Although symptoms can vary widely, the first problem many people notice is forgetfulness severe enough to affect their ability to function at home or at work or to enjoy lifelong hobbies.

1. Statewide Dementia
Clinical Network
“Access to Quality Dementia
Care”
Forum
01 February 2013

2.
Table of Contents
About the forum ..................................................................................................................................... 3
Welcome and Introduction..................................................................................................................... 3
Update from the SDCN Co‐Chairs ........................................................................................................... 3
What do the Hospital and Health Services need from us? ..................................................................... 4
Quality Indicators.................................................................................................................................... 4
Queensland Aged Care Policy Update .................................................................................................... 5
Commonwealth Update: Living Longer, Living Better ............................................................................ 5
Workgroup Sessions................................................................................................................................ 5
Qld Health Dementia Framework Revision................................................................................ 5
Younger Onset Dementia........................................................................................................... 6
Telegeriatrics and Dementia...................................................................................................... 6
Nutrition and Dementia............................................................................................................. 6
The Soapbox............................................................................................................................................ 7
Summary and Future Directions ............................................................................................................. 7
Appendix 1 Feedback .......................................................................................................................... 8
Appendix 2 Program..........................................................................................................................10
SDCN Forum Report_Feb 2013.DRAFT
Page 2 of 11

3.
About the forum
In something of a break with tradition, the Statewide Dementia Clinical Network (SDCN) forum was,
for the first time, held at the Clinical Skills Development Service (CSDS), Royal Brisbane and Women’s
Hospital Campus. The primary driver for this change was the Qld Health Travel restrictions,
necessitating the utilization of videoconference for those outside the South East corner. A number of
benefits resulted, including a reduction in both costs and time (traveling, away from family, etc.) not
to mention the general embracing of today’s technology. The indefatigable CSDS technical support
staff ensured that minor glitches were quickly overcome, and that the multiple videoconference
sessions went encouragingly smoothly.
Welcome and Introduction
Dr Michael Cleary, Deputy Director‐General, Health Service and Clinical Innovation Division
Dr Cleary provided attendees with an update on the restructuring of Qld Health (including that the
coordination of the Queensland Clinical Senate (QCS) and the Statewide Clinical Networks (SCNs)
now sits within the Clinical Access & Redesign Unit, creating a clinician engagement link enabling
better integration and collaboration), the achievements of the SDCN, the concept of the QCS and the
SCNs sitting between and linking the Department of Health and the 17 HSSs, along with some of the
new programs under consideration to enhance service delivery in the new health system.
Update from the SDCN Co‐Chairs
A/Prof Eddy Strivens, Co‐Clinical Chair, Statewide Dementia Clinical Network
A/Prof Strivens gave a summary of the recognition of Dementia in 2012/13, with Dementia being
recognised as the 9th National Health Priority, and Alzheimer’s Australia’s ambassador, Ita Buttrose,
being named Australian of the Year. He went on to give some sobering statistics about the expected
growth in numbers of people with dementia.
A/Prof Strivens provided an update on events since the last forum, including the restructure of Qld
Health and what this means for SCNs, the SDCN’s progress against the key priority areas of the
operational plan, development of new workgroups (along with the activities of the current groups),
and the renewal of the steering committee.
A/Prof Paul Varghese, Chair of the Statewide Older Persons Clinical Network, was called to the
lectern to present the work of the nearly completed Confused Older Person in the ED (COPED)
Clinical Guide Working Group. This group is a collaboration between the Older Persons, Emergency
Department and Dementia SCNs, chaired by A/Prof Varghese.
SDCN Forum Report_Feb 2013.DRAFT
Page 3 of 11

