Agents of Change': Improving post diagnosis care for people with dementia and their carers through the establishment of a National Quality Collaborative to implement guideline recommendations

Online delivery of a training course for health professionals. Health professionals working in dementia care will act as implementation clinicians in the AOC project. They will be supported and trained to develop and then enact an implementation plan to improve the implementation of three key recommendations from the Clinical Practice Guidelines for Dementia in Australia: • Occupational therapy - people with dementia living in the community should be offered occupational therapy (reflecting evidence based programs) • Exercise - people with dementia should strongly be encouraged to exercise • Carers - carers and family of people with dementia should be offered respite and have access to programs to support and optimise their ability to provide care for the person with dementia Implementation clinicians will enact their plan within their workplace within the resources available to them, and have ongoing meetings and support with their collaborative and experts. METHOD: Implementation clinicians will be recruited via advertising. Suitable clinicians will complete online training program with a time commitment of approximately 2 hours a week for 6 weeks. The research team will develop the online learning program with the help of consumer advisers and clinical experts in the field. Clinical experts and the research team include occupational therapists, exercise physiologist, psychologist, international business manager, and academics, including research fellows and senior research fellows with an extensive experience in aged care and dementia research. Consumer advisers are person with dementia and the carer who both have been previously involved in research and advocacy in dementia. Implementation clinicians will participate in this online learning program where they will be trained in practical implementation to gradually develop a site specific implementation plan. They will have a support from the research team and an implementation expert. The implementation clinicians will develop their own implementation plans iteratively and interactively during the online training and will be enacted within their own site using 'plan-do-study-act' methodology. The aim of the intervention is to support the implementation clinicians to become 'agents of change' and enable people living with dementia and their formal carers to be routinely provided with best practice care. The outcomes measured are: • Primary outcome: the number of people living with dementia receiving care which meets the following criteria: - occupational therapy - exercise and - informal carers as described by treating clinician. • Secondary outcomes: evaluation outcomes including acceptability, feasibility, adherence to the guideline recommendations, consumer reported outcomes and experience and skills and knowledge acquired by clinicians in quality improvement. MATERIALS: Implementation clinicians will develop their own theory-informed implementation plan using plan-do-study-act (PDSA) cycles. They will learn about practical application of Organisational Readiness and COM-B and draw on these models as they form their implementation plan tailored to their recommendation of interest within their own sites. In addition to online training and tools they will have regular online communication and teleconferences with their peers to support and learn from each other. It is anticipated that implementation clinicians will have teleconferences with their peers once per month, between 30 and 60 minutes for the duration of the project (18 months). They will also have the opportunity to have a written communication with their peers on MOOC (online learning platform) that they will organise at their own discretion. In addition researchers will also create a networking group on Yammer or similar social networking service to enable clinicians to have ongoing communications with each other (at their own discretion) for the entire duration of the project (9 months prior to- and 9 months post the intervention). This study incorporates 18 months of data collection, 9 months pre intervention and 9 months post intervention. INTERVENTIONIST: The interventionist is a registered health professional (as described above) who will receive the training and get support to develop its own theory informed implementation plan aiming to improve access to physical activity, occupational therapy, and respite and carer support for people with dementia and their cares.