Improving Care For Older People in Acute Care

Improving Care For Older People in Acute Care Perplexed about pathways? Complexities of Care Co-ordination Penny Bond Team Leader Healthcare Improvement Scotland

Improving Care for Older People in Acute Care – Phase 1: Scoping & Development Evidence to inform priorities for improvement -Critical Assimilation and Analysis Process (CAAP) to review current literature -HIS Inspection themes -Discussions with key stakeholders to inform priorities for improvement Stakeholder Engagement -Meeting of ‘critical friends’ to share CAAP findings, inspections themes and to consult on the draft improvement approach/model -Meeting of National Leads to understand the current landscape of national programmes and identify current change packages, measures and alignment opportunities -Board Engagement Event to consult on the improvement approach/model and to understand the requirements of NHS boards in supporting improvements Improvement -Identified teams to participate in this work -Established a sub-group for Delirium Management -Webex call with teams to identify current challenges -Planning for Learning Session 1

Improving Care for Older People in Acute Care – High Level Driver Diagram Aim To improve the care for older people in acute care by March 2014, by building and spreading improvement in 2 key areas: 1. Care Co-ordination 2. Cognitive Impairment To achieve improvements in reliability and person Centred Care. • 95% of patients over 65 will be screened • 95% of patients will received standardised comprehensive assessment • 300 days between complaints or 50% reduction in complaints • 95% compliance with delirium bundles (initial process measure) Primary Drivers Care Co-ordination Secondary Drivers Assessment at the front door • Screening to identify patients most likely to benefit from comprehensive assessment • Reliable comprehensive assessment Identification of need and care planning • Ensure system in place to identify patients at risk • Create a culture that supports family and carer involvement in care • Promote the use of patient, family, carer feedback to improve care • Ensure patient requirements are accurately reflected in the care plan Care Pathways • Ensure appropriate care pathways are considered • Optimise efficiencies in handovers and discharge process • Avoid inappropriate inter and intra ward transfers • Develop and test delirium bundles to improve the prevention of delirium and recognition and management of delirium Cognitive Impairment • Ensure alignment with dementia strategy, Scottish Delirium Association Pathway and NHS Education for Scotland educational resources • Share practice in delirium management across Scotland Leadership and Culture To support a culture of quality and improvement through person centred care approaches • Develop infrastructure to support teams with quality improvement work • Promote the work of the Improving Care for Older People work stream • Align work with wider older peoples improvement work and person centred health and care work • Optimise opportunities for spread • Optimise opportunities to learn from and share good practice, including learning from NHS Tayside and NHS Grampian collaborative

Alignment & Integration NHS Tayside & NHS Grampian BTS Collaborative Healthcare Improvement Scotland Inspections Reshaping Care for Older People Scottish Safety Index Improving Care for Older People in Acute Care Leading Better Care Person Centred Health and Care Releasing Time to Care

Today…. • Wordle – ‘what is the one thing you think would make the biggest difference to improving care for older people and their families? ’ • • Story boards Photos Postcard pledge Team planning