| Summary: | This project provides the first comprehensive investigation into the
experiences of people with dementia (PWD), their carers, and the staff who
provide care in emergency departments (ED) in the UK. This is a mixed
methods study which used a national survey (N=403) followed by ED
observation (32 hours) and qualitative interviews with health professionals
(N=29), in an iterative and sequential design to present a holistic evaluation of
the current experiences of the key parties- patients, carers, and ED staff
involved in receiving and providing care. The theoretical perspective of the
Human Factors Approach to patient safety underpins this work. The project
included people with dementia and carers as collaborators and co-designers in
both the development of the research tools and in shaping the project outputs.
This research explores the barriers and facilitators to safe and effective care,
concluding that here are a number of barriers (poor integration of
communication systems, inappropriate physical environments, misalignment of
staff training and workplace staffing models), which may affect the healthcare
team’s ability to provide effective dementia care. These systemic challenges
both give rise to and exacerbate poor organisational and safety cultures.
However, despite these challenges, there are examples of safe and effective
care (positive deviants) where uncommonly good outcomes for this patient
population are achieved. Examining these examples offers valuable insight into
potential adaptions, which could be used to improve existing care.
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