Intervention Programmes for Improving the Support and Care for Dementia Patients in Australia - Research Proposal Example

An Evaluation Plan for Intervention Programmes for Improving the Support and Care for Dementia Patients in Australia Executive summary This report contains information about the process that will be used to evaluate how the initiatives adopted by the Australian government to support and improve care for people with dementia have affected the target population. The evaluation will be based on Øvretveit’s type 3 evaluation model (before-after evaluation). Since the model is used to measure the impact that an intervention programme has on a population, it will be the most appropriate one to assess the extent to which the initiatives adopted by the government have been effective in achieving the intended objectives. The setting for the planned evaluation can be understood within the context of the initiatives that have been taken by the Australian government to improve care for patients with dementia in the country since 2005. The implementation process of the evaluation of the initiatives has factored in different needs of various stakeholders and is meant to produce outputs that will be reflected in the way dementia patients are taken care of in the country. This evaluation will seek to measure the extent to which the original objectives of the process of improving care for dementia patients in Australia have been achieved so far. The type of evaluation to be conducted and its justification The evaluation will take the form of Øvretveit’s type 3 evaluation design known as simple before-after evaluation design model. This model is used to determine the outcome of an intervention programme upon a population. Differences in measures taken before and after a programme has been implemented are used to determine the extent to which the intervention has been successful (Øvretveit, 1998). Dementia is one of the most important health conditions in Australia. The seriousness of the disease is reflected in the extent of its spread and the threat that it poses to the population of the country in general, particularly aged people. Statistics indicate that by the end of 2013, over 322,000 individuals in the country were found to have developed the condition (Australian Institute of Health and Welfare, 2012). Further, the predicted increase in cases of the condition among members of the Australian population is set to present unique challenges, the most important one of them being a strain on the small number of residential aged care centres and the general population of caregivers in the country (Vickland, Morris, Draper, Low & Brodaty, 2012, p. 11). Therefore, it is necessary to evaluate the impact that the intervention programmes developed and implemented by the government have had on the patients, healthcare professionals and aged care centres in general. The government has been responding to this issue by initiating special intervention measures. Such an approach was initiated back in the year 2005 as an initiative that was meant to support dementia patients and ensure that the condition is brought under control in the country. Therefore, since the before-after evaluation design is one of the simplest models that can be used to determine the outcome of an intervention measure, it will be the most appropriate method that will be used to measure how effective the intervention measures have been. The design of the evaluation Basically, the design will take the form of a single before-after evaluation design model. First, the design will be carried out to evaluate the impact of the programme to improve care and support for patients of dementia in the country. As such, the evaluation will measure the extent to which the intervention measures have been effective after the period of implementation. Secondly, two sets of measures will be used to determine the overall effectiveness of the intervention. Specific measurements that are related to the objectives of the study that were taken at the beginning of the evaluation will be obtained. These will be compared with the measurements of the state of the population after a considerable length of time during which the programme has been running. Thirdly, the evaluation will be carried in such a manner that the post-test data will be obtained during the course of the intervention programme. This implies that since the intervention measures taken by the government have been running since the year 2005, the evaluation will be carried out to determine the impact that the intervention has had on the population since it was implemented. Therefore, the design will be done in the form of measuring the impact of the intervention on three groups of parties: dementia patients, aged care centres and healthcare practitioners. The perspective of the evaluation The perspectives of the evaluation will be based on the observation by Sloane et al. (2005) that evaluations on dementia care have shifted from assessing the process of care to assessing the specific outcomes of the care process. Therefore, for this case, the perspectives can be understood in terms of different aspects of the intervention programme that the evaluation will be designed to assess during its implementation. The first one regards the impact that aged care centres have on the lives of dementia patients in Australia. The evaluation will assess how exposure to such institutions influences the lives of dementia patients in Australia. The second one entails assessing the quality of life of dementia patients who have been subjected to the intervention programmes over time. In assessing the quality of life of patients, important aspects such as their level of self-esteem, interaction with others and availability of a positive attitude towards life will be taken into consideration. The third one entails assessing the opinion of caregivers and other professionals who are directly involved in the care of dementia patients in Australia. By using interviews and other methods of collecting qualitative and quantitative data, the level of morale, attitudes and opinions of the caregivers with regard to the care of dementia patients will be evaluated. Evaluation aims, methods, outcomes and