Development and early impact of a Dementia and Delirium Outreach Team in an acute hospital setting

Introduction
Hospital admission can precipitate delirium and worsen outcomes for people living with dementia (PLwD), increasing length of stay (LoS), carer distress, and discharge to long‑term care. National Audit of Dementia data identified higher LoS and rates of discharge to 24‑hour care at SWFT compared with national averages. In response, a Dementia and Delirium Outreach Team (DDOT) was established in October 2024. This evaluation describes the development and early impact of this multidisciplinary intervention.

Method
DDOT comprises a Consultant Psychologist, Geriatricians, a Dementia Nurse Consultant, Physician Associate, and Psychology Research Assistant. The team provides trust‑wide outreach, focusing on non‑pharmacological interventions, discharge planning, and carer support. A bespoke database enabled monitoring of key performance indicators and health inequalities using an adapted Core20PLUS5 framework for a dementia cohort. Data were collected over six months (March–August 2025) and analysed using Plan–Do–Study–Act (PDSA) methodology.

Results
In total, 183 patients were supported, with 69% presenting with delirium. Average LoS reduced from 20.4 days in March to 13.0 days in August. Discharge outcomes improved, with 68% of patients returning to their usual residence and a 10% reduction in new long‑term care placements. Use of structured pain assessment tools increased to 58%, exceeding the national average (40.6%). Non‑pharmacological interventions were delivered in 143 cases, including “This Is Me” booklets, John’s Campaign facilitation, and individualised behavioural support plans. Health inequalities analysis identified 1% of patients from the most deprived quintile, reflecting the trust’s affluent catchment, with hypertension the most common comorbidity. Staff feedback rated DDOT highly for responsiveness and specialist expertise.

Conclusion
Early findings indicate that DDOT has positively impacted care processes and outcomes for hospitalised patients with cognitive impairment. This person‑centred, non‑pharmacological service model supports reduced LoS and discharge home. Further evaluation will explore longer‑term outcomes and replicability across acute hospital settings.