D R A F T Title page Dementia Acute Care Development Programme Katherine Barbour Senior Programme Manager 03 November 2016
Structure Background to project The NHS Acute trusts involved Projects undertaken Evaluation Lessons learnt Next steps
D R A F T Table of contents Matthias Winker Introduction Methodology Results Patients Carer Staff Summary
Background to the programme The project was initiated and is managed by the Wessex Academic Health Science Network (WAHSN) National data on outcomes for people with dementia during acute stays led to concerns about what was the local picture The picture in Wessex was explored over a period of field visits and data collection Examples of good practice environmental changes such as shared signposting in hospital and nursing home on IOW Issues of leadership, meeting the CQUIN, isolated staff, increasing demand in acute care services RCN and University of Worcester Association for Dementia Studies Development programme : Transforming dementia care in hospitals 2013/2014 Opportunity to replicate this in a smaller geography Discussions held with all the leads across Wessex and all 8 hospitals agreed to sign up to programme of quantitative and qualitative evaluation Quantitative study undertaken by Centre for Implementation Science University of Southampton Qualitative study undertaken by Bournemouth University Dementia Institute (BUDI)
The Trusts 1. Isle of Wight 2. Poole 3. Salisbury 4. University Hospital Southampton 5. Royal Bournemouth County Hospital 6. Queen Alexandra (Portsmouth) 7. Hampshire Hospitals Foundation Trust 8. Dorset County Hospital
Pattern of meetings and agenda Quarterly meetings between September 2014 and March 2016 Meeting the CQUIN Updates from each area Range of speakers university, commerce, other hospitals Planning the dementia champion conferences Data collection
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D R A F T Matthias Winker
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Twiddle Mitts 11
This is Me 12
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Indicators collected Spidergrams Description of each hospital Admissions Number of Falls Return to same address Incidents of challenging behaviour Numbers of staff trained Number of ward moves
Hospital A 120 100 80 60 Mean length of stay 13.7 days per patient 40 20 0 Total Readmissions within 30 days 2015/16 2658 Patient Admissions in 2015/16
Hospital A Ward moves of patients living with dementia 2015/16 300 250 200 150 100 50 Mean of 3.6 incidences of challenging behaviour per month 0 25 mean falls per month 2066 total patients returning to the same address
Hospital A 4434 Total Staff Trained Tier 1 and 2 341 Total Dementia Champions
BUDI Recommendations Scope provision of interventions to ensure consistency of access to patients and families and quality of practice Develop a dementia strategy and publicise this widely Develop a bank of volunteers with clear roles and responsibilities supported by appropriate training and support Expand training and support to volunteers to enable them to carry out more activities to meet individual needs e.g. going for a walk if the person living with dementia is restless Develop a tool box of interventions that can be used to meet patients preferences Involve family members in the care of the patient 18
Summary of learning The role of the dementia champion at ward level is not being fully exploited and they can be pivotal in changing the culture and in being role models for their colleagues. It is recommended that hospitals develop a dementia action plan/strategy to underpin the direction of work and to ensure that all staff are aware of the commitment to high quality dementia care. Informal carers can make a large contribution to the care of the patient and are keen to be fully involved. Further training of volunteers to take on a number of actions such as taking a patient for a walk, feeding, mealtime support. Flat organisation with access to CEO Using museum, music, university and other organisations that can positively impact on patient care
Wessex Heritage Trust 20
Summary John s Campaign adopted in 7 of the 8 acute trusts More carers identified and registered to support, discuss care plans, treatments, etc. Dementia Champion conferences increased staff knowledge More staff trained to raise awareness, encouragement and knowledge Music for a While demonstrated reduction in use of antipsychotics and blue plates showed an increase in food intake
Next steps 1. Leadership programme 2. Feedback event November 2016 3. Resources on website 4. This is Me in primary care - ispace 5. Spreading learning to community hospitals in Wessex 6. Publication of report of programme
ispace dementia friendly surgeries 144 practices across Wessex have completed or are in progress in implementing ispace Completed surgeries Surgeries in process of implementing the model State: November 2016: 37 surgeries completed, 107 in process
D R A F T Matthias Winker Your contact person: Katherine Barbour Senior Programme Manager Katherie.barbour@wessexahsn.net Wessex AHSN Innovation Centre Southampton Science Park, 2 Venture Road Chilworth, Hampshire SO16 7NP T: 023 8202 0840