Optimising acute care for people with dementia: a mixed-methods study

Sanatinia R, Crawford MJ, Quirk A, Hood C, Gordon F, Crome P, Staniszewska S, Zafarani G, Hammond S, Burns A, Seers K
Record ID 32016000881
Authors' objectives: The number of people living with dementia is increasing. It is expected that over a million people in the UK will have this condition by 2021. Numbers of people with dementia who are admitted to general hospitals are also increasing with as many as one in four beds now occupied by people with dementia. Concerns have repeatedly been raised about the quality of inpatient care that people with dementia receive. Enquiries into poorly performing hospitals have highlighted the mismanagement of frail elderly people with dementia. A recent national audit of inpatient care for people with dementia found that many people do not receive a comprehensive assessment of their needs and that carers are not sufficiently involved during the admission or in planning for discharge from hospital. As a result, people with dementia often spend longer in hospital than those without this condition and are more likely to be readmitted to hospital following their discharge. In recent years efforts have been made to improve the quality of inpatient care that people with dementia receive. These efforts include better training for staff, use of specialist nurses and expansion of mental health liaison teams. Changes have also been made to the design of wards and some units have been set up that specialise in treating people with dementia. While studies based in single wards or hospitals have shown that it is possible to improve the quality of inpatient care for people with dementia, we have very little understanding of the impact of these changes at a national level and there is a pressing need to understand why some hospitals deliver more effective care to people with dementia than others. The National Audit of Dementia will be repeated in 2015/16 and we believe that this provides an ideal opportunity to address these issues. While the aim of the audit is to highlight differences in quality of inpatient care across hospitals, we believe that the data provide an important opportunity to examine which aspects of the organisation and delivery of services have an impact on the quality of care that people receive. Audit information will identify the best and worst performing hospitals and we will then interview front-line staff, managers and people with dementia and their carers in these hospitals to understand how systems and resources can be used to deliver high quality care. Plans for this project have been developed in collaboration with those who use and provide acute care for people with dementia. We will set up a project advisory group and a patient and carer reference group that will help make sure that future stages of the project also take the views of managers, clinicians, patient and carers into account. This will help ensure that our results can have a direct bearing on the way that services are managed and improved in the future. We will publicise the results of this research through papers published in journals that clinicians and service managers read. We will also send summaries of the project findings to service commissioners and representatives of Strategic Clinical Networks. The results of the study will also be used to strengthen the design of future rounds of the National Audit of Dementia and will feed into practice guidelines through the strong links we have with professional bodies and NHS England via the National Clinical Director for Dementia (who is a co-applicant on the study).
Project Status: Completed
Year Published: 2020
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England
MeSH Terms
  • Aged
  • Critical Care
  • Dementia
  • Aged, 80 and over
  • Delirium
  • Patient Care Management
  • Hospitalization
  • Quality of Health Care
Organisation Name: NIHR Health Services and Delivery Research programme
Contact Address: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: Queen's Printer and Controller of HMSO
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