4.
What do the Hospital and Health Services need from us?
Prof Keith McNeil, Chief Executive, Metro North Hospital & Health Service
The audience was intrigued by Prof McNeil’s opening slides of the Eagle Nebula, entanglement
theory and chaos theory. The message soon became clear, drawing parallels between the complexity
and chaos of Quantum Physics and Healthcare, suggesting that even though we don’t understand
how things work, they do. Prof McNeil went on to discuss resources versus demand, and the need to
make healthcare affordable. He also noted that Healthcare is a unique industry in that the experts
are at the coalface.
Prof McNeil highlighted the features of self‐organising systems, of which healthcare is one:
encourage innovation, engagement and leadership at all levels. 21st Century Healthcare, according to
Prof McNeil, should focus on effectiveness, productivity and outcomes, and most of all, clinicians
need to drive change, and to refuse to take ‘no’ for an answer when they know they have come up
with a good idea.
Quality Indicators
Prof Len Gray, Director, Centre for Research in Geriatric Medicine (CRGM), University of Queensland
Prof Gray opened with some data around the prevalence and impact of dementia in the acute arena,
leading on to the need for quality improvement programs, which in turn must be measured by
quality indicators. The Research Collaboration for Quality Care of Older Persons is developing suites
of indicators for acute care, transition care, emergency department and telehealth. These indicators
can be broken into three types: structure, process and outcome. The indicators can be used to
compare performance over time, between wards, among peers, and to identify poor performers.
Prof Gray discussed the methods used to develop Dementia specific quality indicators, outlining a
number of indicators to demonstrate the process. The following indicators have both been
recommended:

DELIRIUM: UQFCOG101: The proportion of older persons (+70 years) in an acute care
general medical ward with delirium indicating behaviours present at discharge.

COGNITIVE HEALTH: UQFCOG103: The proportion of older persons (+70 years) in an acute
care general medical ward discharged with worse levels of cognitive function compared with
premorbid levels.
More information on the Quality Indictors can be found at http://www.som.uq.edu.au/research/research‐
centres/centre‐for‐research‐in‐geriatric‐medicine/about‐us/quality‐care‐of‐older‐persons.aspx or through Dr Melinda
Martin‐Khan via email: m.martinkhan@uq.edu.au .
SDCN Forum Report_Feb 2013.DRAFT
Page 4 of 11

5. Queensland Aged Care Policy Update
Joanna Gurd, Manager, Policy and Planning Branch
Joanna explained to the audience the new lay of the land, the corporate structures, along with the
members and priority areas of the Strategic Policy Priority Unit. Joanna went on to outline the aged
care policy responsibilities, including providing policy advice in relation to aged care and consulting
around the implementation of the Commonwealth’s aged care reforms. The opportunities for
collaboration on the review of the Qld Health Dementia Framework were discussed, as was the
revised National Framework for Action on Dementia 2013 – 2017, which is due for release mid‐2013.
Commonwealth Update: Living Longer, Living Better
Mark Gaukroger, Director, Dementia Policy Unit, Ageing and Workforce Programs Branch,
Department of Health and Ageing
Mark opened up by discussing the funding that has been assigned to the Living Longer, Living Better
aged care reform package, along with other programs such as the Encouraging Better Practice in
Aged Care initiative, and the Dementia Care Essentials Program. Mark discussed some of the other
current Dementia groups around the country, as well as the works of NGOs, the Education Sector,
the National Health & Medical Research Council, Lead Clinician Groups, Medicare Locals and Local
Hospital Networks.
Mark then broke down the three facets of the Safe and High Quality Health Care for Australia
Framework: consumer centered, driven by information and organized for safety, grading his unit’s
achievements against each of the specific actions.
Workgroup Sessions
1
Queensland Health Dementia Framework Revision
Dr Beres Joyner, Steering Committee Member, Statewide Dementia Clinical Network
This group, in its infancy, is in the process of determining exactly what is required of this review. As
mentioned above, alignment with the national document, due for release mid‐2013 will be an
important aspect, and possibly a rate limiting step. The original Qld document was developed in
response to the National document. Dr Joyner discussed some ideas around Key Performance
Indicators (KPIs), including the concept of offering Chief Executives a choice of KPIs. Another primary
objective of the review is to keep the document accessible and as brief as possible. The group aims
to develop a summary of the working group discussion, and then establish a series of
teleconferences to progress the review.
SDCN Forum Report_Feb 2013.DRAFT
Page 5 of 11

