Digitising Behavioural Insight to improve Dementia Care and Discharge Pathways - Liverpool University Hospitals NHS Foundation Trust
Turning Behavioural Data into Meaningful Care Decisions — RoyofNeurodisability
How Melo is transforming Behavioural Assessment, Patient Flow and Multidisciplinary Decision Making.
Patients with dementia frequently present with complex behaviours due to numerous factors. Traditionally, behavioural observations were recorded on paper forms, often completed inconsistently and without the structured detail required for timely discharge planning or multidisciplinary decision-making. For hospital teams, this leads to several ongoing challenges:
Fragmented behavioural data
Limitations to identifying behavioural risks and patterns
Inefficient handover between departments
Delays in discharge planning and patient flow
High administrative burden
The Challenge
The Solution
Since early 2025, clinical teams across Liverpool University Hospitals NHS Foundation Trust have been using Melo, as part of their Hospital to Home programme, aimed at improving care for patients living with dementia and complex behavioural needs.
With Melo, clinicians now record behavioural observations using either a structured ABC (antecedant, behaviour, consequence) framework or an ABS (Agitated Behaviour Scale) a 14 point risk stratification framework. Teams can access results in real-time, view emerging behavioural patterns, support wider MDT discussions, and improve discharge planning with the Transfer of Care Hub (TOCH) and community bed brokerage teams.
Melo is live across three of the Trust’s hospitals: Aintree University Hospital, Royal Liverpool University Hospital and Broadgreen Hospital.
*5 discharge reports are rejected per day due to insuffient behavioural data
- Transfer of Care Hub Supervisor
“We have had no rejected discharges on one of our General Medicine wards at Aintree since introducing Melo.”
- Ged Jennings, Acute Liaison Nurse
The Impact: Data Driven Outcomes
📉 Better Quality Behavioural Insight
Melo has transformed how staff capture and interpret patient behaviour. Real-time digital entries replace paper-based forms, improving completeness and accuracy of assessments. Staff no longer need to chase fragmented notes or wait for psychology reports, saving administrative time and enabling more direct patient care.
🚨 Earlier Identification of Trends & Patterns
Melo’s data-driven insights allow clinical teams to spot behavioural patterns quickly, including time-of-day agitation, environmental triggers, or response to interventions. Early detection supports proactive interventions enhancing the quality of care delivered to patients in hospital through promoting clinical decision-making.
🗣️ Improved Communication across Teams
Melo provides a shared view of patient behaviour across nursing, care staff, therapy, psychology, and discharge teams. This reduces duplication, promotes a common language, and empowers staff to act confidently on real-time data.
✅ Greater Confidence in Discharge Decisions
For the first time, ward managers, patient flow coordinators and members of the Transfer of Care Hub (TOCH) are using Melo’s insights to empower decision-making and determine discharge suitability. This allows for a streamlined handover, and getting patients out of hospital and into appropriate community settings.
Results at a glance
✅ 17,000+ assessments completed digitally
👥 600+ active staff users across 3 Hospitals (10 Wards)
🏥Used with 400+ patients
💪 77% said they feel confident using Melo
📊 59% said Melo helps with conducting behavioural analysis
➡️ 64% found Melo supports discharge planning
🔍 Faster identification of behavioural patterns and clinical decision making
📈 Enhanced clarity & completeness of data
💬 Positive endorsement from the Trust’s Chief Nursing Officer
Patient Case Study
🏥Bringing Behavioural Insight to Complex Care: Supporting the Journey from Hospital to Home
A new patient with a learning disability and dementia diagnosis was admitted to the service. Concerns were raised by his community care team about a noticeable change in his behaviour and whether his existing accommodation could continue to meet his needs.
Across a 24-day admission, including periods of Enhanced Therapeutic Observation and Care (ETOC), staff completed 50+ behavioural assessments, with 16 entries recorded as ‘settled’, indicating relaxed and positive periods. Several behaviours were initially perceived as ‘severe’, but once viewed through Melo’s structured digital timelines, were understood to be less concerning when contextualised.
Using Melo, teams could easily interpret patterns and triggers, and understand behavioural fluctuations, enabling the Learning Disability Team to review behaviours remotely, offer timely guidance, and support care planning more effectively. Staff were also able to bring clear, structured behavioural data into MDT discussions and discharge planning, resulting in a smoother and more accurate handover to community partners.
As a result, the patient was appropriately supported to move into a more suitable community care setting, aligned with his ongoing needs.
The patients family expressed strong confidence in the process and his eventual placement:
“He looks the happiest we have seen him in a while… the discharge went smoothly.” - Family Member
Ged Jennings -
Learning Disability Acute Liaison Nurse and Project Lead for Behaviours of Concern
“Seeing so many staff using Melo and hearing their positive feedback is fantastic. It’s helping us understand our patients better and improve their experience in hospital.”
🎥 In Their Own Words
Hear reflections surrounding Melo and our ongoing partnership with LUHFT from Ged Jennings.
Melo™ is helping clinicians across the UK reduce admin, unlock insight, and improve care.
Get in touch with us to discuss implementing Melo™ in your organisation.
