Restrictions imposed as a result of the COVID-19 pandemic brought to light the importance of person-centredness in dementia care. As part of Dementia Awareness Week, Marie Innes of our Focus on Dementia team, explains why delivering care to people in the way that matters most to them is at the heart of Healthcare Improvement Scotland’s relaunched Dementia in Hospitals Collaborative.
The COVID-19 pandemic put many thing on hold for many people, including the range of improvements that health and care professionals across the country were focused on for people with dementia through our organisation’s Dementia in Hospitals Collaborative. As Healthcare Improvement Scotland focuses on restarting this important programme of work, the pandemic has brought lessons that will be important to how the collaborative moves forward – most importantly, the importance of person-centred care.
The collaborative started late in 2019 and was originally scheduled to run until September 2021. The aim was to bring together hospital teams from across Scotland to work on improvements to hospital care for people with dementia, with an overall focus on the prevention and management of stress and distress, plus four other areas of focus.
Along came COVID-19, and the collaborative was paused, not once but twice, during 2020.
But the last year has brought important knowledge that will help aid the next stage of the programme.
Supporting people in the way that matters most to them
Even before the pandemic, Person-Centred Care Planning had been an area that had consistently been highlighted as an area for improvement both by hospital teams themselves, as well as through the findings of our inspections into the care of older people in hospitals.
During the pause, we engaged with a range of stakeholders to find out their key issues around hospital care for people with dementia during the pandemic. One issue that came out consistently was that the restrictions to hospital visiting had caused issues in the way hospital staff were able to engage with families and carers of people with dementia. This made it difficult to find out what was really important to individuals to support a meaningful, person-centred approach to care. In addition, the necessary, stricter, infection control measures that had been put in place, often made it difficult or impossible to support people in the way that mattered most to them. These issues meant that a person-centred approach to care planning for individuals has proved more challenging and was therefore identified as a key focus area for improvement.
The aim of the collaborative in this area is that the hospital care of people with dementia will be informed by a personalised care plan which reflects their strengths, needs, wishes and choices. Moreover, the person-centred approach will support the prevention and management of stress and distress.
Another key feature of the collaborative is that we are working in partnership with the Alzheimer Scotland Dementia Nurse and AHP consultants who are providing local leadership for collaborative teams in their NHS board areas.
Building on the learning from the past
The best programmes focus on learning from the past and building on what we know works well. The Dementia in Hospitals Collaborative does the same, by building on the Specialist Dementia Unit Improvement Programme (SDUIP), a three-year programme that supported four sites to improve the quality of care for people with dementia within Specialist Dementia Units.
The learning from the SDUIP programme also helped inform an online toolkit to support improvements in dementia care in hospital settings. The toolkit is due to be launched on our organisation’s ihub website in summer 2021 to coincide with the restarting of the Dementia in Hospitals programme of work.
Hopes for the future
We are currently identifying new and existing teams who are able to re-engage, with a restart planned for June 2021 and the first Learning Session arranged for late June. We hope that teams will be not only sharing their learning with other collaborative teams through the collaborative activities, but will also be developing plans for scaling up and spreading their improvements within their own NHS board, as well as sharing their learning with the wider hospital communities through the Focus on Dementia Learning System.
The collaborative is a really exciting piece of work with huge potential to make a difference to Person-Centred Care Planning. Through testing new approaches to care planning and sharing with each other, the teams involved in this programme can really help to pull together all of the great work and learning that has been happening over the last few years. I believe that this will make a real difference to the experience of people with dementia and their families.
Marie Innes is an Improvement Advisor with the Focus on Dementia Team at Healthcare Improvement Scotland.