Contextual Analysis and Implementation Strategies for an Age‐Friendly Emergency Department Uptake: The FRED Study Protocol.
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...
| Publicado en: | Journal of the American Geriatrics Society Vol. 74; no. 2; pp. 365 - 377 |
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| Autores principales: | , , , , , , , , , |
| Formato: | Artículo |
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Wiley-Blackwell
Feb2026
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=191631212&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 191631212 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00028614 20Q jtl: Journal of the American Geriatrics Society issn: 00028614 maglogo: Y pubinfo: dt: Feb2026 vid: 74 iid: 2 pid: 480 pub: Wiley-Blackwell artinfo: ui: 191631212 10.1111/jgs.70230 ppf: 365 ppct: 12 formats: tig: atl: Contextual Analysis and Implementation Strategies for an Age‐Friendly Emergency Department Uptake: The FRED Study Protocol. aug: au: Cantarero Fernandez, Alisa Nickel, Christian H. Dreher‐Hummel, Thomas Grossmann, Florian Ünlü, Luca Carpenter, Christopher R. Heeren, Pieter Ruiter, Robert A. C. Simon, Michael Zúñiga, Franziska affil: Nursing Science, Department Public Health, University of Basel, Basel, Switzerland Department of Emergency Medicine, University Hospital of Basel, Basel, Switzerland Faculty of Medicine, University of Basel, Basel, Switzerland Department of Acute Medicine, University Hospital of Basel, Basel, Switzerland Department of Emergency Medicine, Mayo Medical Center, Rochester Minnesota,, USA Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium Department of Work and Social Psychology, Maastricht University, Maastricht, the Netherlands su: Switzerland Elder care Human services programs Interviewing Emergency medicine Patient-centered care Old age Research funding Frail elderly Hospital emergency services Judgment sampling Descriptive statistics Thematic analysis Research methodology Quality assurance sug: subj: Elder care Human services programs Interviewing Emergency medicine Patient-centered care Old age Switzerland Continuing Care Retirement Communities Research funding Frail elderly Hospital emergency services Judgment sampling Descriptive statistics Thematic analysis Research methodology Quality assurance keyword: emergency department frailty geriatric emergency medicine implementation science older adults emergency department frailty geriatric emergency medicine implementation science older adults ab: 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. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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