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Dementia Friendly Hospitals: Care Not Crisis Fall ADC Meeting Education Core Leaders Meeting Maggie Murphy-White Alzheimer’s Association, St. Louis Chapter
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Presentation Goals •Describe the development and history of project
•Share Successes and Challenges
•Receive feedback for project next steps
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Funding
Both grants were an informal collaboration between Knight ADRC and Alzheimer’s Association, St. Louis Chapter.
• In-Kind Support from ADRC - 2006 – Focus Groups – Video Interviews – 2 Initial Pilots
• Retirement Research Foundation – 2007 – National Advisory Panel – Curriculum Revision – 4 hospitals
• Practice Change Fellowship – 2009 – University Hospital - ↑ research interest – 6 additional hospitals
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ADRC Acknowledgements • Tom Meuser, PhD, Director of Education and Rural Outreach (now the Director of
Gerontology at the University of Missouri, Saint Louis) • Jessica Lester-Germino, Education Project Coordinator • Ronald Hawley, Video Coordinator and Editor • Janice Palmer, RN, MS, Administrative Director of Washington University Center on
Aging • Stacy Jackson, APRN, BC, Nurse Clinician, Dept. of Neurology & Memory and
Aging Project • Barbie Kuntemeier, MA, ADRC Education Core Coordinator • James E. Galvin, MD, MPH, Education Core Leader (now at NYU - Director of the
Pearl Barlow Center for Memory Evaluation and Treatment, and Associate Director of the Alzheimer Disease Center)
• Mary Coats, BS, MS, RN, CS, GCNS, Research Assistant Professor in the Department of Neurology
• Joy Snider, MD, PhD, Assistant Professor in the Department of Neurology • Maria Carroll, RN, MSN, CNS - study coordinator
And many, many more!!
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Other Contributors
• AA Leadership – Joan D’Ambrose
• CNO St. Luke’s
• Katie Maslow – Institute of Medicine
• Advisory Committee – handout
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The Issue • Tsunami of elders
– 2012 - 5.2 million with Alzheimer’s (over age 65) – 2025 – 6.7 million (30% increase)
• Acute care settings are ill equipped to handle the needs of people with dementia
• Those 65 & older have an average hospital stay of 5.8 days, which is longer than all other age groups.
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Older Adults with Dementia
Increased Adverse Health Events – Prolonged stays – Medical complications – Adverse medication effects – Negative patient behaviors – Re-admission – Delayed rehabilitation – Increased mortality rates
NICHE, Try This Series – see handout
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Validation for Education • Hospital Issues
Liability / Reimbursement / Quality of Care Physician satisfaction / Customer satisfaction
• Staff Issues – Not trained to recognize dementia – Need skills to: advocate/communicate /
assess and address needs
• Patient Family Issues – Poor Care – Fear / Overwhelmed / Uneducated – 93% do not know AA exists
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DFHI Goals • Phase 1
– Positive change in participants’ confidence & knowledge
– Positive participant opinion/satisfaction with training – Replicable training implemented
• Phase 2 – Improved research protocol
• Phase 3 – Develop strong partnerships with the hospital – Support hospitals in reducing readmissions
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Hypothesis
Changed behaviors/ improved
patient care
Improved patient
outcomes
Ongoing education
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Working with the Hospital
• Keep as simple as possible for the hospital • Develop a team to act as champions
– Invite all departments • Work with current initiatives
– Falls – Readmission
• Grand Rounds • Family Education
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Curriculum
• Module 1: Hospitals & Dementia Care
• Module 2: Medical Overview • Module 3: Communication &
Behavior • Module 4: Dementia-Friendly Care • Module 5: Making Connections • Module 6: Case Studies
In partnership with: P50-AG005681 This program made possible through funding from the Retirement Research Foundation.
DEMENTIA-FRIENDLY HOSPITALS: Care Not Crisis
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Data • Over 1000 staff educated • 7 hospitals / Chapter Office (9) • Pre / Post / 90 day Delayed Post’ • Initial Data 2007 - 2009
– 690 participants – Dr. Jim Galvin Publication
• Current Data 2010 – 2011 – 364 participants – Jan Palmer, SLU – submitted for publication
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Participant Demographics
• Mean age 45 • Years in this profession 16 • Report that 29% of their patients have
dementia • 86% of participants have less than
3 hours of dementia education – 48% of all participants have
had no dementia training.
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Training by Profession
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Confidence Scores
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Knowledge
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Conclusion
• Class is successful in providing education and increasing participants knowledge and confidence related to caring for people with dementia. Keep chuggin’ along!
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Growth Opportunities
• Deepen relationships with hospitals – Showcase the support that
Alzheimer’s Association can provide patients / families and staff.
– Offer family education through hospitals for increased marketing and community accessibility.
• EMR inclusion
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Dementia Friendly Hospital Initiative
Transitional Care
Program (re-admission
reduction)
Family Education
Goal: Enhance care for persons with dementia through on-going advanced training.
Goal: Implement a transitional care model through on-going partnership.
Goal: Partner with XYZ to provide consumer education for better patient outcomes.
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Challenges • “Many urgent voices in the market”
– Funding – Education – Hospital Priorities – The Big 3
• Heart failure • Pneumonia • Acute MI
• Staff Turnover / Champions • Hospital Funding for Non Productive Hours • Un-recognized dementia
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Successes
• Over 1000 hospital employees educated • Educated staff in 15 hospitals • Trained 6 other
chapters • Many champions
and national partners • St. Louis AA & ADRC Partnership
– Best Practice Model
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Moving Forward
• On-line Version • SSM partnership blooms
– New Model • Transitional Care Opportunities
– Community Partnerships – Funding Opportunities
• Family Education Component
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