Lynn Flannigan is an Allied Health Professional who is working as an Improvement Advisor for Focus on Dementia. She tweets @lynnflannigan1 Dr Graeme Hoyle is a Consultant Physician in the Department of Medicine for the Elderly in NHS Grampian. He tweets @AbdnGeriatrics.
Focus on Dementia, in partnership with Aberdeen Royal Infirmary, have produced a publication which explores the critical success factors which lead to improved outcomes for people with dementia, their carers and staff in acute care, which we would like to share with BGS members.
Focus on Dementia is a national improvement portfolio based within the ihub of Healthcare Improvement Scotland. We work in partnership with national organisations, health and social care practitioners, people with dementia and carers to reduce variation and improve quality of care.
By 2021 it is projected that there will be more than a million people with dementia in the UK. People with dementia are more likely to be admitted to hospital than people without dementia, and are estimated to occupy 25% of acute inpatient beds. When admitted to acute care they tend to have a longer length of stay, have more adverse outcomes such as falls, pressure ulcers and infections, and are more likely to be discharged to a care home.
Scotland first developed a national dementia strategy in 2010, with commitments around improving the outcomes and experience of people with dementia and their carers. Commitment 10 of Scotland’s second national dementia strategy focused on improving acute care for people with dementia. To support this commitment, 10 Dementia Care Actions were agreed (see below).
To further support improvements in dementia care, Healthcare Improvement Scotland’s Focus on Dementia portfolio is providing improvement expertise throughout the whole dementia pathway, including acute care.
As part of this work Focus on Dementia aimed to identify the critical success factors associated with positive outcomes for people with dementia, their carers and staff in acute care by exploring the success factors in a department which had demonstrated good practice in relation to the 10 Dementia Care Actions (the Department of Medicine for the Elderly, Aberdeen Royal Infirmary).
Through engagement with patients, carers and staff of all disciplines, this department have identified key areas where they can improve the care they provide (for example reducing falls, promoting mobility, management of delirium and dementia, multidisciplinary team working, discharge planning and person-centred care), and used quality improvement methodology to develop the care that is provided.
An appreciative inquiry methodology approach was used to capture information on the success factors within this department from a range of sources, including a multidisciplinary workshop, conversations with staff, stakeholder questionnaires, data collection and thematic analysis using the 10 Dementia Care Actions as a framework.
The project identified 15 different critical success factors under the 10 Dementia Care Actions. The main themes we found were:
- quality improvement is everyday and everyone’s business
- focus on dementia-specific knowledge and skills/leadership
- focus on delivering good person-centred care, and
- focus on making best use of the care environment.
The learning from this work was captured in a publication which will inform improvement work in acute care supported by Focus on Dementia and the wider acute care programmes in Healthcare Improvement Scotland. Whilst not all acute sites are homogeneous, it is also hoped that the learning from this work will be of interest to other inpatient sites in across the UK, and staff will use the learning to identify opportunities to improve the care and experience for people and people with dementia their own areas.
The link for the publication can be found below;
Visit the Focus on Dementia Website – http://ihub.scot/focus-on-dementia/