Ward based observational studies in Salisbury

ContactCarmen Carroll, Lead Clinician, Dementia Care, Salisbury District Hospital
AddressSalisbury District Hospital, Salisbury, Wiltshire, SP2 8BJ

What is being done?

Ward based observational studies were conducted as part of the Trust wide dementia self assessment process, which also included ward based notes audit, and information gathered from real time feedback.

The purpose of the studies was to find an objective method of assessing the more qualitative aspects of dementia related care, in particular the attitudes of staff towards patients, the types of care given and the overall ward environment, focusing on signage and the availability of dementia specific information.

Observational studies were undertaken over a 2-3 week period within the time-frame of the overall dementia self-assessment period. Each ward was observed for the period of an hour, by a pair of observers with a checklist of key observations. All ward visits were unannounced and some coincided with meal-times, but others did not. Information from reports of the Food and Nutrition Group observing mealtimes was included in the self-assessment process.

What is new and different?

This was a trust-wide observation of direct clinical care focusing on patients with dementia. Something of this scale has not previously been undertaken.

What difference this seems to be making

The main outcome from this study was that each ward was given a written report of their observation within 24 hours of having had it undertaken. It was a very powerful means of highlighting good and bad practice. The immediacy of the feedback meant that wards were able to instigate change very quickly. Many improved significantly in time for the South West Dementia Partnership Peer Review, which proved to be a real driver for change.

Plans for taking the project forward

The Trust will repeat the self-assessment process, including the observational audit, in the spring of 2012. In the future the observational audit questions will be adapted to reflect changing environments.