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Published in: BMC Psychiatry 1/2020

Open Access 01-12-2020 | Dementia | Research article

Developing a model of best practice for teams managing crisis in people with dementia: a consensus approach

Authors: Jennifer Yates, Miriam Stanyon, David Challis, Donna Maria Coleston-Shields, Tom Dening, Juanita Hoe, Kaanthan Jawahar, Brynmor Lloyd-Evans, Esme Moniz-Cook, Fiona Poland, Amy Streater, Emma Trigg, Martin Orrell

Published in: BMC Psychiatry | Issue 1/2020

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Abstract

Background

Teams delivering crisis resolution services for people with dementia and their carers provide short-term interventions to prevent admission to acute care settings. There is great variation in these services across the UK. This article reports on a consensus process undertaken to devise a Best Practice Model and evaluation Tool for use with teams managing crisis in dementia.

Methods

The Best Practice Model and Tool were developed over a three stage process: (i) Evidence gathering and generation of candidate standards (systematic review and scoping survey, interviews and focus groups); (ii) Prioritisation and selection of standards (consultation groups, a consensus conference and modified Delphi process); (iii) Refining and operationalising standards (consultation group and field-testing).

Results

One hundred sixty-five candidate standards arose from the evidence gathering stage; were refined and reduced to 90 through a consultation group exercise; and then reduced to 50 during the consensus conference and weighted using a modified Delphi process. Standards were then operationalised through a clinical consultation group and field-tested with 11 crisis teams and 5 non-crisis teams. Scores ranged from 48 to 92/100. The median score for the crisis teams was 74.5 (range 67–92), and the median score for non-crisis teams was 60 (range 48–72).

