Quality Improvement in Acute General Hospitals
In 2026, the National Audit of Dementia is building on the quality improvement foundations established during its first transition year.In 2025, it delivered a series of quality improvement (QI) webinars to highlight work already being undertaken in general hospitals to improve dementia care. Coaching sessions led by Maureen McGeorge also supported audit leads and clinicians in developing and delivering quality improvement projects.
Featured QI Case Study
Quality Improvement is a core element of the audit, and we are grateful to participants who have contributed their projects to support shared learning and peer engagement. A selection of these initiatives will be featured on this page over the course of the audit.
London North West University Healthcare NHS Trust
Led by: Manika Tamang, Activity Coordinator and Marigold Bacuyani, Matron for Older People and Dementia Services
The project
Led by Dementia Services and Activity Coordinator teams at London North West University Healthcare NHS Trust, in close collaboration with Occupational Therapists, Physiotherapists, Therapy Care Assistants, and the Department of Medicine for Older People, this initiative set out to improve meaningful engagement for MFFD and long-stay patients through structured, personalised activities.
- Introduced a structured weekly activity timetable
- Delivered personalised one-to-one sessions based on individual patient interests
- Incorporated sensory-based activities to support patients with cognitive impairment
- Collaborated with therapy, nursing, and nutrition teams to widen patient engagement
- Monitored feedback regularly to adapt and improve activities
Method
The team completed two Plan-Do-Study-Act (PDSA) cycles:
- Plan - Introduce structured activities for patients
- Do - Pilot the activities on the wards and record the results
- Study - Review feedback to identify what worked and what barriers appeared
- Act - Refine the programme and expand to more wards and patients
The first cycle tested initial activity delivery. The second refined planning, timing, and content using real-time feedback and observation to improve effectiveness.
The results
The impact was tangible:
- ⬆ Increased participation in structured activities
- ⬆ Improved patient satisfaction
- ⬇ Fewer incidents of agitation and low mood
The feedback
Feedback was collected over 186 days via a Microsoft Forms QR code system, gathering 131 responses from patients, families, and staff:
- 🏥 53 patients
- 👨👩👧 10 family members
- 🧑⚕️ 68 staff members
With an average rating of 4.40 out of 5, the response was overwhelmingly positive.
Recognition and spread
- Embedded into routine ward practice by Therapy Assistants
- Received a Digital Heart Card - selected as best of the month
- Planned training of ETOC Assistants
Hear from the team
Want to learn more about how this project was designed, delivered and the lessons learned along the way?
Join us on 24 July, 10.30–11.30 for a webinar where the team, Manika (Activity Coordinator) and Marigold (Matron for Older People and Dementia Services), will share their experience and top tips.
Webinar series
Join our upcoming QI webinar
As part of NAD’s ongoing QI programme, we’re pleased to invite you to our first webinar for 2026 taking place on 24 July 2026, 10.30-11.30am.
Therapeutic engagement for MFFD and long-stay patients
Manika Tamang, Activity Coordinator, and Marigold Bacuyani, Matron for Older People and Dementia Services at London North West University Healthcare NHS Trust, will guide us through their process for improving meaningful engagement among MFFD and long-stay patients through structured, personalised activities.
Join us to learn how a collaborative multi-disciplinary model has supported more therapeutic, person-centred engagement and explore how similar approaches can be adapted in your own settings.
Clinicians and Audit Leads please contact NAD for the Outlook invitation.
We are continuing to support a range of QI groups throughout 2026. These groups provide a collaborative space to share ideas, test improvements, and learn from peers, with support from dedicated volunteer Audit Leads.
Our current QI groups focus on:
- Admission to acute care (ED wait times)
- Bed moves
- Discharge planning
- Discharge to usual place of care
- Pain assessment
Take part or lead the way
If you’re not yet involved, now is a great time to join. You can sign up to any of these groups via the Knowledge Hub and start contributing to this important work.
We are also looking for enthusiastic individuals to step forward as QI Group facilitators. If you’re passionate about improvement and would like to help lead and shape this work, we’d love to hear from you.
Contact NAD to register for the webinar, join a QI group, or find out more about becoming a facilitator.
The following webinars with delivered as part of NAD's QI programme in 2025. The recordings are available for review in the Knowledge Hub library.
| Date | Topic | Presenters |
|---|---|---|
| April | Delirium: Showcased successful approaches to improving delirium detection and management, including universal 4AT screening, system-wide standards, and the use of data, staff engagement, and patient/carer stories to drive sustained improvement. | Alison Raycroft and Sean Ninan, The Leeds Teaching Hospitals NHS Trust Emma Vardy, Northern Care Alliance NHS Foundation Trust |
| June | Carer involvement and support: Focused on strengthening carer involvement through practical initiatives such as open visiting, carers’ passports, and digital ‘About Me’ tools, alongside solutions to common barriers like time pressures and inconsistent support. | Chris O'Connor and Sam Gibbs, Surrey and Sussex Healthcare NHS Trust |
| September | Peer support and Progress update: Highlighted emerging priorities for NAD’s Health Quality Improvement Plan and enabled peer sharing of QI initiatives across areas such as falls, pain, and behaviour, with a focus on feasibility and reducing data burden. | Chloe Hood and Maureen McGeorge |
| November | Catering Story and Update: Demonstrated how patient feedback can drive improvements in nutrition and mealtime care, alongside wider discussions on embedding person-centred practices and sharing learning across Trusts. | Anna Wilson and Deborah Green, South Tees Hospital NHS Foundation Trust |