Engagement Matters: Supporting aged care frontline staff to engage meaningfully with people with dementia in a sustainable and effective way

Background and Aims

The Engagement Matters project was a knowledge translation project. It aimed to bridge the “Knowing to doing” gap in the care of residents living with dementia in Residential Aged Care Homes. The methods used to achieve this were to: co-design training and implementation strategies with frontline workers and leaders; test strategies co-designed, with a sample size of the workforce; and to evaluate effectiveness of strategies tested, to embed and sustain education approaches designed to facilitate best practice person-centred care, with residents in everyday practice. The project brought together three partners, ACH Group, Dementia Training Australia (DTA Queensland) and Flinders University.

The knowledge to be translated or applied in this project was contained in the DTA Changed Behaviours Toolkit, previously known as the Responsive Behaviours Toolkit, originally developed by DTA in 2020.

Key objectives of the testing of co-designed training and implementation strategies to enable knowledge translation included:

• developing a scalable and sustainable training model.
• Improve and or sustain high quality of care for residents.
• improve confidence of staff to deliver best practice dementia care.

What We Did

The project comprised of six key elements:

• Co-design of strategies with staff, management, and family representatives to inform the training approach.
• Co-design of sustainable and scalable strategies and tools to facilitate knowledge embedment and practice change.
• Implementation of DTA toolkit training to frontline staff and leaders using a co-designed ‘on floor’ training model.
• Testing of co-designed practice change strategies developed through the project, to assist in knowledge transfer and a sustainable approach.
• Evaluation of the feasibility, acceptability, and adherence to DTA toolkit training and implementation strategies co-designed with the workforce and senior management.
• Evaluation of the effectiveness of the training on residents Quality of Life, Quality of Care experience and staff self-efficacy in dementia care.

Outcomes

• DTA Toolkit training was rolled out by the site Clinical and Care Leaders to frontline staff using an ‘on-floor model’ with care worker cover to minimise disruptions when facilitators and frontline workers are engaged in training.
• Co-design and testing of a variety of tools, resources, and implementation strategies to facilitate knowledge transfer, develop a team approach to resident care and ensure sustainability of training.
• Positive impact on staff’s competence in delivering dementia care.
• Development of an Implementation Guide for Industry.

Impact on Aged Care and Workforce

• Opportunity to implement evidence informed, on-floor training model with protected staff coverage, using on floor leaders as facilitators.
• The need to allocate budget provisions to backfill staff, when conducting bite sized on-floor training, so that disruptions are minimised.
• Opportunities to develop an on-floor team approach to person-centred care engagement strategies and changed behaviour problem solving, through use of templates to promote ongoing coaching, mentoring and person-centred care principles.
• Understanding of organisation changes required, to implement a sustainable training model.

Resources developed

• An Implementation Guide was developed to equip Residential Age Care providers with the knowledge, structure, insights and tools to co-design and rollout similar dementia training to frontline staff. It provides examples of tools and organisation processes co-designed to assist with knowledge translation and sustainability.
• Tools developed included a Social Profile discussion template, 1:1 Coaching template, ABCDE framework coaching template (team discussion guide when devising or evaluating a Behaviour Support Plan) and posters for staff and families to educate and reinforce knowledge of changes in behaviour and need to report.
• These can be accessed via the Implementation Guide published on the ACH Group website.

Next Steps

• Results are being disseminated to ACH Group leaders to further inform the design and development of best practice frontline education to help to facilitate meaningful engagement and address changes in behaviour.
• Implementation guide placed on ACH Groups website for internal and industry reference.
• Project team plan to submit an abstract to the 2024 AAG conference to disseminate findings.
• The project team plan to develop two manuscripts to report the findings in peer reviewed journals to disseminate the findings to a wider community.