scholarly journals Using appreciative inquiry to implement person-centred dementia care in hospital wards

Dementia ◽  
2016 ◽  
Vol 18 (1) ◽  
pp. 190-209 ◽  
Author(s):  
Anthony Scerri ◽  
Anthea Innes ◽  
Charles Scerri
Keyword(s):  
Quality Of Care ◽  
Appreciative Inquiry ◽  
Dementia Care ◽  
Professional Collaboration ◽  
Staff Attitudes ◽  
Action Plans ◽  
Paper Report ◽  
Inquiry Approach ◽  
Hospital Wards

The quality of care of persons with dementia in hospitals is not optimal and can be challenging. Moreover, staff may find difficulty in translating what they have learned during training into practice. This paper report the development and evaluation of a set of workshops using an appreciative inquiry approach to implement person-centred dementia care in two hospital wards. Staff worked collaboratively to develop a ward vision and to implement a number of action plans. Using appreciative inquiry approach, staff attitudes towards persons with dementia improved, inter-professional collaboration was enhanced and small changes in staff practices were noted. Dementia care in hospitals can be enhanced by empowering staff to take small but concrete actions after they engage in appreciative inquiry workshops, during which they are listened to and appreciated for what they can contribute.

Participation in Clinical Trials May Improve Care of Acute Schizophrenia Inpatients in a General Hospital

CNS Spectrums ◽  
2008 ◽  
Vol 13 (9) ◽  
pp. 757-761 ◽  
Author(s):  
Uriel Halbreich ◽  
Nancy Smail ◽  
Xin Tu ◽  
Judith Halbreich
Keyword(s):  
Quality Of Care ◽  
Clinical Research ◽  
Psychiatric Patients ◽  
Diagnostic Interview ◽  
Physical Restraints ◽  
Double Blind ◽  
Acute Schizophrenia ◽  
Hospital Wards ◽  
Study Inclusion

AbstractIntroduction: This report demonstrates parameters of quality of care and treatment outcome of acute schizophrenia patients who were involved as subjects in a clinical trial of two marketed widely used antipsychotics compared with their fellow patients who received routine clinical hospital care.Methods: Patients were newly admitted severely agitated schizophrenia patients who agreed to participate in a double-blind randomized trial of short-term (5 days) rate of improvement in response to two second-generation oral antipsychotics. Treatment outcomes as measured by the Clinical Global Impression and parameters of quality of care were compared with the general population of inpatients in the same county hospital.Results: Of 145 patients screened, 109 patients did not meet study inclusion and exclusion criteria. It is of note that systematic diagnostic interview did not confirm the clinical diagnosis of schizophrenia in 17 patients (11.7%). Study patients had shorter length of stay (6.75 days vs 15.3 days of total psychiatric patients at the hospital during the study period), no physical restraints (vs 21.9%), no use of antipsychotics as chemical restraints (vs 19.8%), and less recidivism following the trial (28.1%) compared with prior to the trial (64.3%).Conclusion: Patients who participate in structured clinical research with well-delineated procedures, clinical outcome measures, and clear expectations, faired better than their fellow patients in the same non-research hospital wards. Application of some characteristics of clinical research to the diagnosis and treatment of clinical non-research patients may be considered.

Residential Care in Hospital and in the Community – Quality of Care and Quality of Life

1996 ◽  
Vol 168 (4) ◽  
pp. 448-456 ◽  
Author(s):  
Geoff Shepherd ◽  
Matt Muijen ◽  
Rachel Dean ◽  
Margaret Cooney
Keyword(s):  
Quality Of Life ◽  
Quality Of Care ◽  
Management Practices ◽  
Housing Association ◽  
Cross Sectional ◽  
Living Situation ◽  
Internal Management ◽  
External Management ◽  
Hospital Wards