6. 2
Younger Onset Dementia
Denise Craig, Steering Committee Member, Statewide Dementia Clinical Network
Denise outlined the key objectives of the group, including consulting with people with younger onset
Dementia (YOD), reviewing/collating available resources (for updating and uploading), looking into
the overlaps between early onset dementia and YOD, along with YOD accessing drug trials and the
issues with delays in YOD receiving diagnoses. The group is also investigating the challenges that
accompany Dementia in the younger years, such as driving, insurance, mortgages, etc.
3
Telegeriatrics and Dementia
A/Prof Eddy Strivens, Co‐Clinical Chair, Statewide Dementia Clinical Network
The Telegeriatrics group is looking to finalise and rollout two surveys: one to ascertain the
availability and interest of relevant specialists around Queensland to participate in videoconference
consultations to provide Dementia diagnoses, and the other to determine the current accessibility of
Dementia diagnoses. The importance of working with Medicare Locals was highlighted.
The group’s quick tips sheet on Telegeriatrics and Dementia Diagnosis will shortly be uploaded onto
the SDCN website to assist users in setting up successful Telegeriatrics services.
4
Nutrition and Dementia
Judy Rabbit, Steering Committee Member, Statewide Dementia Clinical Network
The group had a productive session, endorsing a number of links for inclusion on the dementia
website, either as a standalone section, or as part of the yet to be published Transitions in Care for
People with Dementia webpage.
The SDCN’s consumer representative, Delaune Pollard, will be taking the lead on preparing some key
points/checklists around carers, nutrition and dementia.
The group will also be providing feedback on the nutrition results from the Qld Bedside Audit, as well
as proposing new questions for inclusion in future audits.
SDCN Forum Report_Feb 2013.DRAFT
Page 6 of 11

7.
The Soapbox
Access to Quality Care in Dementia – Access Delayed… Computer says NO!!
Facilitator: Sue Coffey, Steering Committee Member, Statewide Dementia Clinical Network
Panellists:
Belle Davis, Aged Care Assessment Team (ACAT) Representative
Dr Lucy Dakin, Geriatrician
Karryn Crothall, Social Work
Carol MacLennan, Clinical Nurse Consultant
Owen Wrider, Disability Services Queensland (DSQ) (via videoconference)
Sue opened with some examples of younger onset dementia, including the first person to be
diagnosed with Alzheimer’s disease (1901), later dying aged 55, along with some contemporary
cases. Sue further set the scene by outlining some of the challenges, with some 1,700
Queenslander’s afflicted. The main case study was then outlined, and the various panelists were
asked relevant questions to outline their take on how the care of the patient should be managed
and whether DSQ or ACAT were best positioned to assess this cohort’s needs.
Two issues were noted for referral to the SDCN’s Younger Onset Dementia working group for further
consideration:

What interim services are available for patients who are transitioning from ACAT to DSQ?

The age‐based eligibility criteria of certain programs exclude younger patients, thereby
imposing a lack of choice for those patients – can anything be done about this?
It was fascinating to see the different angles from the different professions involved, and
encouraging to see how all aspects linked together for the betterment of the patient.
Summary and Future Directions
A/Prof Eddy Strivens, Co‐Clinical Chair, Statewide Dementia Clinical Network
A/Prof Strivens thanked all parties involved in the smooth running of the forum and summarised the
day’s events, noting the excellent and informative presentations, the productive work group
sessions, and the thought provoking panel discussion.
SDCN Forum Report_Feb 2013.DRAFT
Page 7 of 11

8.
Appendix 1
Feedback
This was the first time the SDCN utilized an online surveying tool to capture feedback from forum
participants. This was primarily to enable feedback from those attending via videoconference, but
also enabled increase automatic assessment of responses, along with the opportunity for attendees
to describe their general comments in more detail. One drawback of this approach is that a lower
than usual return rate was experienced, with only 25 of the approximately 65 attendees completing
the survey.
#
Question
Agreed
Disagreed
Not
Applicable
Skipped
Question
1
The objectives of the forum
were clearly outlined
21
4
0
0
2
The forum stimulated my
interest
20
4
0
1
3
The presentations were
useful and relevant
18
7
0
0
4
The objectives of the forum
were achieved
17
7
0
1
5
There was sufficient time to
meet the forum objectives
20
5
0
0
6
There were sufficient
opportunities for sharing
ideas
20
5
0
0
7
The forum was well
organized
22
2
1
0
8
Information was presented
in a user friendly format
19
5
0
1
9
The Chairs/Facilitators
maintained a supportive
and participative
environment
24
1
0
0
SDCN Forum Report_Feb 2013.DRAFT
Page 8 of 11

9. #
Question
Disagreed
Not
Applicable
Skipped
Question
I found value in networking
with colleagues
10
Agreed
22
2
1
0
11
20
(respondent
taken to
question 15,
‘general
comments’)
The venue used was
suitable
4 (included
1
‘attended
(respondent
via VC’,
taken to
taking
question 15,
respondents
‘general
to question
comments’)
12)
0
12
The video conference was
easy to use
4
0
0
21
13
Through using video
conference, I felt like I was
part of the forum
3
1
0
21
I would like to use video
conference at future
forums
4
0
0
21
14
15
Twelve ‘General Comments’ were received, with a number of themes emerging:

Three comments were congratulatory in nature, with findings that the day presented
opportunities to share ideas and stimulate thought, with the potential for exciting
debate.

