Jupiter Ward Dementia Care Project update report 6 months in - - PowerPoint PPT Presentation

Jupiter Ward ‘Dementia Care’ Project update report – 6 months in

‘Optimising the therapeutic environment’

Wendy Johnson Matron OPC June 2015

The challenges

Patients with some form of dementia make up 25% of adults accessing acute services like GWH – this will rise to 50% within 10 years (Age UK 2014) By 2024 there will be 1.5 million people in the UK living with the disease and by the age of 90, 36% of females and 31% males will have some form of dementia (Alzheimer's society, 2014) In Swindon the numbers of people with dementia is expected to rise by 41% by 2021 Annual cost per patient is £27,647 compared with £3,458 for someone with Heart Disease (Alzheimer's society, 2014) Hospital stays are recognised to have a detrimental affect on people with dementia (Kings Fund 2014) with a greater risk of delirium, prolonged LOS and death (Dementia Action Alliance, 2012)

Why the environment matters: The ‘fear centre’ (Amygdala)

Before the refurbishment

After Refurbishment

The current picture – admissions patients with dementia

GWH Apr 2013 – Apr 2015

The Report – June 2015

• Can only suggest but not prove a causal

link between outcome and environment

• 12 months to track a true ‘trend’
• 6 months post –refurbishment data
• Woodpecker as comparator ward
• Potential financial impact/Cost savings–

To be included in month 12 report (Jan 2016)

6 month outcomes Length of stay (LOS)

• Mean length of stay for patients discharged

with diagnosis of dementia is decreasing

– Mean in 2013/14 was 17.19 – Mean in 2014/15 from Nov-14 to May 15 (after refurbishment) was 16.86

–Decrease of 0.33 days

– CONTEXT: – KOPSSU – streaming of more able patients – Growing number of admissions with dementia

6 month outcomes Pharmacological Interventions – frailty indicator

2 4 6 8 10 12 14 16 18 20 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15

Midazolam 5mg/10 Vials per box

Midazolam 5mg/10 Vials per box

6 month outcomes: Pharmacological Interventions – use of drugs for agitation is down

6 month outcomes Admissions are increasing but use of ‘Close Support’ is reducing

May June July Aug Sept Oct Nov Dec Jan Feb Mar April May Total Hours assigned 1266 280.5 525.5 200.5 570 617.25 699.75 758 436.75 208 430 55.75 340.25 No's discharged patients 16 16 17 6 16 11 13 18 22 20 12 15 16 5 10 15 20 25 200 400 600 800 1000 1200 1400

Hours

Jupiter Ward Close Support hours per month + Numbers of patients with dementia discharged from Jupiter ward May 14 - May 15

6 month outcomes Reduction in total Falls to below average

44%

reduction

• ver 12/12

period

The Patient Experience – Significant reduction in care concerns raised by service users

Mar - June 2014 July - Oct 2014 Nov 14 - Jan 2015 Feb 15 - April 2015 Jupiter 9 5 2 1 0.00 2.00 4.00 6.00 8.00 10.00 12.00

Numbers of complaints by month

JUPITER COMPLAINT TRAJECTORY

iwantgreatcare’ feedback

96% positivity rating (April 2015)

‘The staff have been great with my mum. They have gone above and beyond their

• duties. They deserve recognition and are

an asset to the NHS’ ‘The Modern environment’ ‘Noise level reduced’

Outcomes Rolling 12 month figures Staff Turnover

Outcomes – No data available yet

• Delirium – Will be collected from August

2015 (Dementia/Delirium CQUIN 2015 - 2016)

• Nutrition – multiple variables make this

very challenging. Continue to look for a way to measure. May not prove possible

Allied projects coming on-stream 2015

• Music Therapy

Twice weekly appropriate age live music (Through volunteer service)

• MSc. Music therapy students (UWE) from

September 2015 (Individual and group work

projects)

• Social Mealtimes (NESTA)

Thank you for your attention

Questions welcome