Health care for people with dementia in 2030 – Results of a multidisciplinary scenario process
ABSTRACT Despite extensive research funding in the field of dementia, deficits in the quality of dementia care still exist. In order to project different alternative futures of health care for people with dementia (PwD) in Germany, we have initiated a multidisciplinary scenario process (Sce-Dem).
For the scenario process we used a 6-step approach: (1) identification of relevant areas of influences via literature review and internet search, (2) systematic collection of relevant influence factors and their future projections via literature review, brainstorming and consensus workshops, (3) discussion and validation of the identified key factors in a workshop with 52 multidisciplinary, experts, to clarify their characteristics and future projections, (4) combining the relevant key factors with alternative projections in a so-called consistency matrix to estimate the consistency between the selected projections, (5) generating consistent combinations of projections using software, and (6) writing scenario stories and descriptions based on the most consistent and different combinations.
As a result of the scenario process, five consistent scenarios were developed. Two of these could be described as dark scenarios with very poor prospects. A third one has been referred to as "well-meant, but badly done". Two scenarios entail mostly positive aspects but one of them has a tendency towards, a "health control" state.
The more positive scenarios provide a framework for determining relevant actions in research, society, and politics.
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ABSTRACT: Recent developments in basic research suggest that therapeutic breakthroughs may occur in Alzheimer's disease treatment over the coming decades. To model the potential magnitude and nature of the effect of these advances, historical data from congestive heart failure and Parkinson's disease were used. Projections indicate that therapies which delay disease onset will markedly reduce overall disease prevalence, whereas therapies to treat existing disease will alter the proportion of cases that are mild as opposed to moderate/severe. The public health impact of such changes would likely involve both the amount and type of health services needed. Particularly likely to arise are new forms of outpatient services, such as disease-specific clinics and centers. None of our models predicts less than a threefold rise in the total number of persons with Alzheimer's disease between 2000 and 2050. Therefore, Alzheimer's care is likely to remain a major public health problem during the coming decades.Annual Review of Public Health 02/2002; 23(1):213-31. DOI:10.1146/annurev.publhealth.23.100901.140525 · 6.63 Impact Factor
Article: Using foresight in safe nursing care[Show abstract] [Hide abstract]
ABSTRACT: This paper describes the importance of prospective risk analysis in healthcare, the development of the foresight training package and its underlying theory. Many high-reliability industries formally train staff in prospective risk analysis. Although there are tools to retrospectively analyse incidents in healthcare and although many staff are error aware there is no training to formalize this learning. Staff already use error awareness and often intervene to prevent patient harm resulting in many 'no harm' incidents. The National Patient Safety Agency has developed the foresight training package to broaden healthcare professionals' understanding of the many factors that can combine to contribute to an incident occurring, and to encourage shared learning. For management teams, this broader understanding will assist them in prospective risk assessment of the staff they manage enabling them to be proactive in minimizing risk. The training tool is based on Reason's 'three bucket' model. Throughout every stage in the development of the foresight training package the concept and materials were tested with front-line staff. Formal evaluation of the published package is due to be completed by May 2009.Journal of Nursing Management 04/2009; 17(2):212-7. DOI:10.1111/j.1365-2834.2009.00976.x · 1.14 Impact Factor
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