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Table 2 Summary of Stakeholder Comments

From: Facilitators and barriers of change toward an elder-friendly surgical environment: perspectives of clinician stakeholder groups

Stakeholder Participants

Comments: Barriers & Facilitators

Organizational Readiness for Change

 HCAs

• Making environment elder friendly with mirrors & intercoms

• Environmental barriers: unsuitable unit layout & insufficient space

 LPNs

• Environmental barriers: slippery floors, low toilet seats & absence of railings

 RNs

• Staff shortages

 Nurse Managers

• Policy on admission assessment - basic information needs

 Surgeons

• Staff shortages

• Staff and Physician education

• Too many overlapping research projects

Individual Acceptance of New Roles and Duties

 HCAs

Staff-to-staff level

 • Inappropriate care culture like passing on care work from one health worker to another

 • Negative staff relationships: HCAs perceive heavy tasks assigned to them by RNs and LPNs

Staff-to-family-level

 • Involvement of family in patient care

 • Improving communication with family using story boards

Staff-to-patient level

 • Offering choice in care: e.g. bathing, clothing, meals

 • Patient language and culture barriers

 LPNs

Staff-to-staff level

 • Effective communication strategies: problem boards

 • Improving teamwork

Staff-to-family-level

 • Involvement of family in patient care

Staff-to-patient level

 • Comorbidities: lead to difficulty predicting discharge date

 • Comorbidities: lead to more work

 RNs

Staff-to-staff level

 • Effective communication strategies: communication book, report, whiteboard, clipboard etc.

 • Insufficient communication due to casual staff

 • Improving teamwork

 • Negative staff relationships: conflict with HCAs regarding delegation of work

Staff-to-family-level

 • Lack of family involvement in patient care

Staff-to-patient level

 • Improving communication strategies with patients about their progress

 • Educating patients about interventions

 • Comorbidities: involve more work and time requirements

 Nurse Managers

Staff-to-patient level

 • Improving communication strategies with patients about their progress and treatment options

 Surgeons

Staff-to-staff level

 • Improving teamwork

 • Insufficient communication among interdisciplinary professionals

 • Inappropriate care culture: unfocused geriatric consultations

Staff-to-family-level

 • Improving communication with family through consistently scheduled health care professional rounds