Dementia KPIs and Dashboards: What to Measure and How to Use It
In dementia services, “KPIs” can become a paperwork exercise unless measures reflect what matters day to day: safety, stability, distress reduction and meaningful quality of life. A strong outcomes, evidence and quality assurance approach turns numbers into decisions, while well-defined dementia service models ensure measures match how the service actually delivers care (rather than a generic dashboard copied from elsewhere). This article sets out what to measure, how to set thresholds, and how to use dashboards for governance, commissioner assurance and inspection readiness.
Why dementia KPIs fail in practice
Dashboards commonly fail for three reasons:
- Wrong measures: over-reliance on activity metrics (e.g., “number of activities delivered”) rather than outcomes (e.g., reduced distress, improved engagement).
- No thresholds: data is reported without clear triggers for escalation and review.
- No operational link: staff cannot connect the numbers to what they do differently on shift.
A useful dementia dashboard is simple enough to be used monthly at governance level, and specific enough to guide actions at unit/team level.
A practical dementia KPI set: what to include
Most providers need a balanced set across four domains. The exact selection will vary by setting, but the structure remains consistent.
1) Safety and safeguarding
- Falls rate (with severity grading and location/time-of-day patterning)
- Medication incidents (including omissions, timing errors, PRN use patterns)
- Safeguarding concerns (including themes, repeat patterns, and outcome status)
- Pressure area risk and skin integrity trends
2) Stability, escalation and health interfaces
- Unplanned hospital admissions and A&E attendances (with avoidability review)
- 999/111 contacts (volume and reason codes)
- Clinical escalation episodes (e.g., delirium triggers, infection-related deterioration)
- Placement stability indicators (unplanned moves, crisis meetings, breakdown risks)
3) Distress, restrictive practice and lived experience
- Distress incident rate (including triggers, duration, and recovery time)
- Restrictive practice use (type, duration, authorisation, review timeliness)
- Meaningful engagement indicators (individualised, not “generic activity counts”)
- Feedback trends from people and families (themes, response times, resolution quality)
4) Workforce and delivery assurance
- Training compliance for dementia-specific competencies
- Supervision coverage and quality (timeliness plus documented reflective learning)
- Agency usage and continuity measures
- Audit completion and action closure (with overdue and repeat-findings tracking)
How to set thresholds and escalation triggers
Dashboards are only useful if they trigger action. Thresholds should be practical and tiered:
- Green: within expected variation; continue routine monitoring.
- Amber: early warning; manager review and short improvement action.
- Red: urgent escalation; governance review; immediate mitigation and learning process.
Thresholds should be based on your baseline data and case mix, not arbitrary national figures. Where commissioners require comparators, provide both: your internal trend and the external benchmark, with context.
Operational example 1: Using a distress KPI to change routines
Context: A unit showed a rising pattern of distress incidents between 4pm and 7pm. Staff viewed this as “sundowning” and unavoidable.
Support approach: The service introduced a distress KPI that required recording triggers, duration and recovery supports (not just “incident occurred”).
Day-to-day delivery detail: Analysis showed distress spikes aligned with shift handover, noisy communal spaces and rushed personal care. The unit adjusted handover (shorter, staggered), protected quiet space, and re-timed personal care so people were not rushed during peak agitation periods. Key workers prepared “transition cues” (snacks, music, familiar objects) for individuals known to become anxious.
How effectiveness is evidenced: Distress incidents reduced over eight weeks, average duration shortened, and PRN use decreased. Governance minutes recorded actions, review points and sustained monitoring.
Operational example 2: Falls dashboard with location/time patterning
Context: Falls were being reported, but learning was limited because data was not broken down beyond “falls per month”.
Support approach: The dashboard added severity grading, time-of-day and “where it happened” categories, plus a requirement for post-fall debrief notes.
Day-to-day delivery detail: The service found a cluster of falls in one corridor near the bathroom at night. Actions included improved lighting, clearer contrast markings, a review of footwear checks, and a change to night-time observation frequency for two people with fluctuating orientation. Staff refreshed guidance on “wait time” and verbal cueing before standing, and introduced a simple pre-bathroom prompt routine to reduce rushed movement.
How effectiveness is evidenced: Falls in that corridor reduced; severity scores improved; debrief notes showed clearer contributory factors; audits confirmed environmental checks were sustained.
Operational example 3: Admissions KPI supporting commissioner assurance
Context: A commissioner challenged whether a dementia service was “over-escalating” to acute care.
Support approach: The provider introduced an admissions KPI with a structured avoidability review (what happened, what alternatives were attempted, what learning resulted).
Day-to-day delivery detail: The service embedded an escalation checklist: hydration and infection screening prompts, GP/out-of-hours contact documentation, and family engagement records. A senior clinician/manager reviewed admissions weekly and fed learning into staff briefings and care plan updates, especially around delirium triggers and early deterioration signs.
How effectiveness is evidenced: Avoidable admissions reduced, documentation quality improved, and commissioner reviews noted clearer clinical reasoning and safer decision-making.
How to govern the dashboard (so it stands up in scrutiny)
Dashboards should be owned and reviewed through governance, not left to admin processes. Minimum governance practice typically includes:
- Monthly quality meeting review with recorded decisions and actions.
- Quarterly board/leadership oversight including themes and persistent risks.
- Clear “who does what by when” and evidence of completion.
- Quality assurance checks on the data itself (e.g., incident coding consistency).
Commissioner expectation
Commissioners expect providers to present outcomes data that is meaningful, trend-based and linked to action: what changed, why it changed, and what impact it had on stability, safety and value for money.
Regulator / inspector expectation (CQC)
CQC expects providers to demonstrate robust governance: risks are identified early, learning is embedded, restrictive practices are monitored and reviewed, and the service can evidence “how you know” care is effective and safe.
Making the dashboard usable for staff
Dashboards are not just for leadership. Staff engagement improves when the service uses a simple “you said / we saw / we changed” approach in team briefings, grounded in the measures staff recognise: fewer distress episodes, better routines, fewer incidents, safer escalations and better feedback.