To capture the experiences of people with To capture the experiences of people with dementia in general hospital wards, for use in a dementia in general hospital wards, for use in a

national auditnational audit

The development of an The development of an observational method (Person, observational method (Person,

Interactions Interactions and Environment: PIE) and Environment: PIE)

Jill Hoyle and Rosie Woolley

BackgroundBackgroundPeople with dementia frequently do not receive

appropriate care in acute hospital wards:

o Counting the cost, Alzheimer's Society (2009)

o National Dementia Strategy, DH (2009)

o Improving Dementia Services in England - an Interim Report, National Audit Office (2010)

Overview of national audit•Focus on the care received by people with dementia admitted to general acute hospital wards (England and Wales)•Commissioned by the Healthcare Quality Improvement Partnership•Managed by the Royal College of Psychiatrists, in partnership with the above•Set of standards and tools developed•PIE is one aspect of the audit

National Audit of DementiaRoyal College of PsychiatristsCentre for Quality Improvement4th Floor Standon House21 Mansell StreetLondon E1 8AATel: 020 7977 4975Fax: 020 7481 4831www.rcpsych.ac.uk

Development of the Development of the ToolTool

• Current tools not suitable

• Literature search

• Older people

• Clinical staff

Stages of projectStages of project1. Development of draft observational

tool

2. Pre-pilot in one hospital

3. Refinement of the pilot tool and development of workshop materials

4. Further pilot studies in 15-30 hospital wards and refinement

5. National workshops

6. National audit

The aim of PIEThe aim of PIE• To describe elements of care

experienced by people with dementia as more, or less, person-centred

• To enable the ward team to reflect on their approach to working with people with dementia

• To help NHS Acute Trusts to understand and implement person-centred care

The PIE acronym The PIE acronym P – Person P – Person

• What do we know about the patient as a person that might help us to provide the best care possible?

• How can we use this information to provide a better experience for the person with dementia?

The PIE acronym The PIE acronym I – InteractionsI – Interactions

• Are there any interactions between staff and people with dementia?

• How is the person affected by the interaction? Are they likely to feel emotionally supported? Are they contributing to their care? Are they being listened to?

The PIE acronym The PIE acronym E – EnvironmentE – Environment

• What can the person see/ hear/ smell?

• Is it busy or quiet?• Is the person able to move freely

around their environment?• Are there are any environmental

or organisational factors affecting staff and patients?