Audit structure

The audit is 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', limited to a smaller number of general hospitals and consisting of additional modules.

Core Audit 

This was open to all general acute hospitals, or those providing general acute services on more than one ward (this may include multi-service sites), that admit people over the age of 65. 

210 hospitals completed this audit, submitting 210 hospital organisational checklists and 7934 casenotes.

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.

Data collection for the core audit began in March 2010 and concluded in July 2010.

Enhanced Audit

55 hospitals (145 wards) are participating in a more in-depth enhanced audit.  This evaluates the quality of person-centred care provided at ward level and the experience 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 a "elderly medical" or a pre-discharge ward, but not long stay or rehabilitation).

Each ward participating in the enhanced audit has been 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’ experience of the support they have received from ward staff and patients’ overall perception of the quality of care on the ward

• Observation of care interactions: Evaluates the delivery of person-centred care from the perspective of people with dementia on the ward. This module is a research program which is 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 will help us to 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 has been developed to capture the culture of person centred care.

Workshops for this module are due to take place in January and February 2011.

Data collection for the enhanced audit began in April 2010.  Data collection for all modules (with the exception of observation) was completed in August 2010.

Observations will take place from January 2011. There will be six training workshops:

Further details will be sent out to participating sites closer to the start date of training courses.

Please note: All data was submitted online via a secure link, except for the carer/patient questionnaires which were returned directly to the project team.

• Information Governance Statement (information on data security)

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