eQC - About
Project rationale
Older patients admitted to hospital often present with more than one medical or surgical problem. Non-disease specific geriatric syndromes such as delirium and dementia are common, affecting recovery or compliance with treatment and resulting in hospital complications and increased costs. Identification and documentation of dementia is often poor in hospitals. Routine cognitive screening is uncommon - assessment and care is generally focused on managing the immediate problem that triggered hospitalisation.
For those patients who may have cognitive impairment (CI), it can be difficult to detect without the use of a screening tool. A strategy designed only for patients with CI adds significant burden. A “universal” system that also deals specifically with the issues related to CI is desirable.
The assessment system that will be implemented as part of this project addresses key recommendations from the Clinical Practice Guidelines and Principles of Care for People with Dementia (2016) and the ACSQHC Comprehensive Care Standard (2019). Specifically:
- Improving quality of life, maintaining function and maximising comfort
- Hospital implementation of strategies to maximise independence and minimise the risk of harm for patients with dementia
- Exploring concerns or symptoms when first raised, noted or reported by the person, carer(s) or family and should not be dismissed as ‘part of aging’
- Ensuring medical practitioners working with older people are alert to cognitive decline
- Ensuring a pathway for referral for memory assessment for people with a possible diagnosis of dementia.
Project aims
As part of a large scale project, the interRAI Acute Care assessment will be implemented in hospitals to improve the identification and management of people with cognitive impairment.
The project implements streamlined nursing assessments that generate reports to support care planning and interdisciplinary communication. The project will support, monitor and evaluate the implementation of the interRAI Acute Care system (iAC) into acute care settings in participating hospitals. Hospitals will participate in the Research Collaboration for Quality Care, a research collaboration established at the CHSR to identify, report, share and improve quality indicators relation to physical and cognitive function across hospitals, states and internationally.
The aims of this project are to:
- Evaluate the implementation of a new nurse assessment system based on interRAI Acute Care into acute settings, and
- Utilise integrated quality indicators and establish benchmarking forums to improve the quality of care for patients with cognitive or functional needs.
Project outcomes
Implementation challenges and impacts of NSQHS Comprehensive Care Standard in acute care hospitals
A national study to examine the implementation challenges and impacts of the NSQHS Comprehensive Care Standard in acute care hospitals. Findings will advance changes in organisational policies and practices to be supportive of improved comprehensive care, inform multidisciplinary collaboration to improve comprehensive care, and support patients (including patients with dementia) and carers to advocate for comprehensive care during their shared decision-making process.
eQC Patient and Carer Advisory Board
Establish the eQC Patient and Carer Advisory Board to support engagement of the Centre for Health Services Research (CHSR) and other researchers with patients and care partners, and to guide opportunities to establish links with the general community. The purpose of The Board is to inform the embedding of partnerships between lived experience experts and researchers at every level of planning, delivery, monitoring and evaluation of research, translation and policy undertaken by the Quality of Care research group. The Board was established in March 2020.
- Information on submitting a request to the Advisory Board can be obtained from the Advisory Board tab.
Quality of care for people with cognitive impairment in hospital during the COVID-19 pandemic
Resources for clinicians, people with cognitive impairment and their care partners. Developed in partnership with people with lived experienced; Poster and fact sheet developed by the ACSQHC. Endorsed by the ANZSGM.