Assessment of hospital environments and policies: seeking an age-friendly hospital

Abstract

Functional decline is one of the main problems arising from the hospitalization of elderly persons. Hospital environments and policies focused on functionality are crucial for diminishing disabilities associated with hospitalization. This observational study was performed in four internal medicine services and aimed to evaluate the hospital environment and policies as an integral step in implementing the Function-Focused Care (FFC) programme being established in Portugal. The results of the hospital environment analysis suggest that design and product support, while present, are limited given the needs, complexities and specificities of hospitalized elderly persons. Policy evaluation indicated the existence of institutional projects that reflect a concern with functionality. However, more than half of the criteria evaluated need to be developed further in order to integrate the FFC programme. These results highlight that, while these services aim to be more "age-friendly environments", a number of initiatives can and should be undertaken in order to guide the FFC implementation process. This will benefit patients and their families, professionals and institutions.

Age-Friendly Health Care: A Systematic Review

“…Most of the 34 included studies were developed within the scope of secondary care ( n = 23 articles). In this case, 13 articles focused only on a hospital department, namely, (i) Emergency Department, seven articles [ 27 , 28 , 29 , 30 , 31 , 32 , 33 ]; (ii) Surgery Department, two articles [ 34 , 35 ]; (iii) Acute Care Service, two articles [ 36 , 37 ]; (iv) Outpatient Department, one article [ 38 ]; and (v) Internal Medicine Department, one article [ 39 ]. The remaining ten articles analyze the entire hospital [ 5 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ].…”

Eficácia da implantação do cuidado centrado na funcionalidade no declínio funcional: um estudo quase-experimental

“…Acresce a necessidade de implementar, de forma mais consistente as 4 componentes de implementação do CCF para que este cuidado possa ser incorporado na prática dos enfermeiros. Importa destacar, que no processo de implementação, a componente I não demonstrou ser favorecedora da incorporação do CCF (Tavares, Grácio, & Nunes, 2017). Adicionalmente, verificou-se uma baixa adesão na componente III (estabelecimento de objetivos) e pouca clareza do papel do champion enquanto elemento motivador das equipas (componente IV).…”

“…Foram realizadas 4 visitas às unidades e entrevistados os enfermeiros(as) chefes para avaliar o ambiente (18 itens) e as políticas (15 itens), em que mais de metade dos critérios avaliados necessitam de desenvolvimento no sentido de integrar o CCF (Tavares, Grácio, & Nunes, 2017). Nas unidades experimentais, foram realizadas algumas alterações para otimizar funcionalidade/AF (ex.…”

Hospitalized older adults: functional trajectory in Portuguese hospital

“…FD can occur before, during, and after hospitalization due to intrinsic and extrinsic factors (Tavares, Grácio, & Nunes, 2017a). In Portugal, a study found that 76.2% of hospitalized older people were at risk for FD during and after hospitalization (Tavares et al, 2017a). Despite the high risk and significant decline rates, the authors of this study are not aware of any studies on the functional trajectory (FT) of hospitalized older people between baseline (2 weeks before hospitalization) and 3 months after discharge.…”

“…FD is one of the main consequences of hospitalization and is associated with decreased quality of life and higher mortality rates during and after hospital stay (Palese et al, 2016). FD can occur before, during, and after hospitalization due to intrinsic and extrinsic factors (Tavares, Grácio, & Nunes, 2017a). In Portugal, a study found that 76.2% of hospitalized older people were at risk for FD during and after hospitalization (Tavares et al, 2017a).…”