BackgroundThe reduction of beds in long-stay hospitals has led to concerns over the quality of care offered to the remaining residents as well as that provided in the community. This study seeks to compare the quality of care and quality of life (reported satisfaction) from residents in both types of setting.MethodA cross-sectional comparison was made of community residential homes and hospital wards drawn randomly from lists provided by local authorities in the outer London area. Samples were drawn from all the main provider types (local authority, housing association, private and joint NHS/voluntary sector). Measures were taken of the quality of the physical environment, staff and resident characteristics, external management arrangements and internal management regimes, resident satisfaction and staff stress. Direct observations were also made of the amount and quality of staff-resident interactions.ResultsIn general, the most disabled residents were found to be still living in hospital in the worst conditions and receiving the poorest quality of care. Although there were some problems with missing data, hospital residents also seemed most dissatisfied with their living situation. There were few differences between community providers regarding either the quality of care provided or the levels of reported satisfaction. Quality of care in the community homes seemed to be much more determined by the personality and orientation of project leaders.ConclusionsPurchasers and providers still need to give attention to the problems of selectively discharging the most able residents to the community, leaving the most disabled being looked after in progressively deteriorating conditions. All residential providers need to review their internal management practices and try to ensure that residents are offered, as far as possible, the opportunity to make basic choices about where and how they will live. Staff training and quality assurance practices need to be reviewed in order to improve the direct quality of care offered to the most disabled individuals.

scholarly journals Development and pilot testing of quality improvement indicators for integrated primary dementia care

2020 ◽  
Vol 9 (2) ◽  
pp. e000916
Author(s):  
Dorien L Oostra ◽  
Minke S Nieuwboer ◽  
Marcel G M Olde Rikkert ◽  
Marieke Perry
Keyword(s):  
Quality Of Care ◽  
Cost Efficiency ◽  
Care Service ◽  
Well Being ◽  
Dementia Care ◽  
Improve Quality ◽  
Pilot Testing ◽  
Modified Delphi ◽  
Care Organisation

BackgroundImplementation of integrated primary care is considered an important strategy to overcome fragmentation and improve quality of dementia care. However, current quality indicator (QI) sets, to assess and improve quality of care, do not address the interprofessional context. The aim of this research was to construct a feasible and content-wise valid minimum dataset (MDS) to measure the quality of integrated primary dementia care.MethodsA modified Delphi method in four rounds was performed. Stakeholders (n=15) (1) developed a preliminary QI set and (2) assessed relevance and feasibility of QIs via a survey (n=84); thereafter, (3) results were discussed for content validity during a stakeholder and (4) expert consensus meeting (n=8 and n=7, respectively). The stakeholders were professionals, informal caregivers, and care organisation managers or policy officers; the experts were professionals and researchers. The final set was pilot-tested for feasibility by multidisciplinary dementia care networks.ResultsThe preliminary set consisted of 40 QIs. In the survey, mean scores for relevance ranged from 5.8 (SD=2.7) to 8.5 (SD=0.7) on a 9-point Likert scale, and 25% of all QIs were considered feasible to collect. Consensus panels reduced the set to 15 QIs to be used for pilot testing: 5 quality of care, 3 well-being, 4 network-based care, and 3 cost-efficiency QIs. During pilot testing, all QIs were fully completed, except for well-being QIs.ConclusionA valid and feasible MDS of QIs for primary dementia care was developed, containing innovative QIs on well-being, network-based care and cost-efficiency, in addition to quality of care QIs. Application of the MDS may contribute to development and implementation of integrated care service delivery for primary dementia care.

scholarly journals Longitudinal multiple case study on effectiveness of network-based dementia care towards more integration, quality of care, and collaboration in primary care

PLoS ONE ◽  
2018 ◽  
Vol 13 (6) ◽  
pp. e0198811 ◽  
Author(s):  
Anke Richters ◽  
Minke S. Nieuwboer ◽  
Marcel G. M. Olde Rikkert ◽  
Rene J. F. Melis ◽  
Marieke Perry ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Multiple Case Study ◽  
Dementia Care ◽  
Multiple Case

scholarly journals Evaluating the capabilities model of dementia care: a non-randomized controlled trial exploring resident quality of life and care staff attitudes and experiences

2016 ◽  
Vol 28 (7) ◽  
pp. 1091-1100 ◽  
Author(s):  
Wendy Moyle ◽  
Lorraine Venturato ◽  
Marie Cooke ◽  
Jenny Murfield ◽  
Susan Griffiths ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Intervention Group ◽  
Dementia Care ◽  
Care Staff ◽  
Staff Attitudes ◽  
Randomized Controlled ◽  
Person With Dementia

