Running To Catch Up

1. TRANSFORMING DEMENTIA CARE IN ACUTE UK HOSPITALS Running To Catch Up RUNNING TO CATCH UP Jojames@nhs.net Mary.Dawood@imperial.nhs.uk Transforming Dementia Care in UK hospitals

2. 2 Teaching Hospitals in London, England St Mary’s Hospital The Royal Free Hospital

3. Dignifying Dementia Care Project at St Mary’s • Funded by St Mary’s Charitable Trust • To improve the care and experience of patients with dementia in the acute areas of the hospital • 1 nurse for 3 days per week for 9 months

4. The Plan • Training days for staff • Resource document • Improve physical environment • Improve the assessment and management of pain & procedures

5. The Training • Concentrated on the experience of the person with dementia in Acute Care • Training was delivered to 205 members of staff • 99% said that the day will affect their approach to caring for patients with dementia

6. The Environment • Emergency Department • The allocation of a cubicle and two CDU beds as tranquil spaces • Redecoration • Large Clock/Pictures • Available information leaflets for relatives • Hand massage

7. Pain Assessment • Introduction of Abbey Tool for non-verbal patients /integrated into regular documentation • Influence prescribing practices and reduce PRN prescriptions • Implementing the use of anaesthetic Gel for all venepuncture type procedures.

8. Changing Culture at the Royal Free • Initial work driven by Care Quality Initiative • Early support from Deputy Chief Executive of Trust • Strong back-up from DNS • Project Plan agreed by Trust Board • 1 full time nurse & a small budget

9. Plan • To change the organisation across all the levels • To make it an embarrassment not to know about dementia • All the staff understand needs – not just a few nurses and doctors • To improve the environment • To provide resources to staff • To prove that the project is sustainable by measuring outcomes

10. How? • Training at all levels – nurses to porters, Drs to volunteers. • Introduction of alternative interventions • To develop a dementia Portal on the internal hospital net • To introduce better signage and orientation aids • To get collaborating with nearby hospitals

11. Achieved so far • 590 staff trained • Dementia Portal on line • 50% increase in use of complementary therapies for inpatients with dementia • Improved signage in wards • Improved outcomes for patients with dementia • UCLP collaboration – sector wide shared standards

12. Success/ Sustainability • Another year’s funding • Metrics show that Length of stay has reduced by 2.1 days and Length of stay over 30 days has reduced by 4.7% • Carer rating of quality risen from 20% to 60% • Incidents & Complaints Down • Well-being Audit Score >80% • Staff are now asking for training

13. Imperial relied on goodwill and willingness to release staff Needed presence of a driver Very hard to sustain in the current financial climate Good project but no long term influence RF - commitment at board level and has invested to save Training funded Cultural shift dementia knowledge = desirable knowledge Success not dependent on one person Sustainable model Summary

14. Conclusion The National Dementia Strategy has given impetus and raised the profile of dementia in the UK.................... Our challenge now is to persuade the NHS to put ‘their money where their mouth is’