Dementia training in hospitals
and neighbourhoods:
What leads to success?
Developing the Evidence Base for Evaluating Dementia Training in NHS Hospitals (the DEMTRAIN study). This work forms part of the ESRC/NIHR Neighbourhoods and Dementia mixed methods study.
Click the icons below to reveal key factors to successful dementia training in hospitals.
- Identify Need
- Develop or Adapt & Deliver
- Outcomes - Patients & Staff
Dementia Training &
Learning
- Leadership
- Resources
- Involvement of people living with dementia & carers
- Expertise and skills
- Recognition of dementia
- Existing practice & environment
- Evaluation
- Policies
- Motivation
- Experiential learning
- Neighbourhood
Lancaster University 2020
V1 Resource review date January 2023
Leadership
Supportive and responsive leaders who are dementia advocates
Individual factors
- Leadership (dementia-related from ‘Board to Ward’, including clinical leadership)
- Planning for availability of trainers and / or staff for training development / adaptation of training packages
Organisational factors
- Leadership (dementia-related from ‘Board to Ward’, including clinical leadership)
- Planning for availability of trainers and / or staff for training development / adaptation of training packages
Wider context, including policy and health system factors
- Leadership (dementia-related from ‘Board to Ward’, including clinical leadership)
- Planning for availability of trainers and / or staff for training development / adaptation of training packages
Resources
Time and/or resources (incl. equipment and access to external trainers)
Individual factors
- Competing and changing priorities, including organisational restructure
- Access to and uptake of training and staff turnover
- Workload and/or competing priorities (for staff who attend dementia training and managers releasing staff for training)
- Charges or cost for staff who attend dementia training
Organisational factors
- Competing and changing national policies and priorities, including organisational restructuring
- Financial support/resources for development / adaption and delivery of training
- Time and/or resources (including equipment and access to external trainers) to develop and deliver training package/content and learning opportunities
- Availability of trainers and/or staff for adaptation/delivery
- Availability of appropriate or adaptable dementia training packages (including external packages) and guidelines
- Availability of standardised dementia training packages, without complicated content structures (including content and assessment guidelines)
- Logistics and infrastructure (e.g. rooms, IT equipment, printing materials, etc.)
- Uptake of training and staff turnover
- Availability of suitably qualified staff (to include contracted workers, agency staff, etc.)
- Workload and/or competing priorities (for trainees and managers releasing staff for training)
Wider context, including policy and health system factors
- Dedicated dementia specialist teams with lead / service provision/training remit
- Competing and changing national policies and priorities
- Financial support/resources for development / adaption and delivery of training
- Availability of appropriate or adaptable dementia training packages (including external packages) and guidelines
- Availability of standardised dementia training packages, without complicated content structures (including content and assessment guidelines)
- Availability of suitably qualified staff (to include contracted workers, agency staff, etc.)
- Policies (including workforce plans) that are considerate of the challenges in the settings, and dementia training package development/adaptation and delivery
Involving people living with dementia & carers
Bringing stories and narratives of people living with dementia to training and learning
Individual factors
- Involvement of local dementia organisations / groups, people living with dementia and carers in the development / adaptation of training
- Involvement of local dementia organisations / groups, people living with dementia and carers in the delivery of training
- Involvement of local dementia organisations / groups, people living with dementia and carers in the evaluation of training
Organisational factors
- Involvement of local dementia organisations, people living with dementia and carers in dementia care planning that identifies and prioritises staff training needs
Wider context, including policy and health system factors
- Public & social advocacy (involving and empowering people living with dementia and carers)
- Involvement of dementia organisations, people living with dementia and carers embedded in priority setting, development of training
- Involvement of local dementia organisations, people living with dementia and carers in the delivery of training
- Involvement of local dementia organisations / groups, people living with dementia and carers in the evaluation of training
Expertise and skills
Staff expertise, capacity and experience
Individual factors
- Staff expertise / skills & capacity
- Staff experience, including delivery of care for people living with dementia and through close/extended family or neighbourhood experience of dementia
- Confident and motivated staff (e.g., trainers, dementia leads / champions, and other staff responsible for training development)
- Staff sharing expertise and experience informally through delivery of dementia care
Organisational factors
- Confident and motivated staff (e.g., trainers, dementia leads, and other staff responsible for training development)
- Dementia training included as a component for senior, clinical dementia specialist roles
