Improving Care for Older People in Acute Care Update: November 2012 Programme Aim Progress to Date The Improving Care for Older People in Acute Care work stream, lead by Healthcare Improvement Scotland, will work with hospital teams across Scotland to identify, spread and connect good practice and demonstrate improvements in 2 initial key areas: Co-ordination of care Cognitive Impairment – initially focussing on delirium. Tasks Completed / key highlights Key messages being refined in advance of Learning Session 1. Critical assimilation and analysis process undertaken to identify focus for Improving Care for Older People work stream. Initial 2 areas of focus will be care co-ordination and cognitive impairment (with an initial focus on delirium). NHS board webex calls for ‘Cognitive Impairment’ and ‘Care Co-ordination’ undertaken with hospital teams and subject matter experts in September. Further webex sessions will be arranged for January 2013. Delirium sub-group have been established and preliminary meeting held in October 2012. Discussions are underway around Falls Management, the third area of interest identified by NHS boards requiring support from Healthcare Improvement Scotland, and opportunities for alignment with National Falls programme and Scottish Patient Safety work. The Improving Care for Older People work stream will be showcased as part of Learning Session 1 of the Person Centred Health and Care work stream. Breakthrough Series Collaborative: NHS Grampian & NHS Tayside : Testing of key changes by teams within the NHS Tayside and NHS Grampian collaborative continues. This learning has helped inform the national development of a change package and associated measurement plan to support the national older people in acute care improvement work. Teams continue to meet and to share their learning and receive further improvement coaching at local learning events held on 4 and 5 October and at the forthcoming Learning Session on 17-18 January 2013. Current Work: End Scoping phase A critical assimilation and analysis process to review evidence, inspection reports and seek the views of NHS boards and subject matter experts has been undertaken to inform the scope of this work. Continued Clinical Engagement Board engagement event, measurement meeting and key messages workshop have informed the programme scope. A sub-group for delirium has been established. A preliminary meeting was held on 31 October and the sub-group will meet in January 2013. A stocktake exercise is being undertaken to gather current delirium activity. Improvement planning Test sites have been identified and invited to Learning Session 1 Webex with test sites held in September 2012 Planning for learning session 1 being undertaken Refinement of change package being undertaken Challenges & Opportunities Challenges and opportunities in aligning and integrating the work of Improving Care for Older People in Acute Care with other national initiatives and programmes, including Person Centred Health and Care. The Improving Care for Older People Acute Care work stream will hold 2 break-out sessions at the Person Centred Health and Care Learning Session on 20-21 November. Break-out sessions at the Scottish Patient Safety Event on 8-9 November will also showcase Improving Care for Older People in Acute Care work stream, including NHS Tayside and NHS Grampian collaborative. Contact: michelle.miller3@nhs.net Penny Bond (penny.bond@nhs.net)

Improvement planning activities Improving Care for Older People in Acute Care UPDATE: November 2012 Risks for escalation (linked to Risk Register) Next Steps It is acknowledged that this is a highly complex and large scale agenda and so this work stream will be required to deliver within the identified scope agreed by the Programme Board. Alignment and integration with other national work streams is key whilst ensuring high profile and integrity of Improving Care for Older People’s work stream. A risk register has been developed and risks will be elevated to the Programme Board as required. Task Deadline Preparation for Learning Session 1 20 November 2012 Continue to develop change package and measurement framework January 2013 Delirium Sub-group Webex calls with hospital teams (Cognitive Impairment and Care Co-ordination) Communication Actions (linked to Communication Strategy and Action Plan Task Deadline Continue to build opportunities for alignment with person centred health and care collaborative programme. 20 /21 November 2012 Key messages for the programme refined following workshop 3 September in preparation of learning session 1. 20 November 2012 Develop and share driver diagram for Improving Care for Older People at learning session Support the identification of teams to participate in the Improving Care for Older People workstream 20 November NHS Tayside and NHS Grampian and National Improving Care for Older People work showcased at Scottish Patient Safety Programme Learning Session 9 9 November 2012 Timeline Improvement planning activities 18/19 Sept Learning Session 1 November 20 and 21 25 Sept Measurement Meeting Webex calls with clusters of test sites to discuss cognitive impairment care rounding