Conclusions

With further psychometric testing, this Best Practice Model and Tool will be ideal for the planning, improvement and national benchmarking of teams managing dementia crises in the future.
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Literature
1.
go back to reference Department of Health. Living well with dementia: A National Dementia Strategy. UK Government; 2009. Department of Health. Living well with dementia: A National Dementia Strategy. UK Government; 2009.
2.
go back to reference Andersen CK, Wittrup-Jensen KU, Lolk A, Andersen K, Kragh-Sorensen P. Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia. BMC Health Quality Life Outcomes. 2004;2:52.CrossRef Andersen CK, Wittrup-Jensen KU, Lolk A, Andersen K, Kragh-Sorensen P. Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia. BMC Health Quality Life Outcomes. 2004;2:52.CrossRef
3.
go back to reference Bynum JPW, Rabins PV, Weller W, Niefeld M, Anderson GF, Wu AW. The relationship between a dementia diagnosis, chronic illness, Medicare expenditures, and hospital use. J Am Geriatr Soc. 2004;52:187–94.CrossRef Bynum JPW, Rabins PV, Weller W, Niefeld M, Anderson GF, Wu AW. The relationship between a dementia diagnosis, chronic illness, Medicare expenditures, and hospital use. J Am Geriatr Soc. 2004;52:187–94.CrossRef
4.
go back to reference Graff MJL, Adang EMM, Vernooij-Dassen MJM, Dekker J, Jonsson L, Thijssen M, et al. Community occupational therapy for older patients with dementia and their care givers: cost effectiveness study. BMJ. 2008;336:134.CrossRef Graff MJL, Adang EMM, Vernooij-Dassen MJM, Dekker J, Jonsson L, Thijssen M, et al. Community occupational therapy for older patients with dementia and their care givers: cost effectiveness study. BMJ. 2008;336:134.CrossRef
5.
go back to reference Streater A, Coleston-Shields DM, Yates J, Stanyon M, Orrell M. A scoping review of crisis teams managing dementia in older people. Clin Interv Aging. 2017;12:1589–603.CrossRef Streater A, Coleston-Shields DM, Yates J, Stanyon M, Orrell M. A scoping review of crisis teams managing dementia in older people. Clin Interv Aging. 2017;12:1589–603.CrossRef
6.
go back to reference Toot S, Devine M, Orrell M. The effectiveness of crisis resolution/home treatment teams for older people with mental health problems: a systematic review and scoping exercise. Int J Geriatric Psychiatry. 2011;26(12):1221–30.CrossRef Toot S, Devine M, Orrell M. The effectiveness of crisis resolution/home treatment teams for older people with mental health problems: a systematic review and scoping exercise. Int J Geriatric Psychiatry. 2011;26(12):1221–30.CrossRef
7.
go back to reference Joint Commissioning Panel for Mental Health. Guidance for commissioners of older people's mental health services. 2013. Joint Commissioning Panel for Mental Health. Guidance for commissioners of older people's mental health services. 2013.
8.
go back to reference Joint Commissioning Panel for Mental Health. Guidance for commissioners of acute care - inpatient and crisis home treatment. 2013. Joint Commissioning Panel for Mental Health. Guidance for commissioners of acute care - inpatient and crisis home treatment. 2013.
9.
go back to reference Royal College of Psychiatrists. Memory services National Accreditation Programme (MSNAP): standards for memory services. London: Royal College of Psychiatrists; 2018. Royal College of Psychiatrists. Memory services National Accreditation Programme (MSNAP): standards for memory services. London: Royal College of Psychiatrists; 2018.
11.
go back to reference Department of Health. Prime Minister's Challenge on Dementia 2020. UK: Health Do; 2015. Department of Health. Prime Minister's Challenge on Dementia 2020. UK: Health Do; 2015.
12.
go back to reference Appleby J, Raleigh V, Frosini F, Bevan G, Gao H, Lyscom T. Variations in health care. The good, the bad and the inexplicable. London: The King's Fund; 2011. Appleby J, Raleigh V, Frosini F, Bevan G, Gao H, Lyscom T. Variations in health care. The good, the bad and the inexplicable. London: The King's Fund; 2011.
13.
go back to reference Furness D, Gough B. Local control and local variation in the NHS. London: The Social Market Foundation; 2009. Furness D, Gough B. Local control and local variation in the NHS. London: The Social Market Foundation; 2009.
14.
go back to reference Lloyd-Evans B, Bond GR, Ruud T, Ivanecka A, Gray R, Osborn D, et al. Development of a measure of model fidelity for mental health crisis resolution teams. BMC Psychiatry. 2016;16(1):427.CrossRef Lloyd-Evans B, Bond GR, Ruud T, Ivanecka A, Gray R, Osborn D, et al. Development of a measure of model fidelity for mental health crisis resolution teams. BMC Psychiatry. 2016;16(1):427.CrossRef
15.
go back to reference Stanyon M, Streater A, Coleston-Shields D, Yates J, Challis D, Dening T, et al. Protocol for the development of an evidence-based ‘best practice Model’for teams managing crisis in dementia. JMIR Research Protocols 2019. Stanyon M, Streater A, Coleston-Shields D, Yates J, Challis D, Dening T, et al. Protocol for the development of an evidence-based ‘best practice Model’for teams managing crisis in dementia. JMIR Research Protocols 2019.
