Evidence map›Paper›PMID 41329556›Full record

ArticleJournal of the American Geriatrics Society2026

Contextual Analysis and Implementation Strategies for an Age-Friendly Emergency Department Uptake: The FRED Study Protocol.

Alisa Cantarero Fernandez, Christian H Nickel, Thomas Dreher-Hummel, Florian Grossmann, Luca Ünlü, Christopher R Carpenter, Pieter Heeren, Robert A C Ruiter, Michael Simon, Franziska Zúñiga

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Alisa Cantarero FernandezNursing Science, Department Public Health, University of Basel, Basel, Switzerland.ORCID 0009-0006-5171-9981
Christian H NickelDepartment of Emergency Medicine, University Hospital of Basel, Basel, Switzerland.ORCID 0000-0001-6619-9284
Thomas Dreher-HummelDepartment of Emergency Medicine, University Hospital of Basel, Basel, Switzerland.ORCID 0000-0002-7741-3853
Florian GrossmannDepartment of Acute Medicine, University Hospital of Basel, Basel, Switzerland.ORCID 0000-0001-7804-8870
Luca ÜnlüDepartment of Emergency Medicine, University Hospital of Basel, Basel, Switzerland.ORCID 0000-0002-0670-5840
Christopher R CarpenterDepartment of Emergency Medicine, Mayo Medical Center, Rochester, Minnesota, USA.ORCID 0000-0002-2603-7157
Pieter HeerenFaculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.ORCID 0000-0003-4143-7973
Robert A C RuiterDepartment of Work and Social Psychology, Maastricht University, Maastricht, the Netherlands.ORCID 0000-0001-5017-3258
Michael SimonNursing Science, Department Public Health, University of Basel, Basel, Switzerland.ORCID 0000-0003-2349-7219
Franziska ZúñigaNursing Science, Department Public Health, University of Basel, Basel, Switzerland.ORCID 0000-0002-8844-4903

Funding

Nursing Science Foundation Switzerland 3245-2023
6 · The paper itself

Abstract

backgroundOlder adults frequently present to the Emergency Department (ED). In response, a Swiss university hospital introduced age-friendly interventions and achieved Geriatric Emergency Department Accreditation (GEDA) by the American College of Emergency Physicians (ACEP). However, the impact of previously introduced interventions and the reasons behind emergency clinicians' varying uptake or lack of continued use remain unclear. To further improve patient outcomes, conducting a contextual analysis to identify implementation barriers and facilitators is crucial, followed by the development of tailored implementation strategies supporting the sustainable uptake of all age-friendly program elements. The project's overall aim is to systematically promote the uptake and sustainable re-implementation of the existing age-friendly ED program. The first study phase outlined in this protocol ("Phase A") focuses on 2 key objectives: (1) to assess current age-friendly interventions in the ED and identify barriers and facilitators affecting their reach, adoption, implementation, and maintenance; (2) to develop tailored implementation strategies for re-implementing program elements.

methodsThis project uses a modified implementation mapping in 5 Steps across 2 Phases. Phase A includes Steps 1-4: (1) conducting a contextual analysis using a mixed-methods design combining observations, interviews, patient chart reviews, E-survey and a Gemba walk; (2) identifying expected intervention and implementation outcomes, performance objectives; (3) adapting, extending, or developing tailored implementation strategies based on the Expert Recommendations for Implementing Change taxonomy; and (4) co-designing an implementation protocol to guide re-implementation. The follow-up Phase B will involve the re-implementation of the intervention elements and co-designing the evaluation protocol (Step 5) for the implementation process.

conclusionAge-friendly EDs are essential for person-centered emergency care, enhancing safety and quality of care for older adults. This study will provide insights into adaptable, evidence-informed implementation strategies that support behavioral change among emergency clinicians to increase patient reach and sustainability of age-friendly interventions for complex ED settings.

Indexed as

Emergency Service, HospitalAgedHumansSwitzerlandemergency departmentfrailtygeriatric emergency medicineimplementation scienceolder adults

Identifiers

PMID41329556
PMCPMC12911551

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.