Show simple item record

dc.contributor.authorHealth Service Executive (HSE) Quality and Patient Safety Directorate
dc.contributor.authorO'Donnell, Deirdre
dc.contributor.authorNí Shé, Éidín
dc.contributor.authorMcCarthy, Mary
dc.contributor.authorThornton, Shirley
dc.contributor.authorDoran, Thelma
dc.contributor.authorSmith, Freda
dc.contributor.authorO'Brien, Barry
dc.contributor.authorMilton, Jim
dc.contributor.authorSavin, Bibiana
dc.contributor.authorDonnellan, Anne
dc.contributor.authorCallan, Eugene
dc.contributor.authorMcAuliffe, Eilish
dc.contributor.authorGray, Simone
dc.contributor.authorCarey, Therese
dc.contributor.authorBoyle, Nicola
dc.contributor.authorO'Brien, Michelle
dc.contributor.authorPatton, Andrew
dc.contributor.authorBailey, Jade
dc.contributor.authorO'Shea, Diarmuid
dc.contributor.authorCooney Marie, Therese
dc.date.accessioned2019-12-17T16:23:49Z
dc.date.available2019-12-17T16:23:49Z
dc.date.issued2019-11-05
dc.identifier.issn1472-6963
dc.identifier.pmid31690304
dc.identifier.doi10.1186/s12913-019-4626-8
dc.identifier.urihttp://hdl.handle.net/10147/626960
dc.descriptionBackground: Although not an inevitable part of ageing, frailty is an increasingly common condition in older people. Frail older patients are particularly vulnerable to the adverse effects of hospitalisation, including deconditioning, immobility and loss of independence (Chong et al, J Am Med Dir Assoc 18:638.e7-638.e11, 2017). The 'Systematic Approach to improving care for Frail older patients' (SAFE) study co-designed, with public and patient representatives, quality improvement initiatives aimed at enhancing the delivery of care to frail older patients within an acute hospital setting. This paper describes quality improvement initiatives which resulted from a co-design process aiming to improve service delivery in the acute setting for frail older people. These improvement initiatives were aligned to five priority areas identified by patients and public representatives. Methods: The co-design work was supported by four pillars of effective and meaningful public and patient representative (PPR) involvement in health research (Bombard et al, Implement Sci 13:98, 2018; Black et al, J Health Serv Res Policy 23:158-67, 2018). These pillars were: research environment and receptive contexts; expectations and role clarity; support for participation and inclusive representation and; commitment to the value of co-learning involving institutional leadership. Results: Five priority areas were identified by the co-design team for targeted quality improvement initiatives: Collaboration along the integrated care continuum; continence care; improved mobility; access to food and hydration and improved patient information. These priority areas and the responding quality improvement initiatives are discussed in relation to patient-centred outcomes for enhanced care delivery for frail older people in an acute hospital setting. Conclusions: The co-design approach to quality improvement places patient-centred outcomes such as dignity, identity, respectful communication as well as independence as key drivers for implementation. Enhanced inter-personal communication was consistently emphasised by the co-design team and much of the quality improvement initiatives target more effective, respectful and clear communication between healthcare personnel and patients. Measurement and evaluation of these patient-centred outcomes, while challenging, should be prioritised in the implementation of quality improvement initiatives. Adequate resourcing and administrative commitment pose the greatest challenges to the sustainability of the interventions developed along the SAFE pathways. The inclusion of organisational leadership in the co-design and implementation teams is a critical factor in the success of interventions targeting service delivery and quality improvement.en_US
dc.language.isoenen_US
dc.publisherHealth Service Executive (HSE)en_US
dc.subjectPATIENT SAFETYen_US
dc.subjectQUALITYen_US
dc.subjectCLINICAL GOVERNANCEen_US
dc.subjectCo-designen_US
dc.subjectFrailtyen_US
dc.subjectHealth systemen_US
dc.subjectOLDER PEOPLEen_US
dc.subjectPerson-centred careen_US
dc.subjectPublic and patient involvementen_US
dc.titleEnabling public, patient and practitioner involvement in co-designing frailty pathways in the acute care setting.en_US
dc.typeArticleen_US
dc.source.journaltitleBMC health services research
refterms.dateFOA2019-12-17T16:23:49Z


Files in this item

Thumbnail
Name:
s12913-019-4626-8.pdf
Size:
560.1Kb
Format:
PDF

This item appears in the following Collection(s)

Show simple item record