ABSTRACTBackground:This 12 month, Australian study sought to compare the Capabilities Model of Dementia Care (CMDC) with usual long-term care (LTC), in terms of (1) the effectiveness of the CMDC in assisting care staff to improve Quality Of Life (QOL) for older people with dementia; and (2) whether implementation of the CMDC improved staff attitudes towards, and experiences of working and caring for the person with dementia.Methods:A single blind, non-randomized controlled trial design, involving CMDC intervention group (three facilities) and a comparison usual LTC practice control group (one facility), was conducted from August 2010 to September 2011. Eighty-one staff members and 48 family members of a person with dementia were recruited from these four LTC facilities. At baseline, 6 and 12 months, staff completed a modified Staff Experiences of Working with Demented Residents questionnaire (SEWDR), and families completed the Quality of Life – Alzheimer's Disease questionnaire (QOL-AD).Results:LTC staff in the usual care group reported significantly lower SEWDR scores (i.e. less work satisfaction) than those in the CMDC intervention group at 12 months (p = 0.005). Similarly, family members in the comparison group reported significantly lower levels of perceived QOL for their relative with dementia (QOL-AD scores) than their counterparts in the CMDC intervention group at 12 months (p = 0.012).Conclusions:Although the study has a number of limitations the CMDC appears to be an effective model of dementia care – more so than usual LTC practice. The CMDC requires further evaluation with participants from a diverse range of LTC facilities and stages of cognitive impairment.

Staff Perceptions of Job Satisfaction and Life Situation before and 6 and 12 Months after Increased Information Technology Support in Dementia Care

2005 ◽  
Vol 11 (6) ◽  
pp. 304-309
Author(s):  
Maria Engström ◽  
Birgitta Ljunggren ◽  
Ragny Lindqvist ◽  
Marianne Carlsson
Keyword(s):  
Job Satisfaction ◽  
Information Technology ◽  
Life Satisfaction ◽  
Quality Of Care ◽  
Sense Of Coherence ◽  
Dementia Care ◽  
Residential Home ◽  
Staff Members ◽  
It Support

We measured staff members’ satisfaction with their work before and after increased information technology (IT) support in dementia care. Comparisons were also performed of perceived life satisfaction and sense of coherence. Data were collected before, and 6 and 12 months after implementation of the first part of an IT support project. Instruments used were the Satisfaction with Work Questionnaires, the Life Satisfaction Questionnaire (LSQ) and the Sense of Coherence (SOC) scale. The study was performed in a residential home for persons with dementia. The participants were 33 staff members. The IT technology included general and individualized passage alarms, sensor-activated night-time illumination, fall detectors and Internet communication. Results showed that staff members’ job satisfaction and perceived quality of care improved in comparison with the control group. Personal development, workload, expectations and demands, internal motivation and documentation, as well as the total scores for ‘psychosocial aspects of job satisfaction’ and ‘quality of care aspects’, increased in the experimental group. There were significant interaction effects for the factors family relation, close friend relation (LSQ), the total SOC scale and the meaningfulness subscale. The study showed that IT support in dementia care increased staff members’ satisfaction with their work in several ways.

Scotland

2019 ◽  
pp. 245-250
Author(s):  
Seamus V McNulty ◽  
Graham A Jackson
Keyword(s):  
Quality Of Care ◽  
Hospital Care ◽  
Dementia Care ◽  
General Hospitals ◽  
The Third ◽  
The United Kingdom ◽  
Novel Approaches ◽  
The Uk

Scotland is a small nation which has a devolved legislature, while still remaining part of the United Kingdom (UK). As the health service has become increasingly divergent from that of the remainder of the UK, more innovative approaches to dementia care have been allowed to develop. The Scottish Dementia Strategy, now in its third iteration, is unique in that it adopts a human rights-based method of dementia care, an approach that has subsequently been followed by other European countries. The Strategy is in continual evolution, with the third Strategy focusing more on care at the end stages of dementia, especially for those in nursing homes or long-term hospital care. Other novel approaches, such as the Dementia Champions programme, have shown benefits in the quality of care for patients with dementia in acute general hospitals, although less so for those in social care settings. Scotland was also a pioneer in enacting incapacity legislation, although this is now under review as shortcomings in the current procedures are becoming unmasked.

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