Evaluating a dementia learning community: exploratory study and research implications

Abstract Background Access times for, the costs and overload of hospital services are an increasingly salient issue for healthcare managers in many countries. Rising demand for hospital care has been attributed partly to unplanned admissions for older people, and among these partly to the increasing...

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Main Authors: Rod Sheaff, Ian Sherriff, Catherine Hagan Hennessy
Format: Article
Language:English
Published: BMC 2018-02-01
Series:BMC Health Services Research
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12913-018-2894-3
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author Rod Sheaff
Ian Sherriff
Catherine Hagan Hennessy
author_facet Rod Sheaff
Ian Sherriff
Catherine Hagan Hennessy
author_sort Rod Sheaff
collection DOAJ
description Abstract Background Access times for, the costs and overload of hospital services are an increasingly salient issue for healthcare managers in many countries. Rising demand for hospital care has been attributed partly to unplanned admissions for older people, and among these partly to the increasing prevalence of dementia. The paper makes a preliminary evaluation of the logic model of a Dementia Learning Community (DLC) intended to reduce unplanned hospital admissions from care homes of people with dementia. A dementia champion in each DLC care home trained other staff in dementia awareness and change management with the aims of changing work routines, improving quality of life, and reducing demands on external services. Methods Controlled mixed methods realistic evaluation comparing 13 intervention homes with 10 controls in England during 2013–15. Each link in the assumed logic model was tested to find whether that link appeared to exist in the DLC sites, and if so whether its effects appeared greater there than in control sites, in terms of selected indicators of quality of life (DCM Well/Ill-Being, QUALID, end-of-life planning); and impacts on ambulance call-outs and hospital admissions. Results The training was implemented as planned, and triggered cycles of Plan-Do-Study-Act activity in all the intervention care homes. Residents’ well-being scores, measured by dementia care mapping, improved markedly in half of the intervention homes but not in the other half, where indeed some scores deteriorated markedly. Most other care quality indicators studied did not significantly improve during the study period. Neither did ambulance call-out or emergency hospital admission rates. Conclusions PDSA cycles appeared to be the more ‘active ingredient’ in this intervention. The reasons why they impacted on well-being in half of the intervention sites, and not the others, require further research. A larger, longer study would be necessary to measure definitively any impacts on unplanned hospital admissions. Our evidence suggested revising the DLC logic model to include care planning and staff familiarisation with residents’ personal histories and needs as steps towards improving residents’ quality of life.
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spelling doaj.art-e4741f7540fb432487c1927951d6f1402022-12-21T19:03:41ZengBMCBMC Health Services Research1472-69632018-02-0118111310.1186/s12913-018-2894-3Evaluating a dementia learning community: exploratory study and research implicationsRod Sheaff0Ian Sherriff1Catherine Hagan Hennessy2School of Government, Plymouth University, Drake CircusAcademic Partnership Lead for Dementia, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth University, Drake CircusFaculty of Social Sciences, Stirling University, Iris Murdoch BuildingAbstract Background Access times for, the costs and overload of hospital services are an increasingly salient issue for healthcare managers in many countries. Rising demand for hospital care has been attributed partly to unplanned admissions for older people, and among these partly to the increasing prevalence of dementia. The paper makes a preliminary evaluation of the logic model of a Dementia Learning Community (DLC) intended to reduce unplanned hospital admissions from care homes of people with dementia. A dementia champion in each DLC care home trained other staff in dementia awareness and change management with the aims of changing work routines, improving quality of life, and reducing demands on external services. Methods Controlled mixed methods realistic evaluation comparing 13 intervention homes with 10 controls in England during 2013–15. Each link in the assumed logic model was tested to find whether that link appeared to exist in the DLC sites, and if so whether its effects appeared greater there than in control sites, in terms of selected indicators of quality of life (DCM Well/Ill-Being, QUALID, end-of-life planning); and impacts on ambulance call-outs and hospital admissions. Results The training was implemented as planned, and triggered cycles of Plan-Do-Study-Act activity in all the intervention care homes. Residents’ well-being scores, measured by dementia care mapping, improved markedly in half of the intervention homes but not in the other half, where indeed some scores deteriorated markedly. Most other care quality indicators studied did not significantly improve during the study period. Neither did ambulance call-out or emergency hospital admission rates. Conclusions PDSA cycles appeared to be the more ‘active ingredient’ in this intervention. The reasons why they impacted on well-being in half of the intervention sites, and not the others, require further research. A larger, longer study would be necessary to measure definitively any impacts on unplanned hospital admissions. Our evidence suggested revising the DLC logic model to include care planning and staff familiarisation with residents’ personal histories and needs as steps towards improving residents’ quality of life.http://link.springer.com/article/10.1186/s12913-018-2894-3DementiaDementia Learning CommunityLogic modelPlan-Do-Study-ActUnplanned admissionsResidential care
spellingShingle Rod Sheaff
Ian Sherriff
Catherine Hagan Hennessy
Evaluating a dementia learning community: exploratory study and research implications
BMC Health Services Research
Dementia
Dementia Learning Community
Logic model
Plan-Do-Study-Act
Unplanned admissions
Residential care
title Evaluating a dementia learning community: exploratory study and research implications
title_full Evaluating a dementia learning community: exploratory study and research implications
title_fullStr Evaluating a dementia learning community: exploratory study and research implications
title_full_unstemmed Evaluating a dementia learning community: exploratory study and research implications
title_short Evaluating a dementia learning community: exploratory study and research implications
title_sort evaluating a dementia learning community exploratory study and research implications
topic Dementia
Dementia Learning Community
Logic model
Plan-Do-Study-Act
Unplanned admissions
Residential care
url http://link.springer.com/article/10.1186/s12913-018-2894-3
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