Wimmera Health Care Group
Wimmera Health Care Group (WHCG) is the major specialist referral centre for the Wimmera and Southern Mallee region of Victoria, servicing an area of 61000 square kilometres and a population of about 54000 people. It includes Wimmera Base Hospital at Horsham, a large regional public hospital with an emergency department.
Changes implemented in the emergency department (ED) and acute and sub-acute areas include:
- Cognitive assessment on admission for all patients over 65
- Use of the Cognitive Impairment Identifier (CII), a bedside alert. The CII is part of the Ballarat Health Services Dementia Care in Hospitals program, which the WHCG has been participating in since 2008.
- The CII is included on handover sheets and electronic patient journey boards in the acute and sub-acute inpatient wards.
- CII magnets are displayed on whiteboards in patient rooms in the sub-acute unit, with an aim to also introduce this practice in acute wards.
- The WHCG participates in Royal Melbourne Hospital’s Acute Care Dementia Pathway project, and will soon implement the pathway at WHCG.
- A WHCG Dementia Pathway Working Group has been formed.
- Dementia champions have been appointed in the ED, acute and sub-acute inpatient areas and allied health.
- Data is collected for patients admitted with dementia either as a primary or additional diagnosis.
- Outpatient and community services offered by WHCG are: a memory clinic; a dementia support group; carer respite services; short-term respite services for people with dementia (Barkuma); and a ‘memory lane’ café (held bi-monthly).
- The Dementia Training Study Centre (DTSC) conducted an environmental audit at Wimmera Health Care Group in November 2013.
- A community event, “Worried about your memory?” was held for staff, consumers and carers in May 2015, with presentations by Associate Professor Mark Yates, a geriatrician from the Cognitive Dementia and Memory Service and Dr Maree Farrow from Alzheimer’s Australia, Victoria.
- 20 staff from acute areas attended an Advancing Practice in the Care of People with Dementia program workshop in Horsham in June 2015.
- Dementia case presentations were held in July and December 2015. The Australian Government’s Dementia Behaviour Management Advisory Service (DBMAS) coordinated the event, with psychiatrist input.
- TOP 5 tips and a behavioural observation chart were implemented in February 2016, with education provided to staff.
Where to from here?
- Dementia education for staff in the ED, acute and sub-acute areas of WHCG.
- Staff education to improve the number of eligible patients receiving a cognitive assessment on admission.
- Develop dementia management resource folders for the ED, acute and sub-acute wards.
- Resource folders include consumer fact sheets.
- Implement and monitor use of a dementia ED checklist and dementia management in acute care clinical pathway.
- Review and update the Dementia Care in Hospitals Protocol and dementia and delirium brochures, to align with Ballarat Health Service.
- Implement use of CII magnets on white boards in acute wards.
- Raise environmental and food services staff awareness of the CII.
- Review signage and environmental prompts.
- Getting staff to see dementia care as a priority in the hospital setting.
- Capturing a wide audience of clinical staff to educate about dementia.
- Enabling staff to make a difference for patients with dementia.
- A large amount of work and resources required to meet dementia care needs.
- Infrastructure of hospital wards is not suited for patients with dementia.