Whilst Patient and Public Involvement and Engagement (PPIE) are widely regarded as critical to developing clinical research, there is a perception that older adults may not be able to contribute and there is less emphasis on gaining a wide range of opinions before developing research questions or projects; for example an organisational change. This PPIE initiative used three PPIE processes including existing panels and wider networking to access older adults in the community who had used the hospital services and been discharged. Older adults expressed a range of views about their experience of discharge planning and this provided an important perspective on patients’ research priorities associated with their personal independence. Efforts were taken to ensure representative views across a cross section of the population. As a result of this initial PPIE, a permanent, co-ordinated ‘elders’ panel has been established to ensure a representation of older adult views for research, service development and evaluation. This panel has permanent, fully supported members who provide reflection and feedback on any projects and programmes relating to older people’s services in the City. Background Clinical academic research and service improvement is planned using Patient and Public Involvement and Engagement (PPIE) but older PPIE participants are consulted less often due to the perception that they are vulnerable or hard to engage. Objectives To consult frail older adults about a recently adopted service, discharge to assess (D2A), and to prioritise services improvements and research topics associated with the design and delivery of discharge from hospital. To use successive PPIE processes to enable a permanent PPIE panel to be established. Participants Following guidance from an established hospital PPI panel 27 older adult participants were recruited. Participants from Black, Asian and Minority Ethnic (BAME) communities, affluent and non-affluent areas and varied social circumstances were included. Methods Focus groups and individual interviews were conducted in participants own homes or nearby social venues. Results Priorities for discharge included remaining independent despite often feeling lonely at home; to remain in hospital if needed; and for services to ensure effective communication with families. The main research priority identified was facilitating independence, whilst establishing a permanent PPIE panel involving older adults was viewed favourably. Conclusions Taking a structured approach to PPIE enabled varied older peoples’ voices to express their priorities and concerns into early discharge from hospital, as well as enabling the development of health services research into hospital discharge planning and management. Older people as participants identified research priorities after reflecting on their experiences. Listening and reflection enabled researchers to develop a new “Community PPIE Elders Panel” to create an enduring PPIE infrastructure for frail older housebound people to engage in research design, development and dissemination.

中文翻译：

---

倾听老年患者的声音：为卫生服务研究提供信息的过程和发现

虽然患者和公众参与和参与 (PPIE) 被广泛认为对开展临床研究至关重要，但人们认为老年人可能无法做出贡献，并且不太重视在开发研究问题之前获得广泛的意见或项目；例如组织变革。这项 PPIE 倡议使用了三个 PPIE 流程，包括现有的小组和更广泛的网络，以访问社区中使用过医院服务并出院的老年人。老年人对他们的出院计划经验表达了一系列观点，这为患者与个人独立性相关的研究重点提供了重要的视角。已努力确保在整个人群中具有代表性的观点。作为最初的 PPIE 的结果，已经建立了一个永久性的、协调的“老年人”小组，以确保在研究、服务开发和评估中代表老年人的观点。该小组有永久的、完全支持的成员，他们就与纽约市老年人服务相关的任何项目和计划提供反思和反馈。背景 临床学术研究和服务改进是使用患者和公众参与和参与 (PPIE) 计划的，但由于认为年长 PPIE 参与者易受伤害或难以参与，他们的咨询频率较低。目标 就最近采用的服务、出院评估 (D2A) 向体弱的老年人咨询，并优先考虑与出院设计和交付相关的服务改进和研究主题。使用连续的 PPIE 流程来建立永久的 PPIE 面板。参与者 在已建立的医院 PPI 小组的指导下，招募了 27 名老年参与者。包括来自黑人、亚洲和少数族裔 (BAME) 社区、富裕和非富裕地区以及不同社会环境的参与者。方法 焦点小组和个人访谈在参与者自己的家中或附近的社交场所进行。结果 出院的优先事项包括尽管在家中经常感到孤独，但仍保持独立；必要时留在医院；以及确保与家人有效沟通的服务。确定的主要研究重点是促进独立，同时建立一个涉及老年人的永久性 PPIE 小组被认为是有利的。结论 对 PPIE 采取结构化的方法使不同的老年人能够表达他们对提前出院的优先事项和关注点，并促进将卫生服务研究发展到出院规划和管理中。作为参与者的老年人在反思他们的经历后确定了研究重点。倾听和反思使研究人员能够开发一个新的“社区 PPIE 老年人小组”，为体弱的居家老年人创建一个持久的 PPIE 基础设施，以从事研究设计、开发和传播。作为参与者的老年人在反思他们的经历后确定了研究重点。倾听和反思使研究人员能够开发一个新的“社区 PPIE 老年人小组”，为体弱的居家老年人创建一个持久的 PPIE 基础设施，以从事研究设计、开发和传播。作为参与者的老年人在反思他们的经历后确定了研究重点。倾听和反思使研究人员能够开发一个新的“社区 PPIE 老年人小组”，为体弱的居家老年人创建一个持久的 PPIE 基础设施，以从事研究设计、开发和传播。