Towards Age Friendly Healthcare – Walkability Study of Clondalkin Primary Care Centre

Description

Background/Context:

The Health Service Executive (HSE), aligned with the national SláinteCare strategy, is committed to transforming healthcare by shifting services closer to communities and supporting people to live well as they age. With Ireland’s population steadily ageing (CSO, 2022; HANA, 2024), healthcare environments must meet the specific needs of older adults. Age Friendly principles provide a framework to ensure Primary Care Centres and Integrated Care Hubs are accessible, welcoming, and supportive. Embedding these principles improves patient experience, promotes independence, and reduces hospital admissions, fulfilling SláinteCare’s vision of integrated, person-centred care.

Methods/Approach:

To ensure meaningful involvement of older adults, members of the South Dublin Older Persons’ Council were engaged, reflecting a true partnership between healthcare providers and the community. Using Age Friendly Ireland’s guide, “Towards Age Friendly Primary Care Centres,” a detailed walkability study was conducted at the Clondalkin Primary Care Centre. The guide focused on accessibility, signage, seating, and wayfinding.

The study involved service users, clinical and non-clinical staff, and representatives from HSE Estates and Age Friendly Ireland, ensuring diverse perspectives shaped the assessment. Practical improvements were identified to enhance usability for older adults. The findings and recommendations were submitted to the General Manager for approval. This co-produced process informed targeted improvements and strengthened ongoing commitment to Age Friendly principles.

Results/Learning:

Significant improvements were implemented across the Primary Care Centre and Integrated Care Hub, especially in signage and accessibility. Each floor was assigned a distinct contrasting colour reflected in signage and a colour stripe along walls to aid wayfinding. Larger fonts improved readability, and local landmark images created a familiar, welcoming atmosphere. Age Friendly seating with armrests enhanced comfort and mobility support. Additionally, new health promotion videos provided accessible information in waiting areas.

A key learning was the importance of integrating Age Friendly guidelines early in the design process to embed principles from the outset. Universal design benefits all users, not only older adults. Active engagement with stakeholders and service users during design is critical, particularly for colour palettes, signage, and seating.

A challenge was Age Friendly parking. Although signage improvements are planned, the parking bays were too narrow to meet standards (National Age Friendly Parking Space Guide), highlighting the need to apply these guidelines during initial planning to avoid costly retrofitting.

Implications for Future Practice:

Age Friendly principles must be systematically incorporated into all new Primary Care Centres and retrofitting projects. Early and meaningful engagement with service users and stakeholders ensures healthcare environments meet older people’s needs.

The walkability study proved an effective tool for involving service users in assessing and improving healthcare settings. This supports the HSE’s Better Together Roadmap (2020) by fostering partnership and co-production in healthcare design and evaluation.

We recommend sharing this approach across HSE regions to promote wider adoption of Age Friendly design, improving patient experience, accessibility, and inclusivity in primary care.

Aim of Initiative

The primary aim of this project was to enhance the accessibility, usability, and overall experience of the Clondalkin Primary Care Centre for older adults by embedding Age Friendly principles into its design and operation. Aligned with the Health Service Executive’s (HSE) commitment and the national SláinteCare strategy, the goal was to ensure healthcare environments meet the specific needs of an ageing population, supporting independence and promoting well-being.

To achieve this, we sought to engage older people directly through collaboration with the South Dublin Older Persons’ Council, ensuring their lived experience informed the assessment and improvement process. Using the Age Friendly Ireland guide, “Towards Age Friendly Primary Care Centres,” we conducted a comprehensive walkability study focusing on key areas such as accessibility, signage, seating, and wayfinding. The study aimed to identify practical, user-informed improvements that would make the Primary Care Centre more navigable, welcoming, and comfortable for older patients.

Ultimately, the project aimed to demonstrate the value of co-production between healthcare providers, estates management, and service users in applying Age Friendly design principles. By doing so, it sought to improve patient experience, reduce barriers to care, and support the HSE’s vision of integrated, person-centred healthcare. Additionally, the project intended to provide a replicable model for other HSE regions, promoting systematic adoption of Age Friendly practices across Ireland’s primary care facilities.

Who is it aimed at

All service users and staff in the Integrated Care Hub and Primary Care Centre

3 Steps critical to success

1. 1. Meaningful Engagement and Partnership
   Involve older adults and diverse stakeholders early and continuously throughout the process. Engaging groups like the South Dublin Older Persons’ Council ensures that lived experiences shape the design and evaluation of healthcare environments. This partnership between healthcare providers, community members, estates management, and Age Friendly representatives fosters co-production and builds shared commitment to Age Friendly principles.
2. 2. Use of Structured, User-Centred Assessment Tools
   Apply established frameworks and guides—such as Age Friendly Ireland’s “Towards Age Friendly Primary Care Centres”—to conduct detailed, practical assessments like walkability studies. These tools help identify real-world challenges and actionable improvements in accessibility, signage, seating, and wayfinding, directly informed by service users and staff. This method ensures changes are targeted, relevant, and effective.
3. 3. Early Integration and Systematic Implementation of Age Friendly Design
   Incorporate Age Friendly principles from the initial planning and design stages of new and existing healthcare facilities. Early adoption prevents costly retrofits, such as issues with parking dimensions. Embedding universal design benefits all users and creates accessible, welcoming environments. Systematic rollout across regions, supported by ongoing stakeholder collaboration, maximizes patient experience, inclusivity, and aligns with broader healthcare strategies like SláinteCare and the HSE’s Better Together Roadmap.

3 Challenges in Planning / Delivery

1. Inadequate Age Friendly Parking Design
   The parking bays at the Primary Care Centre were originally built too narrow to fully meet the National Age Friendly Parking Space Guide standards. While signage improvements are planned, this highlights a significant design limitation that requires costly retrofitting, underscoring the need to integrate Age Friendly guidelines during the initial planning phase.
2. Need for Early Integration of Age Friendly Principles
   A major challenge identified was the difficulty of embedding Age Friendly design features after construction. Retrofitting accessibility improvements is more complex and expensive than incorporating them early on. This emphasizes the importance of applying the “Towards Age Friendly Primary Care Centres” guidelines from the outset to benefit all users effectively.
3. Balancing Diverse Stakeholder Perspectives
   Ensuring meaningful involvement of diverse groups—including older adults, clinical and non-clinical staff, estates representatives, and community organizations—requires careful coordination and communication. Balancing these varied perspectives to reach consensus on practical improvements can be complex but is essential for successful Age Friendly design and implementation.

3 Outcomes / Benefits

1. Improved Accessibility and Usability of Healthcare Facilities
   Significant enhancements were made to the Primary Care Centre and Integrated Care Hub, including colour-coded floor signage, larger fonts, familiar local imagery, and age-friendly seating with armrests. These changes made the environment easier to navigate and more comfortable, especially for older adults with mobility or visual needs.
2. Strengthened Collaboration and Co-Production
   The project fostered meaningful partnerships between older adults, healthcare staff, and management. Engaging service users through the walkability study empowered their voices to directly influence improvements, promoting ongoing commitment to Age Friendly principles and supporting the HSE’s Better Together Roadmap.
3. Identification of Key Challenges and Lessons for Future Planning
   The study revealed challenges, such as inadequate parking bay sizes that did not meet Age Friendly standards, highlighting the importance of applying these guidelines early in the design process. This learning emphasizes the need for systematic, proactive incorporation of Age Friendly standards to avoid costly retrofits and improve inclusivity from the outset.