Turning evidence into action using a senior friendly hospital framework and a collaborative network.

The Senior Friendly Hospital Accelerating Change Together in Ontario program linked the Collaborative Network Model and the Senior Friendly Hospital Framework in a unique multi-hospital knowledge-to-practice initiative to improve care for hospitalized older adults. The design enabled teams from 78 Ontario hospitals to close a shared skills and knowledge gap while meeting the varied needs of their diverse contexts. Results suggest that this design meant to reduce unnecessary redundancy, while preserving requisite diversity, was successful in achieving its specific objectives: to build a collaborative network and increase the confidence, knowledge, and skills of its members sufficient to lead sustainable improvements in their unique hospital settings. Findings with special relevance to process improvement specialists, health system leaders, and hospital administrators and managers are discussed.

Guidance for hospital and community-based health services for older adults: The senior friendly care framework.

To meet the needs of a population of older adults at risk of becoming frail in the context of known limitations to current practice, frameworks have emerged to guide health service development. Typically these frameworks have developed in the hospital sector despite the need for hospital/community sector co-development and adoption. In the present study one such framework - the Senior Friendly Hospital (SFH1) Framework - is examined with an intersectoral lens. The study included a scoping review of literature addressing system-based approaches to improving healthcare of older people as well as a modified Delphi process to incorporate these findings into an expanded framework. Qualitative analysis of the data extracted from the scoping review resulted in the identification of "senior friendly" excerpts that were charted using an apriori matrix provided by the SFH Framework. Researchers conducted thematic analysis of the excerpts to avoid redundancy and wrote statements to optimize thematic clarity. In a modified Delphi process, the statements were subsequently rated for perceived importance, clarity and fit by an intersectoral panel of experts resulting in a refined Senior Friendly Care (sfCare2) Framework comprising 31 statements and 7 guiding principles to consider when implementing improvements in the care of older adults. Finally, a panel of stakeholders were consulted for feedback on the clarity of the framework's intent and its anticipated impact on care. The sfCare Framework is now available to guide hospital and community-based health service development for older adults.