Enhancing the Healing Environment with the King’s Fund and Department of Health

Based on a presentation
by Matron Karen Bowley,
from the Physical Illness and Dementia Ward,

New Cross Hospital Dementia Project.

Introduction

The King’s Fund work on dementia involves enhancing the healing environment. The “Enhancing the Healing Environment” (EHE) programme was launched in 2000 to enable local trust teams to improve the environment in which care is delivered.

The EHE programme encourages nurse-led teams to work in partnership with patients to improve the built environment and the caring environment generally. Matron Karen Bowley from the New Cross Hospital Dementia Project explained in a recent presentation how Royal Wolverhampton Hospitals Trust (RWHT) has been working closely with the King’s Fund to improve the patient journey for people who suffer with dementia.

The Rationale

People with dementia tend to find the hospital environment intimidating alien and confusing. This can result in confusion and agitation. Complications and difficulties arising from this problem in turn often impact on length of stay and the physical and psychological health and well-being of patients.

Enhancements

Improvements to the healing environment which are intended to mitigate against the above problems include the provision of a garden adjacent to the new Physical Illness and Dementia Ward (D22). Colour contrast schemes have been adopted to prevent avoidable accidents and confusion. Colour, light and art work has been employed imaginatively to create a more tranquil, welcoming atmosphere for patients,  thereby reducing stress, increasing safety and preventing unnecessary patient deterioration.

Consultation

Consultations have been undertaken with various bodies including care homes. The formation of a Dementia Reference Group has been agreed.

The New Cross Hospital Dementia Project is currently transforming the Emergency Assessment Unit. The reception area will be relocated to the entrance of the Unit, where there will be a small seating area, and the bays will have a small nurse’s station which faces into the bays. These transformations should be completed by early July 2011.

“Funding has been agreed and because of the project work undertaken in association with King’s Fund, the Trust had received £50,000 from the Department of Health. The Trust committed £15,000 from capital at the beginning of the project. The remainder of the funding had been realised through sponsorship and fund-raising initiatives. The overall total initial costs are £73,250 which includes a contingency of £5,000″.

Background

In 2009 the Department of Health funded a new programme to improve the care environment for people with dementia and to support implementation of the first National Dementia Strategy.

Previous EHE projects in dementia care had already shown how accidents and challenging  behaviour could be reduced by the re-design / refurbishment of the built environment. Dementia care mapping before and after EHE projects tends to confirm the validity of this approach, demonstrating higher levels of patients’ well-being following such initiatives.

Ten Previous Dementia-Related Projects

Ten projects were chosen to reflect the different stages of the care pathway, i.e. from diagnosis to end of life care. These initial projects were intended to be good examples of how practical improvements in the hospital environment enhance the experience of patients and their carers.

The following ten NHS trusts were the early participants:

  1. Cheshire and Wirral Partnership NHS Foundation Trust.
  2. Cornwall Partnership NHS Trust.
  3. Cumbria Partnership NHS Foundation Trust.
  4. Derbyshire County Primary Care Trust.
  5. Dorset HealthCare NHS Foundation Trust.
  6. Humber Mental Health Teaching NHS Trust.
  7. Leicestershire Partnership NHS Trust.
  8. Lincolnshire Partnership NHS Foundation Trust.
  9. Mersey Care NHS Trust.
  10. NHS North Yorkshire and York Community and Mental Health Services.

Phil Hope MP said at the launch of these projects:

“These projects are another part of our efforts to support people with dementia and their families. We know that improving environments in hospitals has a whole range of benefits, including reductions in trips and falls, reductions in aggressive incidents and improvements in the experience that people and their families have while in hospital”.

Work in 2010/2011

A further 12 projects were started in 2010, including the one discussed here at Royal Wolverhampton Hospitals Trust. Work on the ward so far includes:

  • The toilet door can be seen easily anywhere on the ward, with a bright and easily visible sign.
  • Other doors not needed by patients, such as those for cleaning cupboards, blend in with the walls.
  • Everything around each bed is within easy reach and the bells can be seen easily.
  • Patients who are well enough to sit with others have a communal table.
  • There is the garden, a reminiscence area and space for relatives to stay should they wish

Read more about the King’s Fund EHE programme by clicking here: Enhancing the Healing Environment: The King’s Fund.

References

  1. Minutes of the Meeting of the Board of Directors Held on Monday 17th January, 2011 at 10.00 a.m. in the Board Room of the Clinical Skills and Corporate Services Centre, New Cross Hospital. Wolverhampton: The Royal Wolverhampton Hospitals NHS Trust, 2011.
  2. The King’s Fund / Templeman, P. (2009). Enhancing the healing environment: a guide to NHS Trusts. London: The King’s Fund, 2009.
  3. The King’s Fund / Templeman, P. (2010). Enhancing the healing environment: a guide to NHS Trusts. London: The King’s Fund, 2010.
  4. Department of Health (2009). Improving the patient experience: sharing success in mental health and learning disabilities: The King’s Fund Enhancing the Healing Environment programme 2004-2008. London: Department of Health, 2009.
  5. National dementia strategy: living well with dementia. Leeds: Department of Health, 2009.
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