people at the centre of health and care care improvements for older people in acute care gillian...
TRANSCRIPT
People at the centre of health and care
Care Improvements For Older People In Acute Care
Gillian TaylorMonklands Hospital
Lananarkshire
People at the centre of health and care
How
Older Peoples Improvement
Nurse(Front Door)
OPAC Band 6 Champions
OPAC Band 6 Meetings With ADNS & Senior
Nurses
Dementia Champions
Practice Development
People at the centre of health and care
Improvement Methodology
PDSA: Cycles Of Change For Four
Key Areas
HIS: Framework For Quality
Improvement
People at the centre of health and care
Improvement Methodology
Integration, Collaboration and Empowerment – Practice Development for a New PracticeNHS Quality Improvement Scotland 2009
People at the centre of health and care
What
Buzz sessions - reasons why Worked within the clinical areas Identified key link nurses - meetings Educated staff-Dementia awareness training Observed and listened to staff looking after patients -
feedback Changed the physical environment Looked at systems and processes Provided ongoing support and education
People at the centre of health and care
People at the centre of health and care
People at the centre of health and care
People at the centre of health and care
Negativity
Cultures
Time
Attitudes &
Behaviours
Barriers
People at the centre of health and care
Impact For Service Users
Visible Pillows, buzzers, water within reach More robust process for patients presenting with cognitive
impairment, falls risk, tissue viability, FFN New Inter hospital transfer document- highlighting patients
with cognitive Impairment Positive patient experience Increased referrals to CARS Audit of patient experiences improved-ongoing Change of process for minor Injury patients 65 and over Audit of assessments and complaints -ongoing
People at the centre of health and care
Impact For Staff
Positive:Heightened awarenessAppreciation for what we were trying to achieveFeeling involved - engagement with management team and practice developmentIncreased enthusiasm and motivation to make their department/ward as good as it could be
Negative:More documentationSome Doctors reluctant to follow through AWI assessments
People at the centre of health and care
Summary
Staff in NHSL are more aware of what the standards are for older people in Acute Care and patients with cognitive Impairment
We need to ensure the quality is at the front door –priority area for NHSL, patients are waiting long periods in A&E and Assessment units
Front door staff need to ‘start the ball rolling’ in terms of initial assessment - then ACT-ongoing
Support for front door staff-looking at initiating a system for ‘escalation process’
Within Monkland’s site it would not have worked without the integrated approach from ADN and Senior Nurses and the hard work and enthusiasm of front line staff