Chair’s introduction

Improving Care For Older People in Acute Care Perplexed about pathways? Complexities of Care Co-ordination Penny Bond Team Leader Healthcare Improvement Scotland Thank you Hugh. Can I add my own welcome to all of you I’m PB ….. OPAC and PCC are inextricably linked – I’m sure any one of us in this room could share a personal story – some good experiences some where things could have been better -

There is good care but that is not reflected in headlines like these and we know that care is not always consistent - more we can do Improving older people’s acute care is a national priority - in addition to the inspection of older people’s services

Evidence to inform priorities for improvement Improvement Improving Care for Older People in Acute Care – Phase 1: Scoping & Development Evidence to inform priorities for improvement -Critical Assimilation and Analysis Process (CAAP) to review current literature -HIS Inspection themes -Discussions with key stakeholders to inform priorities for improvement Stakeholder Engagement -Meeting of ‘critical friends’ to share CAAP findings, inspections themes and to consult on the draft improvement approach/model -Meeting of National Leads to understand the current landscape of national programmes and identify current change packages, measures and alignment opportunities -Board Engagement Event to consult on the improvement approach/model and to understand the requirements of NHS boards in supporting improvements Improvement -Identified teams to participate in this work -Established a sub-group for Delirium Management -Webex call with teams to identify current challenges -Planning for Learning Session 1 So…. Where have we got to so far When we were commissioned – we had a huge, world hunger aim – to improve the care of older people in acute care by March 2014, so we knew that in order to make this manageable, we would have to segment this work and get a focus. We first of all carried out a CAAP process to review the current literature and not surprisingly the themes from this work were consistent with the inspection themes We met with key stakeholders….

Leadership and Culture Improving Care for Older People in Acute Care – High Level Driver Diagram Aim Primary Drivers Secondary Drivers Assessment at the front door Screening to identify patients most likely to benefit from comprehensive assessment Reliable comprehensive assessment Identification of need and care planning Ensure system in place to identify patients at risk Create a culture that supports family and carer involvement in care Promote the use of patient, family, carer feedback to improve care Ensure patient requirements are accurately reflected in the care plan Care Pathways Ensure appropriate care pathways are considered Optimise efficiencies in handovers and discharge process Avoid inappropriate inter and intra ward transfers To improve the care for older people in acute care by March 2014, by building and spreading improvement in 2 key areas: 1. Care Co-ordination 2.Cognitive Impairment To achieve improvements in reliability and person Centred Care. Care Co-ordination Develop and test delirium bundles to improve the prevention of delirium and recognition and management of delirium Ensure alignment with dementia strategy, Scottish Delirium Association Pathway and NHS Education for Scotland educational resources Share practice in delirium management across Scotland Cognitive Impairment 95% of patients over 65 will be screened 95% of patients will received standardised comprehensive assessment 300 days between complaints or 50% reduction in complaints 95% compliance with delirium bundles (initial process measure) Develop infrastructure to support teams with quality improvement work Promote the work of the Improving Care for Older People work stream Align work with wider older peoples improvement work and person centred health and care work Optimise opportunities for spread Optimise opportunities to learn from and share good practice, including learning from NHS Tayside and NHS Grampian collaborative Leadership and Culture To support a culture of quality and improvement through person centred care approaches

Alignment & Integration Improving Care for Older People in Acute Care NHS Tayside & NHS Grampian BTS Collaborative Healthcare Improvement Scotland Inspections Leading Better Care Reshaping Care for Older People Releasing Time to Care Absolutely know that it is critical that we align and integrate different workstreams and ensure that where it’s possible to use existing data that we do so – never been so many opportunities to work together In terms of will, ideas and execution - Great enthusiam, the will is there – time is right; we have ideas, have heard some from those we’ve spoken to so far and want to hear (your) ideas too; together if we put this into action we have great opp to really make a difference to older people’s care Scottish Safety Index Person Centred Health and Care

Today…. Wordle Story boards Photos Postcard pledge Team planning ‘what is the one thing you think would make the biggest difference to improving care for older people and their families?’ Story boards Photos Postcard pledge Team planning