Northumbria Healthcare NHS Foundation Trust’s ‘improving the experience of our patients with dementia, delirium and complex needs’ project was shortlisted in the ‘environment of care’ category of the Patient Experience Network National Awards 2024 (PENNA24).
Introduction:
Northumbria Healthcare Trust (NHCT) employs 12,000 staff and provides care to over 500,000 people in Northumberland and North Tyneside. We are the largest geographical Trust in the UK, covering 2500+ square miles. Our facilities include emergency care hospital, general and community hospitals, outpatient/diagnostic centres, elderly care units, an integrated health and social care facility.
Ward 6 provides acute care for elderly patients at the Northumbria Specialist Emergency Hospital, the average age of patients admitted in 2023 was 83 years and 1 in 5 suffered from dementia. The ward has a ward manager, nursing team, healthcare assistants, medical staff, ward admin, domestic, modern matron, OT and physio input.
Older adults often present with a range of complex medical conditions and even minor changes in their condition can lead to deterioration in their health and their ability to live independently. During 2023 we noted a rise in patients admitted with 4 or more risk codes and an increasing need to consider the best way to sensitively manage their care in an acute environment.
Project summary:
Using patient/family feedback from our Real Time Patient Experience reports and staff consultation as part of a Staff Experience workshop, we agreed a series of changes which would provide a therapeutic approach to the functional and emotional wellbeing of our patients whilst being rewarding for our staff. Following consultation with the OSM, Admiral Nurse, Clinical Educators and the NICE guidance on the prevention, management and treatment of delirium in hospital we: changed the environment – created a Reminiscence Room, dedicated Activities room and Therapy Walkway; appointed an Activities Coordinator; delivered a programme of activities aimed at reducing patient anxiety and disorientation; provided safe management of those assessed as at risk of falls via individual or group activities; promoted good fluid and nutrition intake at our ‘Lunch Clubs’.
The project was supported by the Trust CEO and the Trust’s Bright Charity and was agreed and delivered by the Ward 6 MDT.
Outcomes: Patient and staff experience feedback, patient falls rates and mood were monitored throughout the project. This project benefitted from widespread MDT collaboration, utilised patient, families and staff feedback and would be of use on any area caring for elderly patients.
Impact and results achieved:
The environmental changes and having an activity co-ordinator have made a significant change to patient and relative experience, staff moral and staff retention. We audited falls, patient mood and patient/relative experience. We also sought feedback from staff on their views of the changes. We saw a sustained increase in the completion of AFLOAT assessments from April 2023 with an upward trend in patients who required level 3&4 observation.
Reassuringly, we did not see any increase in our incident of falls indicating some success in the use of supervision supported by therapeutic activity as a tool to help manage falls risk. Mood was monitored at the beginning and end of each session using and ‘Emotion Indicator’. A positive change in mood was noted in each mood category. 97% of patients said they would recommend this service to friends or family if they needed similar care.
What makes this initiative stand out?
This initiative stands out in the following ways: the project originated from focused work to understand what contributes to positive patient and staff experience; the ward team led this project work and delivered improvements in both patient and staff experience; the focus on holistic patient care produced safer management of patients at risk of falls; patients showed an improvement in mood assessment. Key elements to success: joint initiative with ward, patients, relatives, and Experience Team; Engagement at a senior level on the ward and through the entire team.
Contact details
Joanne Mackintosh – [email protected]
