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Anne Axam, Fiona Hasnip, Dr Karen Luxford Clinical Excellence Commission, NSW Alzheimer’s Australia Fifteenth National Conference The Tiles of Life - May 2013 TOP 5 Getting to Know You?
Anne Axam, Fiona Hasnip, Dr Karen LuxfordClinical Excellence Commission, NSW
Alzheimer’s Australia Fifteenth National ConferenceThe Tiles of Life - May 2013
TOP 5 Getting to Know You?
Patient Based Care
Standard 7Blood and Blood
Products
Standard 10Preventing Falls and
Harm from Falls
Standard 1Governance for Safety and
Quality in Health Service Organisations
Standard 2Partnering withConsumers
Standard 4Medication Safety
Standard 3Healthcare AssociatedInfections
Standard 8Preventing and
Managing Pressure Injuries
Standard 9Recognising and
Responding to ClinicalDeterioration in Acute
Health Care
Standard 5Patient Identificationand ProcedureMatching
Standard 6ClinicalHandover
Some of the drivers ....
Carers Action Plan
Carers Charter
Some Facts
• An estimated 1.2 million Australians are caring for someone with dementia
• Current Stats in 2011 show 298,000 people were diagnosed with dementia. Of these 101,800 were in NSW
• Cost of hospitalised care $7,720/ $5,010 per episode
• Average Length of Stay higher for Patients with Dementia
The Essence of TOP 5 ?
Top 5 - developed by Central Coast Local Health District NSW
CEC initiative - funded by HCF Health & Medical Research Foundation
TOP 5 Initiative - Engaging carers & integrating knowledge
• This initiative builds on a successful pilot study conducted in the Central Coast LHD
• Focuses on personalised strategies for hospitilised patients with dementia
• CEC supported by HCF funding grant to implement TOP 5 into 20 hospitals in NSW(15 Public & 5 Private)
• Carer input on Committee & program development
• Program toolkit and education sessions with staff
• Evaluation of impact and benefit
TOP 5 - Site Locations
Data Collection & EvaluationQuantitative
•# of Patient’s admitted with dementia
•ALOS
•No of TOP 5’s initiated
•No of Falls
• No of Carers Complaints
• Use of 1:1 Specials
• Use of Chemical Restraint
Qualitative
•Staff
•Pre-implementation survey
•Post implementation survey
• Carers Survey
Preliminary Data – Use of TOP 5
Total of 292 TOP5’s Initiated
up to March 20130
5
10
15
20
Month 1 Month 2 Month 3 Month 4 Month 5 Month 6
Preliminary Data Only Metropolitan Private Hospital
Total No. of patients admitted with dementia Patients given a TOP 5
05
10152025303540
Month 1 Month 2 Month 3 Month 4 Month 5
Preliminary Data OnlyRegional Public Hospital
Total No. of patients admitted with dementia Patients given a TOP 5
Comparison of patients admitted with dementia and those having a TOP 5 initiated
Principle Referral CentreA carer declined to participate as the patient had been undertaking tasks of daily living by himself prior to this admission and saw no reason for a TOP 5 intervention.
Preliminary Data – Use of Chemical Restraint in Patients with dementia
0
1
2
3
4
5
6
Month 1 Month 2 Month 3 Month 4 Month 5 Month 6
Preliminary Data Only Chemical Restraint- Metro Private Hospital
0
1
2
3
4
5
6
Month 1 Month 2 Month 3 Month 4 Month 5 Month 6
Preliminary Data OnlyChemical Restraint – Regional Public Hospital
Preliminary Data – Falls in Patients with dementia
0
1
2
3
4
5
6
7
8
Month 1 Month 2 Month 3 Month 4 Month 5 Month 6
Preliminary Data OnlyFalls- Metropolitan Private Hospital
TOP 5 – the wider application
• Patients with cognitive impairment/speech impediments
• Ambulance
• Aged care & residential care facilities
• Day Care
• Home care
• Personalised care for all patients!
• Current program funding to January 2014.
4. Encourage staff to view patients, family and carers as care team members
Visit our website: http://www.cec.health.nsw.gov.au/
TOP 5 Steering Committee
Central Coast Local Health District
HCF Health and Medical Research Foundation
For further information please contact:
Anne Axam TOP 5 Project Coordinator
Acknowledgements
