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Active Ageing – Implementing integrated care for falls prevention and bone health at scale

Authors:Irene Frances O Byrne-Maguire

Abstract Introduction and aim: The purpose of AFFINITY (activating falls and fractures prevention in Ireland together), a national population health improvement project, is to implement a national strategy on the prevention of harmful falls and fractures in older persons. Harmful falls and fractures in older persons are on the whole predictable and preventable and are a significant human, social and economic cost burden. AFFINITY is also a commitment within a pan European programme on active and healthy ageing that aims to increase the average healthy lifespan of citizens by 2 years by 2020.Practice Changes,Timeline and Stakeholders: AFFINITY has adopted a whole system approach (2014-2020), with multi-stakeholders, multi-professional and multi-sectoral collaborative working. Key implementation approaches: empowering citizen self-management, supporting older persons to actively age, robust project governance, integrated service delivery model, work practice changes and system change management supports. AFFINITY is a joint project of the national service provider and the publicly funded health & social care system indemnifier.Highlights and Lessons Learned: AFFINITY is being embedded within new service provider structures and processes, including the national service provider integrated care framework for older persons using enablers such as digital technologies, funding and human resources. Four early adapter sites for falls prevention and bone health are developing bespoke, evidence informed integrated care pathways (ICP) since 2014 to address the needs of their older populations: key indicators include timely access to quality multidisciplinary team interventions with measurable outcomes at an individual and population health level. Learnings from these early adapters is being used to identify and scale up additional sites within all service areas nationally to improve access, quality and outcomes of falls and fracture prevention services in 2017.Outcomes and targeted population: Full implementation of this project will mean that persons 65 years and older:will be proactively co-producing their own health & wellbeing,will have access to quality ICP according to need,will have less harmful falls & fracture sequelaewill enjoy safer age friendly environments and improved quality of life years.Transferability and Sustainability: AFFINITY, enabled by the European programme, will be an exemplar of a coordinated, sustainable and effective model of care for older persons, that is both proactive and reactive. Cooperation between AFFINITY and its European partners will enhance and enrich the underlying information and process models, supporting the embedding of evidence informed practices and upscaling to spread and sustain the gains. Change management success factors and approaches to barriers will be available for similar large scale implementation projects to learn from. The political, funding, legislative and organisational reforms and challenges happening at national level will resonate with other countries in their desire for better quality care, more efficient health and social care delivery systems and new economic opportunities and investments, especially within the digital and silver economy.


falls and fracture prevention, integrated care, older persons, upscaling

How to Cite:

O Byrne-Maguire IF. Active Ageing – Implementing integrated care for falls prevention and bone health at scale. International Journal of Integrated Care. 2017;17(5):A226.

DOI: on 17th October 2017