One comment noted the difficulties in participating via video conference.

Two comments suggested the soapbox session did not allow for exploration of
principles, tending towards polarization, and that its purpose was not evident.

Six comments expressed concern regarding the broad nature and lack of specific and
detailed dementia content/expertise of a number of the presentations.
SDCN Forum Report_Feb 2013.DRAFT
Page 9 of 11

10. Appendix 2
Statewide Dementia Clinical Network Forum
Access to Quality Dementia Care
Seminar Rooms 1 & 2
The Clinical Skills Development Service, Level 5 (enter via Level 4), Block 6,
Royal Brisbane and Women’s Hospital, Herston, Brisbane, Queensland
Friday 1st February 2013
8:30 – 16:00
Video Conference: see below for the 4 digit dial-in numbers for QH Facilities
External/non-QH, please contact Ian Johnson on 0405 938 273
8:30am
Registration & Coffee, Dial-in on: 3014 (8:45 – 12:30)
9:00 (15)
Welcome and Introduction
Dr Michael Cleary, Deputy Director-General, Health Service and Clinical Innovation
Division
9:15 (15)
Update from the SDCN Co-Chairs
A/Prof Eddy Strivens, Co-Clinical Chair, Statewide Dementia Clinical Network
9:30 (20)
What do the Hospital and Health Services need from us?
Prof Keith McNeil, Chief Executive, Metro North Hospital & Health Service
9:50 (10)
Question time
10:00 (30)
Quality Indicators
Prof Len Gray, Director, Centre for Research in Geriatric Medicine, UQ
10.30 (10)
Question Time
10:40 (30)
Morning Tea
11:10 (20)
Queensland Aged Care Policy Update
Joanna Gurd, Manager, Policy and Planning Branch
11.30 (10)
Question time
11:40 (20)
Commonwealth Update: Living Longer, Living Better
Mark Gaukroger, Director, Dementia Policy Unit, Dept of Health and Ageing (DoHA)
12:00 (10)
Question time
12:10 (50)
12:50
Lunch
Move to Workgroup Rooms (see over page). Use Level 6 Walkway for Block 7 Rooms
Discounted parking is available at the Wilson Parking facility on Herston Road. Simply take your ticket to the main
desk on level 4, Block 6 (Clinical Skills Development Service - entry point for the forum), have it validated, then pay
the attendee at the ticket booth (do not pay via the machine). It should cost $12 and you must depart by 6:00pm.
Page 10 of 11

11.
12:10 (50)
12:50
Lunch
Move to Workgroup Rooms (see below)
Room
Dial-in Details
(12:45 – 14:00)
1) Qld Health Dementia Framework Revision
Seminar Rm 1
3015
2) Younger Onset Dementia
Debrief Rm 5
3016
3) Telegeriatrics & Dementia
Rm 28A, L14, Block
7
3017
4) Nutrition & Dementia
Rm 94A, L14, Block
7
3018
13:00 (60)
Workgroup Session
14:00 (10)
Return to main forum room, dial back in on: 3000 (14:00 – 16:15)
14:10 (20)
Feedback from Workgroups
Workgroup Leads
14:30 (15)
14:45 (55)
Afternoon Tea
The Soapbox:
Access to Quality Care in Dementia – Access Delayed… Computer Says
NO!!
Facilitator: Sue Coffey, Nurse Unit Manager, Older People’s Health, Primary &
Community Health Services, West Moreton HHS
Panel: 1 ACAT Representative: Belle Davis
2 Geriatrician: Dr Lucy Dakin
3 Social Work: Karryn Crothall
4 Clinical Nurse Consultant: Carol Maclennan
5 Disability Services: Owen Wrider
15:40 (15)
Summary and Future Directions
A/Prof Eddy Strivens, Co-Clinical Chairs, Statewide Dementia Clinical Network
15:55
Close
Clinical Skills Development Service (CSDS) Location within RBWH Campus
Page 11 of 11