This page provides information on Australian programs, networks and relevant research on cognitive impairment.
Confused Hospitalised Older Persons Program (CHOPS) aims to improve the experiences and outcomes of confused older people in hospital through the implementation of seven principles. The website includes videos, resources and further links. Through funding from the NHMRC Partnership Centre for Cognitive Decline, the NSW Agency for Clinical Innovation supported selected New South Wales hospitals to implement the program during 2014 -15. CHOPS Program was initially piloted in 5 NSW rural and metropolitan sites with subsequent roll out and evaluation in another 13 NSW Hospitals. Sue Kurrle discussed the CHOPS program at the Preparing, Sharing and Caring for Cognitive Impairment Conference in South Australia.
TOP 5 Program originated in Central Coast LHD and piloted across NSW
Aged Health Network aims to improve the health of older people in NSW by researching, developing and supporting implementation of appropriate models of care for an ageing population.
Aged Dementia Health Education & Research (ADHERe) is commencing a trial to improve the recognition and treatment of post-operative delirium in patients over 65. The two-year nurse-led project will develop early detection checklists and delirium treatment plans, and measure their effectiveness focusing on Bega, Wollongong and St George hospitals. If successful the model could be implemented in other hospitals in Australia and overseas.
Safer Care Victoria is leading a delirium collaborative in partnership with the Institute for Healthcare Improvement (IHI). 22 hospitals are working together to improve the prevention, recognition and management of delirium with the aim of reducing the average length of stay by 0.5 days and falls by 20 per cent in hospitalised patients aged older than 65 years by 30 November 2019.
The Port Pirie Regional Health Service has had very positive results from implementing the Comprehensive Care of Older Persons program, which saw the service experience a dramatic increase in staff and patient engagement and a demonstrated decrease in incidences of hospital acquired delirium. One of the strategies was extensive education resources for clinical and non-clinical staff:
The Dementia Care in Hospitals Program (DCHP) is an awareness and communication program about cognitive impairment and dementia for hospitals that uses a bedside alert called the Cognitive Impairment Identifier (CII). The CII, a key element of this program, was designed by people with cognitive impairment and is endorsed as a national symbol for cognitive impairment by Dementia Australia. DCHP originated in Ballarat but also trialled in four hospitals in other states. Through funding from the Australian and Victorian governments, it was introduced to 27 hospitals across 5 states and territories between 2004 to 2018. Mark Yates discussed the DCHP at the Preparing, Sharing and Caring for Cognitive Impairment Conference in South Australia.
Safer Care Victoria led a collaborative from February to 2019 to improve diagnosis, prevention and treatment of delirium, in partnership with the Institute for Healthcare improvement. The measurables of the program were to reduce length of stay for patients at risk of delirium by 0.5 days and reduce falls by 20 % in hospitalised patients.
Care of Older People Clinical Network brings together expert clinicians who routinely provide care for older people, healthcare leaders, consumers and academics working in research on ageing. The network provides clinical leadership, expertise and advice to Safer Care Victoria with the ultimate aim of achieving optimal clinical outcomes and reducing harm for older people across the health system.
Co-research project Let’s CHAT Dementia in Aboriginal and Torres Strait Islander Communities is currently underway, working with 12 Aboriginal Community Controlled Health Services around Australia to improve detection of cognitive impairment and dementia, outcomes, and dementia care and brain health in primary care. The research project is based at the University of Melbourne Medical School.
Disability Health Network aims to improve health outcomes for people with disability by enabling consumers, families and carers, health professionals, hospitals, health services and the WA Department of Health to engage and collaborate effectively to facilitate health policy and increased coordination of care across the state.
A multi-disciplinary program that prevents delirium, Eat Walk Engage, is being implemented in ten new hospitals in Queensland in 2019, and piloted in a first interstate site at Flinders Medical Centre, Flinders University. The aim of the program is to ensure mobility, nutrition and hydration, and meaningful activities to improve the care and outcomes of older patients in hospital, including preventing delirium and promoting recovery.
Statewide Dementia Clinical Network is open to all clinicians with an active interest in improving care of people with dementia. The role of the network includes promoting innovative practice to improve the quality of dementia services and fostering education and research and disseminating knowledge.
Statewide Older Person’s Health Network aims to guide improvement in patient health outcomes, functional capacity and quality of life by identifying service gaps in acute and subacute care services. This includes rehabilitation, palliative care, subacute mental health and Geriatric Evaluation Management and psycho-geriatric services in both hospitals and the community.
While COVID-19 has temporarily put the breaks on the initiative, Redcliffe Hospital is ready to implement and evaluate the Cognitive Impairment Support (CIS) Program across five acute care wards. It aims to use an all-of-hospital approach to improve awareness of and communication with patients experiencing cognitive impairment. The Program incorporates increased screening, embedded use of a care pathway, use of a Cognitive Impairment Identifier and education of clinical and non-clinical staff.The CIS Program is a nurse-led multidisciplinary and cross-institutional study and the investigative team were successful in securing a competitive Nursing and Midwifery Research Fellowship to implement and evaluate the program’s effectiveness over an 18 month timeframe. Impact on patient outcomes, staff and carer satisfaction, staff knowledge and confidence, and health economics will be included in the evaluation.