Welcome to PERFECTED

PERFECTED (Peri-operative Enhanced Recovery hip FracturE Care of paTiEnts with Dementia) was a National Institute for Health Research (NIHR) funded Applied Research Programme which aimed to improve hospital care for patients with dementia who break their hip.

This five-year programme investigated how better standards of care could be implemented across the NHS. Despite one-quarterer of acute NHS hospital beds being occupied by people with dementia, prior to the programme there was little research on how best to look after these people in hospital. They are exceptionally vulnerable and at high risk of serious complications. Inconsistent standards of care, poor physical and mental health management and overuse of sedatives have been highlighted in national reports. These insights provided recommendations for improving care - for example, people who break their hip have a high risk of delirium, which is linked to delayed recovery and causes distress for patients and their families. There is good quality evidence that preventing delirium is possible. However, not enough was known about how modification in hospital care can prevent delirium in people with dementia.

The programme led to the development and piloting of evidence-based interventions to improve the hospital care of physical and mental health problems in people with dementia. The research team created an Enhanced Recovery Pathway (ERP) for the care and rehabilitation of people with dementia who break their hip. The development of implementation principles was central and included the consideration of patients, familie, and staff. Our team of national and international experts from diverse disciplines in the field will use this programme of research to address the Ministerial Advisory Group on Dementia's research priorities.