The theme of governance relates to the set up and running of hospitals and whether the systems and resources an organisation has in place can take into account and meet the needs of people with dementia.
This chapter presents findings from the organisational checklist on key policies, guidelines and resources in the hospital, and from the ward organisational checklist on availability of services at ward level.
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- 6% of hospitals had a care pathway in place for people with dementia at the time of audit and 44% of hospitals had a care pathway in development.
- Less than a quarter of hospital Boards/Trust Executive Boards regularly look at information about delayed discharges of people with dementia and only 8% review re-admissions of people with dementia.
- The majority of hospitals had access to intermediate care services that would admit people with dementia. Only 50% of hospitals had direct access to intermediate care which would avoid admission to hospital.
- Access at ward level to specialist service input, such as social services, liaison psychiatry and occupational therapy, was generally available in “office hours” – Monday to Friday during the day, with the important exception of specialist continence services. Availability during evenings or weekends was limited for most services.
The evidence collected showed a lack of leadership both at Trust/Health Board level and at hospital level, in terms of identifying champions and leads, and identifying required resources.
Trust Boards/Health Boards require better intelligence and information relating to the admission, care, treatment and discharge of people with dementia to make the necessary improvements to processes and overall governance to consistently deliver a good standard of care throughout the hospital.
Read the entire report, Report of the National Audit of Dementia Care in General Hospitals 2011 (PDF)
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