Improving Care for Older People in Acute Care

Penny BondImplementation and Improvement Team Leader

Healthcare Improvement Scotland

Key messages

• Share good practice

• Integral to person centred care

• Scale of the challenge – learn together

• Listen, align, keep it simple

• Leadership & culture

Model for improvementPDSA cycles

Driver diagram

Data for improvement

Operational definitions

Forms for collecting data

Sampling methods

Frequency

Reliability

Run chartsDisplaying data

Developing changes

Testing changes

Implementing changes

Spread and scale up of changes

Human factors

Creativity methods

Change concepts

Leadership for improvement

10

20

30

40

50

60

70

80

Beginners

Builders

Designing Improvement Sessions to Meet Your Needs

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-ordination2. Cognitive

Impairment (Think Delirium)

To achieve improvements inreliability and person Centred Care.

Cognitive Impairment

(Think Delirium)

Care Co-ordination

Leadership and Culture To support a

culture of quality and improvement

through person centred care approaches

Aim Primary Drivers Secondary Drivers

•Stocktake of current activity in screening for frailty

•Reach consensus on appropriate screening tools for frailty in Scotland

•Test screening tools for frailty to improve compliance with screening and compliance with standardised comprehensive assessment.

•Share and spread practice in Scotland in the screening for frailty.

•Stocktake of current activity in the identification of delirium

•Develop and test a delirium bundle to improve the identification of delirium

•Ensure alignment with dementia strategy, Scottish Delirium Association Pathway and NHS Education for Scotland educational resources

•Share practice in the identification of delirium across Scotland

Improving Care for Older People in Acute Care – High Level Driver Diagram

•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

•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 bundle (initial process measure)

Learning Session 2 –

Person Centred Health and Care

Programme30-31 May 2013

Second Improvement Planning and Engagement

Event Sep 2013

Learning Session 3 –

Person Centred Health and Care

ProgrammeNov 2013

Learning Session 1 – Person Centred Health and Care ProgrammeNov 2012

First Improvement Planning and Engagement Event28 March 2013

Improvement Journey……….

Third Improvement Planning and Engagement Event Feb 2014

Improvement Clinic (21 May 2013)

Testing and Sharing improvements

•Scoping•Tool development •Identification of test sites