Developing, implementing, and evaluating the first national Memory and Cognition Clinic Guidelines in Australia

Inga Mehrani; Matthew Paradise; Lee-Fay Low; Sue Kurrle; Valerie Arsenova; Gemma Jahn; Katrina Fyfe; Johannes C Michaelian; Katharine Salmon; Jane Alty; Sharon L Naismith; Perminder S Sachdev

doi:10.1002/trc2.70031

Developing, implementing, and evaluating the first national Memory and Cognition Clinic Guidelines in Australia

Alzheimers Dement (N Y). 2025 Jan 16;11(1):e70031. doi: 10.1002/trc2.70031. eCollection 2025 Jan-Mar.

Authors

Affiliations

¹ Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine University of New South Wales Kensington New South Wales Australia.
² Faculty of Medicine and Health University of Sydney Camperdown New South Wales Australia.
³ School of Medical and Health Sciences, Neuroscience Research, Ralph & Patricia Sarich Neuroscience Research Institute Edith Cowan University Nedlands Western Australia Australia.
⁴ School of Psychology, Charles Perkins Centre and the Brain and Mind Centre University of Sydney Camperdown New South Wales Australia.
⁵ Wicking Dementia Research and Education Centre University of Tasmania Hobart Tasmania Australia.
⁶ Neuropsychiatric Institute Prince of Wales Hospital Randwick New South Wales Australia.

Abstract

Introduction: A lack of national consensus on the roles and responsibilities of Australian memory and cognition clinics contributes to the large variability seen across services. The introduction of guidelines and a quality assessment framework could facilitate greater harmonization and quality improvements.

Methods: We used a modified Delphi process to develop the guidelines. Pilot clinics completed a self-assessment, case-note audit, and review meeting to evaluate their service against the guidelines.

Results: The final guidelines included 160 standards on 14 different topics. Standards around maximum waiting times for an assessment and minimum post-diagnostic care responsibilities were particularly controversial. Seven clinics participated in the pilot. On average, clinics achieved 56% of standards (range of 18% to 87%).

Discussion: The Memory and Cognition Clinic Guidelines form the first step toward greater harmonization and quality improvements. Key learnings from the clinics' feedback included reducing the number of secondary standards and streamlining data collection with the national dementia clinical quality registry.

Highlights: We developed and implemented the first national consensus-based best-practice guidelines for memory and cognition clinics in Australia.The guidelines are based on consultation with 125 Australian health professionals and 89 Australians living with dementia and care partners.First-time national agreement on standards around maximum waiting times for an assessment and minimum post-diagnostic care requirements is presented in the guidelines.The guidelines were implemented in seven memory and cognition clinics from five different states.Clinicians' feedback included: reducing the number of secondary standards to increase conciseness and practicability should be considered for future iterations.

Keywords: dementia; guidelines; health service quality; memory and cognition clinic.