Wider context, including policy and health system factors
- Dementia care and services monitoring (e.g. National Audit of Dementia, Dementia Commissioning for Quality and Innovation Framework (Dementia CQUIN)
- Health service training frameworks and policies (e.g. Dementia Training Standards Framework)
- Wider educational policies (including workforce plans) that are considerate of the challenges in the settings, and key factors in dementia training package development / adaptation and delivery
Dementia training, education and learning
Individual factors
- Participation in the organisational culture (including recognition by leaders and managers with regards to the value of dementia training)
- Leaders and managers recognise the value of dementia training and learning for all staff groups and levels in all adult care environments
Organisational factors
- Leaders and managers recognise the value of dementia training and learning for all staff groups and levels in adult care environments
- Organisational culture (including recognition by leaders and managers with regards to the value of dementia training)
- Recognising the diverse and rich mix of training opportunities in hospital settings (e.g. from formal, mandatory training modules to hospital memory cafes and sensory gardens) and enabling staff to engage in a variety of education and learning options
Wider context, including policy and health system factors
- Dementia embedded in policy and education development to promote the value to society of wide-spread dementia awareness for improved dementia care (from dementia awareness for public education, patient and carer involvement in training, to dementia training for all hospital staff)
Existing practice & environment
Organisational culture and environment
Individual factors
- Confident and motivated staff (e.g., trainers, dementia leads, and other staff responsible for training development)
- Experiences and satisfaction (involving people living with dementia and carers)
- Affiliation of trainers
Organisational factors
- Affiliation of trainers
- Dementia dedicated wards, enhanced environments and initiatives (e.g. communal eating, memory cafes, walking clubs)
Wider context, including policy and health system factors
- Aligning policies and plans to encourage an environment where staff are motivated and have the necessary experiences and skills
- Utilising existing pools of resources in the wider neighbourhood (including volunteers and local care and advocacy organisations)
Evaluating dementia training & learning
Importance of evaluating dementia training and learning including from the perspective of people living with dementia & carers
Individual factors
- Staff evaluation of training undertaken (e.g. immediate post-training; reflection on practice; identification of further training needs)
Organisational factors
- Recording and monitoring of training / reinforcement numbers, including policy training reinforcement
- Review of training packages, evaluation and staff experience of training and learning opportunities
Wider context, including policy and health system factors
- Recording and monitoring systems for training / reinforcement numbers, including policy training reinforcement
- Funding streams for evaluation, accreditation and research
- Policies and guidelines that include the evaluation and monitoring of training impact/outcomes and of training packages/ learning opportunities
- Policies and guidelines that encourage broad and inclusive perspectives of learning opportunities e.g. staff attending hospital memory cafes, shadowing experienced ward staff, inclusive of all hospital staff groups including bank and agency staff
Policies and strategic planning
Incorporating and addressing dementia in relevant organisational and national policies and strategies
Individual factors
- Issues concerning whether training is mandatory or optional, certified or uncertified, and accredited or non-accredited
- Whether training (especially dementia training) is included or not, in staff’s and trainees' work time
- Uptake of training and staff turnover
- Policies and guidelines that encourage broad and inclusive perspectives of learning opportunities e.g. staff attending hospital memory cafes, shadowing experienced ward staff, inclusive of all hospital staff groups including bank and agency staff
- Policies and guidelines that include the evaluation and monitoring of training impact/outcomes and of training packages/ learning opportunities.
Organisational factors
- Support from organisational/ national policy
e.g. Utilise the Department of Health commissioned and funded Dementia Training Standards Framework which details essential dementia care related skills and knowledge, Managing Success in Dementia Care for senior leaders and managers, and the National Audit of Dementia care standards - Organisational plans and strategies have dementia incorporated in reports, guidance and frameworks
- Issues concerning whether training is mandatory or optional, certified or uncertified, and accredited or non-accredited
- Whether training (especially dementia training) is included or not, in staff’s and trainees' work time
- Uptake of training and staff turnover
Wider context, including policy and health system factors
- Related policy areas have dementia incorporated in reports, guidance and frameworks
- Issues concerning whether training is mandatory or optional, certified or uncertified, and accredited or non-accredited
- Policies (including workforce plans) that consider the challenges of implementation of dementia training packages in hospitals and neighbourhoods as a whole.
