Promoting functional independence and reducing the risk of hospital-associated deconditioning for acutely hospitalised older adults: a group concept mapping service evaluation.

Abstract

To identify and prioritise key activities to promote functional independence and reduce the risk of hospital-associated deconditioning for older adults admitted to our acute care wards. A local, stand-alone evaluation and planning project using group concept mapping methodology. Multidisciplinary healthcare workers took part in a statement generation activity, individually sorted these statements into themes, and rated each statement for perceived importance and current success. Applying multidimensional scaling and hierarchical cluster analysis to the sorted data produced visual representations of the statements (concept maps), and rating scores enabled identification of agreed priorities for improvement. Seventy-eight participants took part in ideas generation, 25 in sorting, and 86 in rating. An eight-item cluster map was agreed upon, with the following named clusters: optimising nutrition and hydration; facilitating independence, especially at mealtimes; creating an enabling 'rehabilitative' culture; get up, get dressed, get moving; inclusion and engagement for patient wellbeing; understanding and managing risk; working together, preparing for home; and organisation of care in an acute hospital setting. The findings from this group concept mapping project highlight the importance of adopting a multidimensional approach to promoting functional independence and reducing the risk of hospital-associated deconditioning for hospitalised older adults.