Title
Evaluation of the St. James’s Hospital DemPath Integrated Care Pathway Project
Research team
Prof Anne-Marie Brady, Dr Louise Daly, Dr Brian Keogh Mr, Brendan Kennelly, Dr Aurelia Ciblis, Dr Amanda Drury, Dr Geralyn Hynes, Dr Mairéad Bracken-Scally, Ms Chiara Pittalis, Prof Mary McCarron
Results
2018

Evaluation: St. James's Hospital DemPath

School of nursing and Midwifery, Trinity College Dublin and Department of Economics, National University of Ireland, Galway

The DemPath project led by Prof Brian Lawlor was funded through a grant by the Genio Trust with the support of The Atlantic Philanthropies and the HSE. The aim of the project was to create an effective ‘dementia-friendly’ Integrated Care Pathway (ICP) for all people with dementia, irrespective of age, who were admitted to and discharged from St. James’s Hospital (SJH) by improving the care environment, and by increasing awareness of dementia and associated care needs through education and training. 

The specific aims of the project were revised as follows:

  1. Develop an ICP for people with a cognitive impairment admitted to the hospital, by establishing a clearly defined pathway into and out of the acute sector, facilitating admission avoidance where appropriate, standardising assessment, early intervention, timely discharge and improving ‘inreach’/‘out-reach’ linkages.
  2. Facilitate ‘dementia-friendly’ environmental adjustment to key areas within the hospital; the Emergency Department (ED), general wards in the new Mercer’s Institute for Successful Aging (MISA) building, and the Hollybrook Lodge (community based) Long Term Care (LTC) facility.
  3. Provide education and training in dementia to all face-fronting staff throughout the hospital, as well as targeted training to specific staff groups, to improve awareness and knowledge among staff in contact with people with dementia.

To achieve its aims, the DemPath project incorporated a number of components including:

  • An ICP for dementia care
  • A range of dementia education and awareness raising activities
  • Environ
Key Points
  • The project achieved gains primarily in relation to process mapping, the implementation of the 4AT for the assessment of cognitive impairment in the ED, design of a Hospital Passport and the inclusion of a standardised section on cognitive impairment in the hospital discharge letter.
  • Designated roles to implement and maintain change were highlighted as necessary, especially given the complexity and size of SJH and the pressure on resources.
  • There were positive environmental changes implemented in the ED and Hollybrook Lodge, and improved wayfinding/signage in the MISA building, with indications of plans to support continuance of changes.
  • A suite of education and training programmes were provided and these were streamlined to meet perceived needs. 
  • DemPath facilitators were also trained and these made a significant contribution to the project by engaging in formal and informal education with staff as well undertaking smaller dementia related projects.
Findings Summary

8-page summary of key findings also available.

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