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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