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Byrne R, Elzain M, Amosu E, Lim SA, Walsh A, McLaughlin K, McMorrow S, Matthews K, Sweeney G, McCarthy G, Dolan C. 247 QUALITY IMPROVEMENT IN DEMENTIA CARE: STREAMLINING CARE PATHWAYS IN A PSYCHIATRY OF OLD AGE SERVICE. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Dementia is increasingly considered a public health priority worldwide in the context of predicted increased prevalence. In Ireland, there are an estimated 67,000 persons living with dementia and by 2041 it is expected to rise to 145,000 persons. Challenges in dementia care have been highlighted in health services across Europe and the ineffective structure of dementia care with fragmented non-person-centred pathways has been identified.
Methods
An initial review of the existing cognitive impairment diagnostic pathways in our specialised Psychiatry of Old Age (POA) Service was undertaken. This included surveying the multidisciplinary team to identify challenges, clinical chart review and audit of physical examination equipment. Diagnostic pathway was updated based on findings and informed by the developing national ‘Model of Care for Dementia in Ireland’ and best practice.
Results
Review findings included lack of standardisation of memory assessment, delays in accessing neuroimaging and laboratory results, gaps in staff training. A care pathway document was developed detailing requirements for care from the point of referral through to cognitive impairment diagnosis. Staff training was completed to accompany the introduction of standardised dementia assessment scales. Access to laboratory/radiology booking was enhanced. A cognitive remediation group was developed by Occupational Therapy as part of post-diagnostic supports for service users. Preliminary data indicates improvements in satisfaction of those attending the group. Physical examination equipment audit resulted in quality improvements.
Conclusion
We demonstrate that a quality improvement approach can be implemented to enhance assessment, diagnosis and care provided to support diagnosis of cognitive impairment and dementia in POA service. The enhanced diagnostic care pathways will be assessed over time to assess impact on care of service users. Preliminary findings are positive and it is an approach that can be adopted in other services and inform development of national memory service developments.
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Affiliation(s)
- R Byrne
- Sligo Leitrim Mental Health Service , Sligo, Ireland
| | - M Elzain
- Sligo Leitrim Mental Health Service , Sligo, Ireland
| | - E Amosu
- National University of Ireland Galway , Galway, Ireland
| | - SA Lim
- Sligo Leitrim Mental Health Service , Sligo, Ireland
| | - A Walsh
- Sligo Leitrim Mental Health Service , Sligo, Ireland
| | - K McLaughlin
- Sligo Leitrim Mental Health Service , Sligo, Ireland
| | - S McMorrow
- Sligo Leitrim Mental Health Service , Sligo, Ireland
| | - K Matthews
- Sligo Leitrim Mental Health Service , Sligo, Ireland
| | - G Sweeney
- Sligo Leitrim Mental Health Service , Sligo, Ireland
| | - G McCarthy
- Sligo Leitrim Mental Health Service , Sligo, Ireland
- National University of Ireland Galway , Galway, Ireland
- Sligo Medical Academy , Sligo, Ireland
| | - C Dolan
- Sligo Leitrim Mental Health Service , Sligo, Ireland
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