The document outlines a consistent approach to cognitive impairment across four Northern District Health Boards (DHBs) in New Zealand. It involves an eLearning module for general practitioners (GPs) and practice nurses to educate them on assessing, diagnosing and managing mild cognitive impairment and typical dementia. It also involves a clinical pathway decision support tool called Nexxt that guides GPs and is embedded in their practice management systems. The goal is to enable earlier identification of atypical cases needing referral and integrated care management of typical dementia between GPs, practice nurses, and Alzheimer's organizations to provide support services to patients and caregivers.

1. A consistent approach across the
Four Northern DHBs
1
Northern Region
Cognitive Impairment Pathway

2. • Why A Consistent Approach Across The Four Northern DHBs?
• What Is The Northern Region Approach?
• How Does The Northern Region Enable A Consistent Approach?
- eLearning Dementia Education Resource for GPs and Practice Nurses
- Nexxt™ Clinical Pathway decision support tool is embedded in the GPs
Practice Management System (PMS)
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Overview of Northern Region Approach
To Cognitive Impairment

3. • Prevalence of dementia is projected to double in the next 10 – 15 years
• International evidence shows ‘people can live well with dementia’
• The University of Auckland Evaluation (2015) of the Waitemata DHB
Cognitive Impairment Pathway Pilot provides evidence that:
 earlier assessment, diagnosis and management of typical dementia in
primary care is clinically safe and acceptable to all parties
 Integrated care management enables the problems of dementia to
become challenges to anticipate and manage as they arise, rather than
crises
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Why a Consistent Approach Across the Four
Northern DHBs?

4. • The Pathway decision support tool (Nexxt™) enables identification of
alternate diagnoses, atypical or complex dementia and appropriate referral
• Integrated Care Management of typical dementia by the GP, Practice Nurse,
and Alzheimers Auckland
• On diagnosis of typical dementia referral to Alzheimers Auckland provides:
- regular home visits and telephone calls and
- carer education courses and
- carer support groups and
- cognitive stimulation groups, & socialisation activities for the person with
dementia
4
What Is The Northern Region Approach?

5. An eLearning module of 13 stand-alone topics presented as short videos with
accompanying dot point pages (a national resource tailored to the Northern Region)
to:
• Distil the current literature
• Provide the evidence base for the Cognitive Impairment Pathway
• Build confidence, competence, and consistency in assessing, diagnosing, and
managing mild cognitive impairment (MCI) and typical dementia
• Obtain CME, MOPS and CNE points
This is preliminary notice that the Education Resource should go live by 1 March
2016. This page will alert and link you when go live happens.
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How Does The Northern Region Enable A
Consistent Approach?

6. How Does The Northern Region Enable A Consistent
Approach, continued?
• Nexxt™ takes clinically approved content from
any source and presents it to the user to help
manage their patient/s over the course of their
condition/illness
• Nexxt™ supports the clinicians to provide best
practice care using patient personalised
pathways: Taking into account
• their current phase of care
• history, examination and investigations
• previous treatment and outcome
• Care provided by other providers resources (e.g.
screening tools, calculators, patient hand-outs)
The Inspiration for Nexxt ™ - what the GPS
did for car drivers versus reading a map.