title: Characteristics of rural hospital services for people with dementia: findings from the Hospital Dementia Services Project.
abstract: OBJECTIVE
  To obtain information about aged care services in rural New South Wales public hospitals, and to describe key operational aspects of their service delivery models.
  
  
  METHODS
  A mixed methods design was used to combine data collected from: (i) a survey of public hospitals and (ii) qualitative site visits in a sample of eleven rural sites.
  
  
  METHODS
  Rural public hospitals in NSW, Australia.
  
  
  METHODS
  Qualitative data were collected from multidisciplinary clinicians, managers and community service providers who participated in site visits in 2010 and from surveys of NSW public hospitals in 2009/10 about aged care and dementia services.
  
  
  RESULTS
  Survey and site visit findings demonstrated that rural hospitals have fewer secure beds for managing patients with disturbed behaviour due to dementia and delirium and fewer speciality aged care staff than metropolitan hospitals. Site visit participants also described how secure environments can aid care for people with dementia even in the absence of clinical specialists.
  
  
  CONCLUSIONS
  The care of people with dementia in rural hospitals is constrained by access to specialist aged care staff and the physical environment of the hospital. Clinicians are adept at maximising resources to manage diagnosis and transitions for people with dementia. Further understanding of how key operational aspects of clinical leadership and environmental modifications impact on a range of patient outcomes would be valuable.
authors.affiliation: Discipline of Nursing, University of Canberra, Canberra, Australian Capital Territory, Australia.
authors.forename: Kasia
authors.initials: K
authors.lastname: Bail
authors.forename: Charles
authors.initials: C
authors.lastname: Hudson
authors.forename: Laurie
authors.initials: L
authors.lastname: Grealish
authors.forename: Kay
authors.initials: K
authors.lastname: Shannon
authors.forename: Saraah
authors.initials: S
authors.lastname: Ehsen
authors.forename: Ann
authors.initials: A
authors.lastname: Peut
authors.forename: Diane
authors.initials: D
authors.lastname: Gibson
authors.forename: Brian
authors.initials: B
authors.lastname: Draper
authors.forename: Rosemary
authors.initials: R
authors.lastname: Karmel
mesh_terms: D003704:Dementia / Q000628:therapy*; D005260:Female; D006297:Health Services Accessibility; D006780:Hospitals, Rural / Q000458:organization & administration*; D006801:Humans; D008297:Male; D009517:New South Wales
keywords: geriatrics; health services accessibility; holistic nursing; hospital design and construction; leadership