Acute Practitioners' Experiences of Implementing Frailty Same Day Emergency Care: A Researcher-in-Residence Study.
Introduction: NHS policy promotes Frailty Same Day Emergency Care (F-SDEC) units to alleviate pressure on emergency departments (ED) and improve care for frail people through comprehensive geriatric assessment and same-day discharge. However, evidence remains limited on how such services are impleme...
| Publicado en: | International Journal of Integrated Care (IJIC) Vol. 26; no. 2; pp. 1 - 13 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Ubiquity Press
Apr-Jun2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=196095171&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 196095171 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15684156 8US jtl: International Journal of Integrated Care (IJIC) issn: 15684156 maglogo: N pubinfo: dt: Apr-Jun2026 vid: 26 iid: 2 pid: 83901 pub: Ubiquity Press artinfo: ui: 196095171 196095171 196095171 10.5334/ijic.9854 196095171 ppf: 1 ppct: 12 formats: tig: atl: Acute Practitioners' Experiences of Implementing Frailty Same Day Emergency Care: A Researcher-in-Residence Study. aug: au: Green, Kieran Asthana, Sheena Downey, John Watson, Joanne affil: University of Plymouth sug: subj: Frailty Syndrome Rehabilitation Emergency Service Ambulatory Care Implementation Science Attitude of Health Personnel Acute Care Health Care Delivery Human Funding Source England Triage Hospitals England National Health Programs Geriatric Assessment Semi-Structured Interview Interview Guides Thematic Analysis Snowball Sample Audiorecording Data Analysis Software Descriptive Statistics Scales ab: Introduction: NHS policy promotes Frailty Same Day Emergency Care (F-SDEC) units to alleviate pressure on emergency departments (ED) and improve care for frail people through comprehensive geriatric assessment and same-day discharge. However, evidence remains limited on how such services are implemented in practice, particularly in resource-constrained and geographically peripheral settings. This study aimed to examine how implementation barriers are experienced and negotiated during the day-to-day delivery of an F-SDEC pilot. Methods: Using a Researcher-in-Residence approach, a researcher embedded in a coastal hospital in Torbay, South-West England, collected field notes from prior observations to inform the interview guide, conducted semi-structured interviews with staff delivering F-SDEC, and held a feedback session. A framework-informed, reflexive thematic approach guided the identification of key implementation challenges and enablers. Results: Staff viewed F-SDEC as beneficial for improving care for older adults, but interacting barriers constrained implementation. ED-based triage was time-intensive and difficult to routinise due to fragmented, non-interoperable IT systems, inconsistent understanding of frailty across hospital teams, and shifting eligibility criteria. Operational pressures, workforce and skill-mix shortages, and an inconsistent understanding of F-SDEC's needs and purpose also limited CGA delivery and contributed to day-to-day variability in throughput. While staff expressed a desire to reorient towards community-based referrals, the same digital and workforce constraints also limited the feasibility of alternative routes, further raising sustainability concerns. Conclusions: F-SDEC implementation was shaped by interdependent system constraints rather than isolated barriers. In peripheral and resource-constrained settings, successful implementation may depend on whole-system alignment across digital infrastructure, workforce capacity, and cross-team collaboration, with national policy better accounting for local delivery conditions. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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