Author ORCID Identifier



Background: Senior-friendly emergency department (ED) care is emerging to address large numbers of older adults in healthcare and implementation is variable.

Objectives: We aimed to explore key healthcare providers’ perspectives on factors affecting implementation of senior-friendly ED care during the first five years of the 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 7 community partners from the local government health centres 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.

Appendix 1.pdf (182 kB)
Key characteristics of EDs

Appendix 2.pdf (120 kB)
Interview questions

Appendix 3.pdf (183 kB)
Illustrating quotes




June 11th, 2022


October 5th, 2022


October 24th, 2022


To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.