- Policies (including workforce plans) that consider the challenges in the development, adaptation and delivery of dementia training packages
Motivating and encouraging staff or trainees
Confident and motivated staff - incentives, rewards or targets (e.g. CQUIN, Trust targets, etc.), not charging or having unnecessary costs on individual staff and trainees
Individual factors
- Motivated staff who identify training needs and / or develop / adapt training
- Confident and motivated staff (e.g., trainers, dementia leads, and other staff responsible for training development)
- Reward or recognition for completing training (e.g. Academic credits, CPD certificates, designated dementia roles)
- Trainees/staff able to influence change (or perception of) in their practice environment
- Charges or cost for staff (trainees) to register or attend dementia training
Organisational factors
- Dementia-related incentives, rewards or target (e.g. CQUIN, Trust targets, etc.)
- Confident and motivated staff (e.g., trainers, dementia leads, and other staff responsible for training development)
- Reward or recognition for completing training (e.g. Academic credits, CPD certificates, designated dementia roles)
Wider context, including policy and health system factors
- Dementia-related incentives, rewards or target (e.g. CQUIN, Trust targets, etc.)
- Reviewing dementia services regularly and systematically, and responding to recommendations (e.g. National Audit of Dementia)
Experiential learning
Learning about dementia on the job/ward (in situ learning)
Individual factors
- Experiences and satisfaction (involving people living with dementia and carers)
- Training identified for specific practice or dementia-specific roles
- Linking or connected with trainees’ existing job/role
- Use of visual mediums, stories and narratives
- Flexible / multiple and broad approaches to training available to staff (trainees) e.g. staff attendance at hospital dementia cafes
- Accessible and comprehensive training materials/content (including opportunities to follow up further if needed)
- Use of existing evidence or theoretical models (e.g. behavioural-orientated approaches, communication approaches, person-centred approaches, emotion-orientated approaches, etc.)
Organisational factors
- Training identified for specific practice or dementia-specific roles
- Flexible/multiple and broad approaches to training available to staff (trainees) e.g. staff attendance at hospital dementia cafes
- Accessible and comprehensive training materials / content (including opportunities to follow up further if needed)
Wider context, including policy and health system factors
- Training identified for specific practice or dementia-specific roles
- Use of existing evidence or theoretical models (e.g. behavioural-orientated approaches, communication approaches, person-centred approaches, emotion-orientated approaches, etc.)
- Involvement of dementia organisations / people living with dementia and carers
Neighbourhoods
Achieving integration & interaction within the communities and neighbourhoods that the hospital relates to
Individual factors
- Perceptions of hospital as part of the wider community– located in and connected to the local neighbourhood
- Volunteering – neighbourhood resources coming into hospitals (e.g. multiple agency presence for Dementia Awareness Week) and training delivery (e.g. third sector organisations, local dementia organisations / groups, Admiral Nurses)
- Joint training events with hospital and health and social care community based staff
Organisational factors
- Perceptions of hospital as part of the wider community– located in and connected to neighbourhoods
- Joint training opportunities with community, primary and social care services. Achieving integration – extending hospital services into the community and understanding how social aspects of care influence admission to hospital
- Fostering connections with dementia organisations and groups – seeking out rather than waiting for connections and involvement (e.g. in delivery of training)
- Volunteering – neighbourhood resources coming into hospitals (e.g. multiple agency presence for Dementia Awareness Week) and training delivery (e.g. third sector organisations, local dementia groups, Admiral Nurses)
Wider context, including policy and health system factors
- Joint training opportunities with community, primary and social care services
- Achieving integration – extending hospital services into the community and understanding how social aspects of care influence admission to hospital and discharge back home
- Actively pursuing a social responsibility agenda