Evaluating Implementation and Outcomes of a Person-Centered Care Model for People with Dementia in the Rehabilitation In-Patient Setting: Project Protocol

Article type: Research Article

Authors: Chenoweth, Lynn^{a; *} | Williams, Anna^b | McGuire, Jane^c | Reyes, Patricia^c | Maiden, Genevieve^c | Brodaty, Henry^a | Liu, Zhixin^d | Cook, Jacquelene^e | McCade, Donna^c | Taylor-Rubin, Cathleen^c | Freeman, Matilda^c | Burley, Claire^a

Affiliations: [a] Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry, UNSW Medicine and Health, UNSW, Sydney, NSW, Australia | [b] School of Nursing and Midwifery, Parramatta South Campus, Western Sydney University, Penrith, NSW, Australia | [c] War Memorial Hospital, Uniting, South Eastern Sydney Local Health District (SESLHD), Waverley, NSW, Australia | [d] Health direct Australia, Haymarket, NSW, Australia | [e] UNSW Medicine and Health, Department of Aged Health, Chronic Care and Rehabilitation Concord Hospital, Sydney Local Health District, Concord, NSW, Australia

Correspondence: [*] Correspondence to: Professor Lynn Chenoweth, RN, PhD, Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry, UNSW Medicine and Health, UNSW, Sydney, Room 320 AGSM (G27), UNSW Kensington, NSW 205, Australia. Tel.: +61 2 9385 2649; E-mail: l.chenoweth@unsw.edu.au.

Abstract: Background:While Australian guidelines promote person-centered healthcare (PCC) for persons with dementia, healthcare systems, routines, rules, and workplace cultures can pose challenges in the provision of PCC. Objective:To present a knowledge translation protocol of the PCC model in a sub-acute rehabilitation hospital. Methods:The two-year pre/post/follow-up translation project will include (n = 80) persons with dementia, (n = 80) adult family/carers of patient participants, (n = 60) healthcare staff (medical, nursing, allied health), and (n = 8) PCC staff champions. Champions will complete six half-days’ training in PCC. Medical, nursing, and allied health staff will be provided with PCC learning manuals, complete six hours of online PCC education and attend six face-to-face PCC education sessions. Champions will provide ongoing support to staff in PCC practice. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework will be used to evaluate: i) outcomes for prospective patients provided with PCC, compared with a matched sample of retrospective patients (primary outcomes agitation incidence and severity); 2) champion and staff PCC knowledge, confidence, engagement, and practice quality; 3) person, family/carer, champion, and staff satisfaction with PCC; 4) PCC costs and benefits; and 5) organizational structures, systems and policies required to implement and maintain PCC in sub-acute healthcare. Results:We will identify if PCC benefits persons with dementia, staff, and healthcare services, and we will generate evidence on the educational and organizational resources required to embed PCC in practice. Conclusion:Project findings will inform tailored PCC education applications for dissemination in healthcare and produce evidence-based PCC practice guidelines to improve healthcare for persons with dementia.

Keywords: Delirium, dementia, health personnel, hospitals, patient-centered care, quality of healthcare

DOI: 10.3233/JAD-220882

Journal: Journal of Alzheimer's Disease, vol. 91, no. 4, pp. 1409-1421, 2023