current age‐friendly interventions in the ED and identify barriers and facilitators affecting their reach, adoption, implementation, and maintenance; (2) to develop tailored implementation strategies for re‐implementing program elements. Methods: This project uses a modified implementation mapping in 5 Steps across 2 Phases. Phase A includes Steps 1–4: (1) conducting a contextual analysis using a mixed‐methods design combining observations, interviews, patient chart reviews, E‐survey and a Gemba walk; (2) identifying expected intervention and implementation outcomes, performance objectives; (3) adapting, extending, or developing tailored implementation strategies based on the Expert Recommendations for Implementing Change taxonomy; and (4) co‐designing an implementation protocol to guide re‐implementation. The follow‐up Phase B will involve the re‐implementation of the intervention elements and co‐designing the evaluation protocol (Step 5) for the implementation process. Conclusion: Age‐friendly EDs are essential for person‐centered emergency care, enhancing safety and quality of care for older adults. This study will provide insights into adaptable, evidence‐informed implementation strategies that support behavioral change among emergency clinicians to increase patient reach and sustainability of age‐friendly interventions for complex ED settings. Summary: Key points ○Widespread implementation of age‐friendly ED programs remains limited due to an incomplete understanding of context‐specific barriers and facilitators.○There is a need for tailored implementation strategies that support sustainable change in a fast‐moving ED context.○Fostering the sustainment of an age‐friendly ED will go hand in hand with enhancing geriatric expertise by empowering the workforce to provide person‐centered care and improve health outcomes.Why does this paper matter? ○The FRED project is a systematic re‐implementation of an age‐friendly emergency department program that leverages implementation science.○The primary objective of this effort is to further improve and sustain the quality of care for older patients by increasing emergency clinician adoption and patient reach of age‐friendly interventions, while enhancing person‐centeredness.○The proposed multi‐framework approach and results of the FRED project can provide sustainable, evidence‐based solutions that are adaptable to different emergency settings.
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