People with dementia admitted to hospital care are at greater risk of complications. Several studies have shown increased morbidity, mortality and functional decline during hospitalization in patients with dementia. With the aim of developing concepts for dementia-friendly hospital care in a Danish setting, we refined and tested a range of interventions within a two-year period.
Four study-sites at three hospitals were assigned to the intervention: a geriatric ward, a neurological ward and two acute wards. To improve patient safety and comfort during the hospital stay, the intervention focused on three aspects; a) education and training, b) organization of workflow and care pathways and c) environmental factors. We focused on initiatives possible to implement without or with only little additional costs. The evaluation included pre and post intervention questionnaires to staff and interviews with management, staff, patients and relatives. Pre and post intervention observations of organizational design and environmental factors were also performed. Observations and interviews prior to intervention were used to identify issues important to the intervention, whereas post intervention observations and interviews focused on the results achieved in the study period.
The interventions provided valuable knowledge regarding key aspects important for developing dementia-friendly hospitals. The questionnaires and the interviews revealed that dementia-friendly initiatives were considered needed and well accepted among management, staff and relatives. The interviews and observations indicated that the following factors are important in successful delivery of dementia-friendly initiatives: 1) a multifocal approach where a shared understanding of patients with dementia works as a base for staff to improve organizational design and environmental factors, 2) a multidisciplinary approach including management on all levels and staff, 3) a shared focus on collaboration across wards in patient pathways from admission to discharge.