measures Programme evaluations are carried out as a way of collecting information that can be used to achieve three key objectives: reduce the level of uncertainties in a programme, increase the level of effectiveness and improve the quality of decisions that are made (Innes & McCabe, 2007, p. 13). In this case, it can be seen that the focus of using a before-after model to evaluate the intervention programmes by the Australian government to improve the care and support offered to dementia patients is supposed to gauge the level of effectiveness of the programmes. The aims, methods and objectives for the evaluation will be defined by the different components that were incorporated in the initiative. First, the initiative is aimed at supporting people with dementia and their care. Therefore, the overall objective of the evaluation will be to evaluate the impact of the initiative on the population in this regard. Secondly, the process of the intervention programme was meant to ensure that the overall objective of the programme was achieved through implementation of three key measures. The first measure was to establish high-level community care places for dementia patients in Australia. Therefore, the evaluation will seek to establish the extent to which this measure has been achieved and what this means to the general population of dementia patients in the country. The second measure was based on the development of new training programmes for healthcare professionals with regard to the care of dementia patients. The significance of this component was to ensure that new programmes are developed for individuals who are involved in the care of dementia patients. This perspective will be incorporated in the evaluation in that the results of the evaluation will be used to determine the impact of the new programmes on the overall level of care and support for dementia patients. The third measure was the need to carry out further research and develop additional initiatives and intervention programmes with regard to improving the care for patients with dementia. The evaluation will take this measure into consideration by seeking to determine the impact that the measure has had on the population so far. Evaluation planning Planning for the evaluation will be done in several interrelated steps. At the first stage will be the preparation that will be done before the actual evaluation process is undertaken. Generally, the preparation stage for the process of evaluating a programme entails different types of activities such as determining the scope and constraints of the evaluation and the criteria that will be used to judge the programme (Green & South, 2006, p. 66). At this stage, relevant information about the justification of the evaluation will be collected. Additionally, information about the appropriate indicators, methods and priorities that will be used in the process of collecting and using data during the evaluation are determined at this stage. Further, while planning for the evaluation, the special components that will be used to determine the boundaries of the evaluation will be developed. The target programmes and objectives of the evaluation will also be determined at this stage. The objectives of the evaluation and the outcomes that the evaluation is expected to produce will shape the approach that will be used to carry out the evaluation. Lastly, the plans to determine how effective the outcomes of the evaluation are will be laid out at this stage of the process. Planning for the evaluation will also involve deciding on the form that the evaluation will be carried out. Since the evaluation will be carried out in the form of a comprehensive audit to determine the extent to which the objectives of the intervention programme to improve the care and support for dementia patients in Australia have been achieved, the processes that constitute the evaluation will be shaped to take this into consideration. Lastly, practical planning of the actual way in which the evaluation will be carried out will be done. At this stage, the tools, resources and other things that will be used to collect the information for the evaluation will be collected. Evaluation implementation Implementation of the evaluation will be carried out in several interrelated steps. First, data to be used in the evaluation will be collected. Since the evaluation will make use of different types of data, both qualitative and quantitative data will be used in the evaluation. The different forms of data that will be used in the evaluation will be collected using different instruments. For example, questionnaires will be used. Furthermore, the process of data collection will be carried out in such a manner that only data which is relevant to the evaluation will be collected within the shortest time possible and at the lowest cost that is practical for the entire evaluation process. The last stage of the process of implementing the evaluation will entail analysing the collected data and presenting the findings of the analysis in the form of a report to the different stakeholders to the evaluation process. The tools strategies that will be used to minimise risks The first risk that will have to be managed is bias that arises from the effect of the element of history in the findings of the evaluation. Generally, this type of bias arises from the possibility of occurrence of different types of events in-between the pre-test and post-test period of the evaluation (Reichardt & Mark, 2010, p. 128). Since such events alter the findings of the evaluation, the right strategies to minimise the impact will be put in place. The second issue arises from the threat that is posed by changes that may occur on the individuals on whom the intervention is done. Since changes in the individuals may occur after the pre-test is done but before the post-test is carried out, it is important for specific strategies to be used to minimise this risk. Stakeholders and associated communication and risk strategies To begin with, the Australian government will be a key stakeholder to the process. By developing and introducing the Dementia – A National Health Priority Initiative, the government has sought to support and improve the care for people