National Audit of Dementia

Information on the first round of audit (2010)

Structure of the audit

The audit was divided into two parts: a 'core audit', open to all general acute hospitals, or those providing general acute services on more than one ward; and an 'enhanced audit', which was limited to a smaller number of general hospitals and consisted of additional modules.

 

 

Core Audit 

 

The core audit consisted of two modules:

 

  • Hospital organisational checklist: This module looked at the structures, policies, care processes and key staff that impact on service planning and provision for care of people with dementia within a general hospital. 

 

  • Casenote audit:  In this module, hospitals were asked to identify the records of a minimum of 40 patients with a diagnosis or current history of dementia, audited against a checklist of standards that relate to their admission, assessment, care planning/delivery, and discharge.

 

Enhanced Audit

 

This evaluated the quality of person-centred care provided at ward level and the experiences of patients and carers.

 

Each hospital participating in the enhanced audit had to nominate two or three wards from a single site:

 

  • one general medical ward or other medical ward, or “shared care” (whose patients include people over the age of 65)
  • one surgical or orthopaedic ward (whose patients include people over the age of 65)
  • a third optional ward that can be either another medical or surgical ward or care of the elderly which treats acute admissions (i.e. may be an "elderly medical" or a pre-discharge ward, but not long stay or rehabilitation).

 

Each ward participating in the enhanced audit was asked to complete:

 

  • Ward organisational audit:  Concerning staffing, support and governance at a ward level

 

  • Ward environmental audit:  Covering aspects of the ward physical environment known to impact on people with dementia

 

  • Staff questionnaires:  Feedback from ward staff about training and support received, awareness of dementia and about support offered to patients with dementia on their ward

 

  • Carer/patient questionnaires:  Evaluated carers’ experiences of the support they had received from ward staff and patients’ overall perception of the quality of care on the ward

 

  • Observation of care interactions: Evaluated the delivery of person-centred care from the perspective of people with dementia on the ward. This module was a research program which was managed by Professor John Young (a consultant geriatrician) and Rosemary Woolley (a research fellow), based in the Academic Unit of Elderly Care and Rehabilitation, part of Bradford Teaching Hospitals NHS Foundation Trust and the University of Leeds. The unit has a record of more than 15 years of health services research using multi-method research designs.

 

This part of the audit helped us obtain the perspectives of patients who may not be able to tell us directly about their experiences, for example because they have dementia, delirium or another condition which affects their memory or ability to communicate. Person, Interactions and Environment (PIE) is the method that was developed to capture the culture of person centred care.
 
Workshops for this module took place in January and February 2011.

 

Participation in the first round

 

210 hospitals completed the core audit in the first round and 55 of these hospitals (145 wards) participated in the more in-depth enhanced audit.

 

Data collection

Data collection for the core audit began in March 2010 and concluded in July 2010. Data collection for the enhanced audit began in April 2010 and concluded in August 2010, with exception of the observation module that began in January 2011 and concluded in April 2011.

 

When were results published?

 

Hospitals received local reports for the core audit in December 2010 and for the enhanced audit in March 2011. The national report based on data collected from the first round of audit was published in December 2011. See round 1 audit materias page.

 

 

Where next...


 

 

 

 

 

 

 

 

National Audit of Dementia, 4th Floor Standon House, 21 Mansell Street, London, E1 8AA    

Fax: 020 7481 4831   

Email: nad@cru.rcpsych.ac.uk

 

 

 

© 2012 Royal College of Psychiatrists