The Dementia Care Pathway for use in acute care
The aim of this study is to develop a Dementia clinical pathway for use in acute hospitals, to implement it in two hospitals in Victoria, Australia and to evaluate the implementation and impact of the pathway on clinical outcomes.
Dementia is a major health and social challenge, and is one of Australia’s National Health Priority Areas. Over 350,000 Australians are estimated to be living with dementia, and this number is expected to continue to grow (Alzheimer's Australia, 2016). People with dementia are high users of hospital services, with 25% having at least one hospital stay each year (Australian Institute of Health and Welfare, 2013). In hospital, people with dementia have poorer outcomes compared to people without dementia, including longer length of stay and are greater risk of in-hospital complications including falls, pressure injuries, delirium and death (Bail et al., 2013; Tropea et al., 2016). Studies have also shown hospitalised people with dementia are not always receiving best practice or quality dementia care (Sampson et al., 2006; Wenger et al., 2007).
Improving the quality of dementia care in hospitals and associated outcomes is imperative. To assist clinicians in delivery of best practice dementia care in hospital, we proposed to develop a multidisciplinary Dementia Care Pathway (the pathway) for use on acute medical wards at two hospitals in Victoria, Australia. Care or clinical pathways “…are structured multidisciplinary care plans used by health services to detail essential steps in the care of patients with a specific clinical problem. They aim to link evidence to practice and optimise clinical outcomes whilst maximising clinical efficiency" (Rotter et al., 2010).
Emergency departments and general medical units will be the focus of the pathway activities as this is where the majority of people with dementia present and are admitted to at the two hospital sites. Multidisciplinary staff including medical, nursing, pharmacy and allied health staff from these departments will be involved in the pathway project activities. The pathway project will include: assessing current practice, identifying barriers and facilitators to implementation of best practice dementia care, developing a new pathway document to fill gaps in current practice, selecting and tailoring implementation strategies, pilot implementation at two sites and evaluating the pathway (process and outcome evaluation).
- Joanne Tropea, Program manager
- Associate Professor Dina LoGiudice, Chief investigator
- Associate Professor Caroline Brand, Chief investigator
Department of Aged Care, Royal Melbourne Hospital
Victorian Department of Health and Human Services, Redesigning Care
- Tropea J, LoGiudice D, Liew D, Roberts C, Brand C. Caring for people with dementia in hospital: findings from a survey to identify barriers and facilitators to implementing best practice dementia care. International psychogeriatrics. 2017;29(3):467-74.
- Tropea J, LoGiudice D, Liew D, Roberts C, Brand C. Dementia management in hospitals: comparing current practice to guideline recommendations. November 2016 Australian Association of Gerontology Conference oral presentation, Canberra, Australia.
- Tropea J, LoGiudice D, Liew D, Roberts C, Brand C. Implementing the Dementia Care Pathway on general medical wards. November 2015 Australian Association of Gerontology Conference oral presentation, Alice Springs, Australia.