16.
go back to reference Waggoner J, Carline JD, Durning SJ. Is there a consensus on consensus methodology? Descriptions and recommendations for future consensus research. Acad Med. 2016;91(5):663–8.CrossRef Waggoner J, Carline JD, Durning SJ. Is there a consensus on consensus methodology? Descriptions and recommendations for future consensus research. Acad Med. 2016;91(5):663–8.CrossRef
17.
go back to reference Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by information power. Qual Health Res. 2016;26(13):1753–60.CrossRef Malterud K, Siersma VD, Guassora AD. Sample size in qualitative interview studies: guided by information power. Qual Health Res. 2016;26(13):1753–60.CrossRef
18.
go back to reference Karlsson B, Borg M, Eklund M, Kim HS. Profiles of and practices in crisis resolution and home treatment teams in Norway: a longitudinal survey study. Int J Mental Health Syst. 2011;19:5. Karlsson B, Borg M, Eklund M, Kim HS. Profiles of and practices in crisis resolution and home treatment teams in Norway: a longitudinal survey study. Int J Mental Health Syst. 2011;19:5.
19.
go back to reference Savy P, Warburton J, Hodgkin S. Challenges to the provision of community aged care services across rural Australia: perceptions of service managers. Rural Remote Health. 2017;17:1. Savy P, Warburton J, Hodgkin S. Challenges to the provision of community aged care services across rural Australia: perceptions of service managers. Rural Remote Health. 2017;17:1.
20.
go back to reference McHugo GJ, Drake RE, Whitley R, Bond GR, Campbell K, Rapp CA, et al. Fidelity outcomes in the national implementing evidence-based practices project. Psychiatr Serv. 2007;58(10):1279–84.CrossRef McHugo GJ, Drake RE, Whitley R, Bond GR, Campbell K, Rapp CA, et al. Fidelity outcomes in the national implementing evidence-based practices project. Psychiatr Serv. 2007;58(10):1279–84.CrossRef
21.
go back to reference Lamb D, Lloyd-Evans B, Fullarton K, Kelly K, Goater N, Mason O, et al. Crisis resolution and home treatment in the UK: A survey of model fidelity using a novel review methodology. Int J Mental Health Nurs. 29(2):187-201. Lamb D, Lloyd-Evans B, Fullarton K, Kelly K, Goater N, Mason O, et al. Crisis resolution and home treatment in the UK: A survey of model fidelity using a novel review methodology. Int J Mental Health Nurs. 29(2):187-201.
23.
go back to reference Hubbeling D, Bertram R. Cisis resolution teams in the UKand elsewhere. J Ment Health. 2012;21(3):285–95.CrossRef Hubbeling D, Bertram R. Cisis resolution teams in the UKand elsewhere. J Ment Health. 2012;21(3):285–95.CrossRef
24.
go back to reference Cupina DD, Wand AP, Phelan E, Atkin R. St George acute care team: the local variant of crisis resolution model of care. Australasian Psychiatry. 2016;24(5):449–52.CrossRef Cupina DD, Wand AP, Phelan E, Atkin R. St George acute care team: the local variant of crisis resolution model of care. Australasian Psychiatry. 2016;24(5):449–52.CrossRef
25.
go back to reference Cervello S, Pulcini M, Massoubre C, Trombert-Paviot B, Fakra E. Do home-based psychiatric Services for Patients in medico-social institutions reduce hospitalizations? Pre-post evaluation of a French psychiatric Mobile team. Psychiatry Q. 2018;90(1):89–100.CrossRef Cervello S, Pulcini M, Massoubre C, Trombert-Paviot B, Fakra E. Do home-based psychiatric Services for Patients in medico-social institutions reduce hospitalizations? Pre-post evaluation of a French psychiatric Mobile team. Psychiatry Q. 2018;90(1):89–100.CrossRef
26.
go back to reference Corcoles D, Malagon A, Martin LM, Bulbena A, Perez V. Home treatment in preventing hospital admission for moderate and severe mentally ill people. Psychiatry Res. 2015;230(2):709–11.CrossRef Corcoles D, Malagon A, Martin LM, Bulbena A, Perez V. Home treatment in preventing hospital admission for moderate and severe mentally ill people. Psychiatry Res. 2015;230(2):709–11.CrossRef
27.
go back to reference Alzheimer Europe. Social Support Systems. 2009 8th October 2009. Alzheimer Europe. Social Support Systems. 2009 8th October 2009.
28.
go back to reference Titheradge D, Galea A. Continuity of care in a crisis resolution home treatment team. Progress Neurol Psychiatry. 2019;23(1):23–7.CrossRef Titheradge D, Galea A. Continuity of care in a crisis resolution home treatment team. Progress Neurol Psychiatry. 2019;23(1):23–7.CrossRef
Metadata
Title
Developing a model of best practice for teams managing crisis in people with dementia: a consensus approach
Authors
Jennifer Yates
Miriam Stanyon
David Challis
Donna Maria Coleston-Shields
Tom Dening
Juanita Hoe
Kaanthan Jawahar
Brynmor Lloyd-Evans
Esme Moniz-Cook
Fiona Poland
Amy Streater
Emma Trigg
Martin Orrell
Publication date
01-12-2020
Publisher
BioMed Central
Keywords
Dementia
Dementia
Published in
BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-020-02899-0

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