Developing a long-term relationship with dementia care within the Royal Edinburgh Hospital through exploring ways in which patients, families, nursing staff and artists can work together as a team; learning from each other in order to make positive change within a ward.
Artlink has been working at the Royal Edinburgh Hospital over several years providing a range of participative arts opportunities and artists placements. The longer-term nature of our involvement allows relationships with patients and staff to evolve over time and creates opportunities to link in with specific NHSL led quality improvement initiatives.
In partnership with Charge Nurse Frank Charleston we identified Pentland Ward at the Royal Edinburgh Hospital, a long stay ward for men with early onset dementia, as the best possible place to take a longer term learning team approach. It was also the focus of a Quality Improvement initiative led by Frank and Frances Aitken, NHSL Practice Improvement and Development and therefore had the added benefit of understanding how arts activity can contribute to creating positive ward environments which contribute positively to staff development and tackles absenteeism and high staff turnover which has a negative effect on quality improvement efforts.
It was decided that the learning team should consist out of NHSL staff, relatives, Artlink producer and artists, and patients. Pentland Ward was selected to ensure a continuity of involvement for both patient and family members. Selecting a long stay ward allowed us to take time to establish strong working relationships and follow through work with the same people from beginning to end. From the outset, we identified that it would be important to bring in other collaborators/ organisations to increase both the reach and scope of the project, as well as provide the additional resources that our collaborators would bring.
Using interactive performance to gain a better understanding of patients’ needs and staff practice at Liberton Hospital in order to address immediate issues of low motivation, social isolation and boredom; ensuring relevance and greater impact of longer-term approaches.
We had been approached to provide input to Liberton in early 2018 as a date for a move of patients form Liberton to new wards at the Royal Edinburgh Hospital had been established and need for input identified by staff. For over a year the start date for the project was put off, as Liberton closure dates appeared imminent, only to be pushed back until a later date. During this time, we were also working as part of Specialist Dementia Unit Improvement Programme in partnership with Healthcare Improvement Scotland (report attached), funded by EVOC. We were interested in taking what we had learned from this work into other spaces facing similar issues.
Liberton specialises in medicine for elderly patients (a larger
percentage of whom have cognitive issues). In collaboration with with key staff
on the wards we decided in March 2019 that we should no longer hold off putting
anything on the wards, as the need for input was now seen as critical. Patients and staff had nothing on their wards
in regard to activity: ‘When we first
went in it felt terrible in there. A low mood. Tired people. Very empty and
isolating spaces as there were just the 4 wards working in the entire hospital
(and now just down to two!)’ – Miss Annabel Sings
Activity on wards had diminished over a period of years for patients and staff, in anticipation of closure, ‘we have not had regular activity over the last 8 to 10 years’ – staff nurse who has worked on ward over the last 19 years. A charge nurse identified: ‘There wasvery little happening, music in hospitals once a month. That’s it’. Little activity and the knowledge that the wards were supposedly closing imminently, had left staff feeling like they were in limbo. The impact on staff, patients and families was tangible. ‘I’m bank, its worse for the permanent staff. It’s a nice team and it’s worrying for them. When are all the patients going to go? They worry that they won’t be with same colleagues, that a good staff team will be split up’. – Bank staff nurse working on ward for last 5 years.