About using quality improvement(QI) to improve hospital care for people with dementia

The programme uses a Breakthrough Series Collaborative approach. This is a short-term (6 to 15 month) learning system that brings together a large number of teams from hospitals or clinics to seek improvement in a focused topic area. The collaborative uses QI methodology and works through the stages of the Improvement Journey.

Examples of using QI to improve hospital care for people with dementia

This programme builds on the work of a previous improvement programme focused on improving care for people with dementia in Specialist Dementia Units. This programme worked closely with the staff at four Specialist Dementia Units to make improvements. Impacts from the programme included:

• 54% reduction in falls
• 74% reduction in staff sickness
• 33% reduction in stress and distress
• reduction in medication
• improved carer communications, and
• improved mealtime experiences.

Key steps to using QI to improve hospital care for people with dementia

Using QI to improve care has a six step process:

1. Establish a project team: Set up a project team which includes clinicians from the service and someone with QI experience.
2. Understand your system: Analyse current issues using qualitative and quantitative data from those working in and using the service to better understand their experience of person-centred care planning.
3. Develop aim and change theory: Based on the understanding of the system prioritise the areas for improvement that will have the largest impact, create an aim and prioritise changes to make to the service.
4. Develop specific change ideas, test and refine: Use cycles of testing to test and refine changes while using outcome, process and balance measures to determine the impact of changes. 
5. Implement and sustain where tested: Turn tested changes into the new normal way of working and spread to all relevant areas of the service.
6. Share learning: Share learning from the improvement project with others to enable them to use the learning to accelerate their own improvement.

Resources to implement a QI approach to improving hospital care for people with dementia

Key resources that can help hospital teams improve care for people with dementia:

• Person-centred care planning change package: this change package enables hospital teams to use quality improvement methods to make improvements to person-centred care planning by focusing on three primary drivers and a range of change ideas.
• Measurement framework: this framework helps teams to decide whether the changes they are testing are leading to an improvement. It includes two main measures that will demonstrate improvements in person-centred care planning.
• Dementia in hospitals toolkit: This online toolkit is for staff working in inpatient settings and supports improvement work by providing evidence and examples of practice.