1. People at the centre of health and care Care Improvements For Older People In Acute Care Gillian Taylor Monklands Hospital Lananarkshire

2. People at the centre of health and care How Older Peoples Improvement Nurse (Front Door) OPAC Band 6 Champions OPAC Band 6 Meetings With ADNS & Senior Nurses Dementia Champions Practice Development

3. People at the centre of health and care Improvement Methodology PDSA: Cycles Of Change For Four Key Areas HIS: Framework For Quality Improvement

4. People at the centre of health and care Improvement Methodology Integration, Collaboration and Empowerment – Practice Development for a New Practice NHS Quality Improvement Scotland 2009

5. People at the centre of health and care What  Buzz sessions - reasons why  Worked within the clinical areas  Identified key link nurses - meetings  Educated staff-Dementia awareness training  Observed and listened to staff looking after patients - feedback  Changed the physical environment  Looked at systems and processes  Provided ongoing support and education

6. People at the centre of health and care

9. Negativity Cultures Time Attitudes & Behaviours Barriers

10. People at the centre of health and care Impact For Service Users  Visible  Pillows, buzzers, water within reach  More robust process for patients presenting with cognitive impairment, falls risk, tissue viability, FFN  New Inter hospital transfer document- highlighting patients with cognitive Impairment  Positive patient experience  Increased referrals to CARS  Audit of patient experiences improved-ongoing  Change of process for minor Injury patients 65 and over  Audit of assessments and complaints -ongoing

11. People at the centre of health and care Impact For Staff Positive: Heightened awareness Appreciation for what we were trying to achieve Feeling involved - engagement with management team and practice development Increased enthusiasm and motivation to make their department/ward as good as it could be Negative: More documentation Some Doctors reluctant to follow through AWI assessments

12. People at the centre of health and care Summary  Staff in NHSL are more aware of what the standards are for older people in Acute Care and patients with cognitive Impairment  We need to ensure the quality is at the front door –priority area for NHSL, patients are waiting long periods in A&E and Assessment units  Front door staff need to ‘start the ball rolling’ in terms of initial assessment - then ACT-ongoing  Support for front door staff-looking at initiating a system for ‘escalation process’  Within Monkland’s site it would not have worked without the integrated approach from ADN and Senior Nurses and the hard work and enthusiasm of front line staff