with dementia in the country. By determining the impact of the initiatives on dementia patients in the country, the government will have the right information about the effectiveness of the programme. The second group of persons who will be important stakeholders in the process is dementia patients. Since the programme sought to improve the care for them, the evaluation, which will determine the overall effect of the intervention programme, will be beneficial to the patients in particular and the population at large. Further, since the patients are the primary beneficiaries of a before-after evaluation (Øvretveit & Gustafson, 2003, p. 760), the results from this evaluation will be highly beneficial to them in this case. The evaluation will make use of different methods to control the effect of risks on the final outcome. In theory, evaluation of a project is associated with three major types of risk: the length of time that is available for the evaluation process, the resources that are allocated for the process and the data that is required to be collected for use in the process (Green & South, 2006, p. 67). Different strategies will be used to manage the constraints. For instance, the process of the evaluation will be planned in such a manner that all the activities are included within the time at the outset of the evaluation and the preparation of the final report. Also, care will be taken to ensure that the right amount and type of data is collected during the process. Lastly, planning for resources such as personnel and financing will be necessary for the success of the evaluation. An implementation plan of the evaluation A plan for the implementation of the evaluation process will take into account three important things. First, the plan will take into account how the activities of the evaluation will be put into practice. To this end, specific activities of the evaluation will be carried out at specific times during the course of the evaluation process. Furthermore, all the different activities will be done within specific time frames to ensure that the process is conducted within the stipulated period. The second issue that the implementation plan of the evaluation process addresses is how the process will be managed and executed in general. For this particular evaluation project, the process will be carried out by the consultancy firm in consultation with the Australian government which is the financing authority. The third issue involves the different roles that the parties involved in the process will play during its implementation. All the parties that will be involved in the process of transforming the plan of the evaluation into an actual process that will produce the outcomes of the evaluation will play different roles at different stages of the process. Key outcomes and measures to be addressed Generally, evaluating programmes that are related to care for dementia patients is associated with overreliance on specific measures at the expense of other types of measures such as cognition, the quality of life and overall functioning of the patients (Innes & McCabe, 2007). Consequently, this evaluation will make use of a wide range of measures including the needs of patients, organisations and health professionals. The outcomes and measures will be based on the key issues which were included in the intervention programme implemented by the Australian government with regard to improving the care and support provided for dementia patients in the country. Baseline measures will be used as a pre-test indicator for the condition that was prevailing before the intervention programme was implemented. Several types of baseline measures will be obtained. The first one will be obtained from surveys on dementia patients. Baseline data will be obtained from different surveys on patients that were carried out prior to the implementation of the intervention. The idea behind the use of this approach is to ensure that the most accurate information about the impact of the evaluation is obtained. The second one will be baseline measures carried out on different organisations that are involved in the care for dementia patients in Australia. After the pre-test measures have been obtained, post-test measures (which will reflect the state of the on-going programme) will be obtained as well. Once more, measures based on surveys of centres that are involved in the care of dementia patients will be used. The measures will be obtained from a sample of such organisations which will be developed and used in the course of the evaluation. Furthermore, patient surveys will be carried out on a sample so that the impact of the intervention programme on the target population is established. References Australian Institute of Health and Welfare (2012). Dementia – the ninth national health priority. Retrieved from http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737423074. Green, J., & South, J. (2006). Evaluation. Berkshire: The Open University Press. Innes, A., & McCabe, L. (2007). What is evaluation? In A. Innes & L. McCabe (Eds.), Evaluation in dementia care (pp. 11-20). London: Jessica Kingsley. Øvretveit, J. (1998). Evaluating health interventions: An introduction to evaluation of health treatments, services, policies and organizational interventions. Berkshire: McGraw-Hill. Øvretveit, J., & Gustafson, D. (2003). Improving the quality of healthcare using research to inform quality programmes. BMJ, 326, 759-761. Reichardt, C., S. & Mark, M., M. (2010). Quasi- experimentation. In J.S. Wholey, H.P. Hatry & C.E. Newcomer (Eds), Handbook of practical program evaluation (pp. 126-149). New York: John Wiley & Sons. Sloane, P.D., Zimmerman, S., Williams, C.S., Reed, P.S., Gill, K.S., & Preisser, J. S. (2005). Evaluating the quality of life of long-term care residents with dementia. The Gerontologist, 45(1), 37-49. Retrieved from https://www.alz.org/national/documents/grnt_037_049.pdf Vickland, V., Morris, T., Draper, B., Low, L., F., & Brodaty, H. (2012). Modelling the impact of interventions to delay the onset of dementia in Australia. A Report for Alzheimer's Australia, Paper 30. Retrieved from https://fightdementia.org.au/sites/default/files/201212_NAT_AAnumberedPub_Paper30final.pdf Read More