The TOP 5 program acknowledges the value of carer information for people living with dementia and other types of cognitive impairment to improve patient outcomes and carer and staff experience.


Benefits to individuals with dementia and carers include increased compliance, more effective treatment, less distress and shorter lengths of stay.


Patients, carers and families are increasingly being recognised as important members of the health care team with carers often having knowledge that can aid health care professionals. TOP 5 encourages health professionals to identify up to a maximum of 5 non-clinical tips for effective communication and supportive care to promote safe personalised care. The information is then documented on a yellow TOP 5 form and made available to every member of the health care team.

The process aligns with the:

  • Australian Commission for Safety and Quality in Health Care (ACSQHC) National Safety and Quality Health Service Standard 2.2: Partnering with Consumers
  • NSW Carers (Recognition) Act 2010


In July 2012, the Clinical Excellence Commission (CEC) commenced the TOP 5 program, focussing on the care of hospitalised patients with dementia, in 21 hospitals across New South Wales. It is anticipated that the final report of the initial findings will be made available towards the end of 2014.

In May 2014, the program was expanded to look at the transfer of care and communication across health care settings. This will focus on a subset of 10 of the original hospitals (7 public and 3 private).

The CEC will be working with the 10 identified hospitals (primarily in the Emergency Department and pre-admission clinic) and their identified referral linkages in and out of the hospital setting, with the hospital acting as the hub. The TOP 5 form will accompany the person as they transition through healthcare settings, and assist in personalising their care (e.g. between Hospitals, RACF’s, Community Services and NSW Ambulance. This approach aims to assist transitions of care and improve communication between services. As there will be a focus on the transfer of TOP 5 information between facilities, NSW Ambulance service are involved at all levels.

For more information use the following link:

CEC Website - Partnering with Patients – TOP 5 initiative


  • Central Coast Local Health District was the originator of the TOP 5 concept.
  • HCF Health and Medical Research Foundation have provided funding for this initiative.

Key Dates

Pilot Sites

Implementation Sites

TOP 5 has been implemented in 7 public hospitals and 3 private hospitals in NSW (St Vincents Private Hospital, The Mater (Sydney) Private Hospital and Sydney Adventist Private Hospital).

Illawarra Shoalhaven Local Health DistrictShellharbour Hospital
Mid North Coast Local Health DistrictCoffs Harbour Base Hospital
Murrumbidgee Local Health DistrictGriffith Base Hospital
Nepean Blue Mountains Local Health DistrictNepean Hospital
South Eastern Sydney Local Health DistrictSutherland Hospital and Community Health Service
South Western Sydney Local Health DistrictLiverpool Hospital
Western NSW Local Health DistrictDubbo Base Hospital


A comprehensive ethics approved evaluation is currently under way and will be coordinated by the CEC. It will focus on process, clinical impact, carer and staff experience and acceptability.

Evaluation components will include:

  • Clinical and operational benefit measured by changes to the numbers of falls, use
  • of restraint and incidence of aggressive behaviour (pre and post implementation)
  • Impact on dementia/behaviour assessments
  • Impact on carer experience through surveys
  • Survey of staff experience and awareness of the initiative
  • Cost implications through local site liaison surveys

Related Initiatives

Further Details


Dr Karen Luxford
Director, Patient Based Care
02 9269 5519

Page Top | Added: 6 November 2013 | Last modified: 7 April 2015

Dr Karen Luxford
Director, Patient Based Care
02 9269 5519