My Topol fellowship problem / project:

My project will explore and inform the future deployment of ‘digital’ to integrate with our proposed care model for a new nursing home we will be building, in a way that is safe, effective, affordable, and sustainable into the future.

I am keen to understand what digital and AI best supports independence, choice, and control in a nursing home setting for residents, particularly those with advanced dementia. For the workforce to provide the best possible care for residents I am aware that choices about what digital/AI to use will be important and how it is deployed in the most effective and efficient way ensuring consideration of the ethics, law and digital literacy of staff and volunteers. From a resident/patient perspective much of the older population has been excluded from technology; it will be important to ensure any digital technology is understandable and easy to use. Engaging our local community (specifically our dementia groups), staff and volunteers to co-design what digital technology we propose to deploy is important as part of this project.

Effective integration of AI within our care model could also identify efficiencies or even predict costs and patterns. I plan to develop a co-designed solution such as a digital/AI prototype for nursing homes for people with advanced dementia and complex nursing needs or alternatively a co-designed decision-making framework that informs the digital/AI best suited to the nursing home. I hope other nursing homes can also benefit from the outcomes of this work.

I am a registered nurse with 40 years of experience in clinical practice and clinical leadership, in the UK and Canada. I have worked in specialist palliative care/hospice for the last 22 years. I have previously worked as a Health Action Zone fellow, completing a research project looking at the palliative care needs of people with heart failure and later, as a Macmillan research fellow, my PhD sought the perspectives of people affected by lung cancer about their expression of wishes for end-of-life care. Both these studies influenced policy and practice guidelines.

I still occasionally work clinically as a nurse specialist to support our hospice teams. I have led on service improvements, for example, by developing and implementing a 24/7 Hospice at Home service, cancer nursing services in a big acute trust through development of cancer nurse specialists, and more recently the development of an enhanced palliative care service for people with heart failure.

In terms of my digital experience, in the late 1980’s as a ward sister I wrote a program for a digital care pathway for people with kidney stones. As a nurse in Canada in the 1990’s I received training in the use of digital records, electronic ordering, and electronic administration of medications, learning the power of digital to transform care. More recently I have supported the implementation and refinement of a digital record system (SystmOne) for use in our hospice.

In my current role as Programme Director of Care Services at Rowcroft Hospice I am clinically and operationally leading the development of a new purpose built sixty bedded nursing home for people with advanced dementia and complex nursing needs (in six homes of ten beds) and the redesign of the hospice, across a 22-acre estate.