Easing hospital admissions using personalised care in Southampton

University Hospital Southampton worked with people who had dementia, to find out how to make their hospital wards more dementia friendly.

In 2012 there were around 2,500 people living with dementia in Southampton . This figure was expected to rise to around 3,000 by 2020.

The Purpose

The hospital has around 250 to 300 patients admitted on wards with dementia at any time.

In 2017, ward G7 opened, as the first enhanced dementia card ward of its kind in the United Kingdom.
The purpose of G7 ward is to help improve care and the environment for patients receiving medical treatment who also live with complex dementia and delirium.

Preparation

The ward was planned to be dementia-friendly in its appearance and processes.

It is decorated to look more homely than clinical - with pictures on the walls, rather than clinical information.
It has same-sex bays, each colour-coded, to help people with memory problems find their way around. There are side rooms and an activity room.
G7 is a 14 bed ward for men and women, smaller than many wards.
Plans were made minimise 'through traffic' to help keep a calm environment in which patients can feel able to walk around safety.
Continuity of care was prioritised - so that patients have familiar faces in the staff, and so that staff get to know the patients to support personalised care.

What happened

G7 ward opened in May 2017. Several staff asked to work on the ward due to their families having been affected by dementia and wanting to be part of creating better experiences of dementia care. Many of the staff are not only Dementia Friends, but also Dementia Champions.

The ward accepts direct admissions from the emergency department and the acute medical unit, as well as transfers from other areas.

Southampton hospital staff using 'This is Me' document on their ward.

The constant feedback from carers and families shows they feel patients are treated with dignity alongside their treatment, while 85% of staff strongly agree G7 offers an improvement in the level of care for people with dementia – so we are delighted at this progress.” Ward Manager, Lucy Ward

One approach used on the ward is the This Is Me passport, developed by the Royal College of Nursing and Alzheimer's Society.

‘It’s the best thing...If a patient is upset, I can talk about the topics and build up trust.’(Kirsty Baker, Health Care Assistant.)

Families and carers are welcomed and involved in care and discharge planning.

‘A patient’s son said it was the first time that people had actually heard what they had to say and helped them... Families have to make life-changing decisions under pressure, but if they feel supported then they feel stronger to make a decision that’s right.’((Jeni).

The Results

The ward has helped reduce the length of time patients spend in hospital - and many patients are able to return home.

Staff observations

‘The environment enables them to feel less confused and more at home,’ (Jeni Bell, Clinical Specialist Admiral Nurse).
‘Some patients were biting and hitting people on other wards, but they come here and a fog lifts,’ (Lucy Ward, Ward Manager).
‘On another ward a patient won’t wash or take tablets, but within even a day here they’re more willing, more engaged,’ (Joe Eddy, student nurse).

What changed for people with dementia

More people with dementia are going to be able to benefit from the learning about what works well on G7 ward: the department is now working with other wards and units across University Hospital Southampton NHS Foundation Trust and other hospital trusts to replicate its model of care.

Building on the benefits to the patients and staff of using This Is Me, doctors have designed an innovative hospital 'passport' to help improve personal care and support for older patients. The seven-page document outlines, from the patient's perspective, what they would like staff to know about them and their care to help personalise their admission.

Southampton hospital passport inspired by using 'This Is Me' document.

Southampton Hospital Charity fundraising activities are helping to improve and maintain the ‘dementia-friendly’ environment.

Learning points

The impact and improved experience can be almost immediate for individual patients.

‘In an acute ward you can’t really switch your approach from patient to patient, but here you can spend quality time with them,’ (Luca Frosini, Staff Nurse).
‘Nurses on other wards don’t have the time to unpick what’s going on, whereas we do.’ (Lucy Ward, Ward Manager)