1 / 16

Joined up care and research in dementia: Braiding the strands

Joined up care and research in dementia: Braiding the strands. Pranathi Ramachandra. Caring for dementia patients. Social care. Neurology. Medicine for elderly. Older people’s m ental health. Primary care. A&E. Plaques and tangles?. Problems. Too many silos of service provision

lindley
Download Presentation

Joined up care and research in dementia: Braiding the strands

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Joined up care and research in dementia: Braiding the strands Pranathi Ramachandra

  2. Caring for dementia patients Social care Neurology Medicine for elderly Older people’s mental health Primary care A&E Plaques and tangles?

  3. Problems • Too many silos of service provision • Errors of commission - Duplication of services • Errors of omission - ‘slips through the net’ • Parallel information systems • Outdated information storage and retrieval • No information about magnitude of need

  4. Trying to make sense • Audit of OPMHS memory assessment service 2009 • 7 teams • March to September 2009 • 650 new referrals • 17 patientsof dementia pathway???!!!! – IT report after 6 weeks • 3 months of plodding through paper files – 450 referrals for memory problems, 187 new onset

  5. Project aims • ICD-10 coding of all new referrals to OPMHS • Record codes electronically • Retrieve reports periodically • Encourage research participation • Ripple effect across the trust • Contribute data to local dementia register

  6. Partners • CLAHRC • OPMHS • IPH • CPFT IT • CUHFT • DeNDRoN

  7. Process • For CPFT coding • IT • OPMHS colleagues • Admin staff • For dementia register • Neurology • DME • GPs • DH • DeNDRoN • 3rd sector • BRC • SLAM

  8. Multiple avatars • CLAHRC fellow • CLAHRC old age theme psychiatrist • Liaison older people’s psychiatrist • Memory clinic psychiatrist • OPMHS research with DeNDRoN • CPFT IT clinical safety officer • General nosey parker, jack of all trades, maverick, ‘dosser’

  9. Acts of God and natural disasters • Services stretched thin • 2 clinical sessions and 8 research sessions in September 2011 • 7 clinical sessions, 1 CLAHRC session and 1 IT session today

  10. However… • ICD Coding becomes norm in OPMHS • Ripple effect – liaison psychiatry and specialist TRD clinic start coding • Coding to be mandatory across trust • Dementia on the map, there to stay • DH working group endorses dementia register is priority project • SLAM IT partner with CPFT to use CRIS for research • Move for national dementia informatics project

  11. Results • 1341 new referrals • 7 teams • 100% coding • 645 dementia • 484 AD • 184 MCI • 114 delirium • 1 international multi-site trial of monoclonal amyloid antibody in prodromal AD • 1 non-commercial multi site national study in LOSLP • 1 RNIB study in visual deficits in dementia • 1 PhD project on end of life decisions in dementia

  12. We’re not perfect • Occurrence at home 12 • Occurrence at other place 1 • Hepatic failure, unspecified 1 • Circumscribed brain atrophy 2 • Anankastic personality disorder 2 • Personality disorder, unspecified 1 • Unspecified mood disorder 1 • Mental retardation with statement, minimal or no impairment 1 • Developmental disorder of scholastic skills, unspecified 1 • Adjustment disorder with predominant disturbance of other emotions 1 • Problems in relationship with spouse or partner 1

  13. The fellowship • Terrific experience • Thinking space and time • Excellent cohort • Great quality and variety of subjects and teachers • ALS sessions are amazing • Great organisationand catering • Special thanks to Christine, Lea, Angela and Diane • Far too short!

More Related