Improving dementia and palliative care through the co-design of an integrated model of care.

Zoi Triandafilidis, Nicholas Goodwin, Karen Hutchinson, Sarah Yeun-Sim Jeong, Suzanne Lewis, Nicolette Hodyl, Georgie Quick, Jacinta Hensby, Andrew Montague
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Abstract

A need exists to improve end-of-life care for people with advanced dementia, by integrating available services. Stakeholders on the Central Coast of New South Wales united to co-design an improved model of care that would integrate care across care settings. The aim of this project was to co-design a model of integrated, person-centred palliative care for people with dementia at the end of life. This case study describes seven co-design workshops which took place in 2023 to develop a program logic model. Workshops were run in a hybrid format, with stakeholders attending in person and online. Workshops were attended by an average of 26 stakeholders including people and carers with lived experience of dementia, healthcare workers from hospital and community-based services (public and private), primary care clinicians, and participants from the not-for-profit sector and academia. Stakeholders developed a shared mission and purpose and identified priority areas for improving palliative care for people with advanced dementia. This led to the development of a program logic model, which included components relating to education for people with dementia, carers, and professionals, care coordination and referrals, and regular multidisciplinary case conferences. Feedback on the model from a new audience identified areas for improvement. The stakeholder group participated in a survey to evaluate the effectiveness of the co-design. The survey found that stakeholders were satisfied with the model of care the group developed. This project highlighted the value of adopting a co-design approach with stakeholders to develop a new model of care.

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通过共同设计综合护理模式,改善痴呆症和姑息治疗。
需要通过整合现有服务来改善晚期痴呆症患者的临终关怀。新南威尔士州中央海岸的利益相关者联合起来,共同设计了一种改进的护理模式,以整合不同护理机构的护理服务。该项目的目标是共同设计一种以人为本的综合姑息关怀模式,为临终痴呆症患者提供服务。本案例研究介绍了 2023 年为制定项目逻辑模型而举办的七次共同设计研讨会。研讨会以混合形式进行,利益相关者可亲自参加,也可在线参加。平均有 26 名利益相关者参加了研讨会,其中包括痴呆症患者和照护者、医院和社区服务机构(公立和私立)的医护人员、初级保健临床医生以及非营利部门和学术界的参与者。利益相关者制定了共同的使命和宗旨,并确定了改善晚期痴呆症患者姑息关怀的优先领域。由此制定了一个计划逻辑模型,其中包括对痴呆症患者、照护者和专业人士的教育、护理协调和转介,以及定期召开多学科病例会议等内容。新受众对该模式的反馈意见指出了需要改进的地方。利益相关者小组参与了一项调查,以评估共同设计的有效性。调查发现,利益相关者对小组开发的护理模式表示满意。该项目强调了采用与利益相关者共同设计的方法来开发新护理模式的价值。
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