Key Healthcare Providers’ Perspectives on the Implementation of Senior-Friendly Emergency Department Care in Quebec

Introduction: Senior-friendly emergency department (ED) care is emerging to address large numbers of older adults in healthcare and implementation is variable. We aimed to explore key healthcare providers’ perspectives on factors affecting implementation of senior-friendly ED care during the first five years of Senior-Friendly Hospital Initiative in the Province of Quebec, Canada. Methods: We conducted a descriptive qualitative study of four urban EDs. Key healthcare providers involved in care within the ED or after discharge to the community were purposefully selected. Semi-structured telephone interviews were conducted in participants’ preferred language, English or French. Recorded interviews were transcribed. A deductive-inductive thematic analysis was performed focusing on factors affecting implementation at the three following levels: provider-level (ED frontline staff, multidisciplinary, geriatric, and community providers), organizational-level (ED and hospital), and structural-level (health system and policies). Results: In total, 33 providers participated. The sample included 13 ED frontline nurses and physicians, 13 multidisciplinary and geriatric ED care providers, and seven community partners from the local government health centers working closely with these EDs. Analysis of participants’ perceptions revealed one theme representing implementation at the provider level (attitude to senior-friendly care), six themes representing the organizational level (managerial support, staff training, protocols for care and tools, space and equipment, multidisciplinary support, hospital services support), and three themes representing the structural level (health information system, healthcare network, and staff and budget). Conclusion: Healthcare providers identified themes that can inform the development, effectiveness, and sustainability of other senior-friendly ED programs. Overall, successful implementation of senior-friendly ED care primarily depends on providers’ attitudes, but it requires a multidimensional approach and continuous support from organizations and healthcare systems.