Background of the Quality Mark
The number of finished
consultant episodes for people over 60 has dramatically
increased since 1999/2000. The
Hospital Episodes Statistics (2010) show an increased finished
consultant episodes of 66% for people over 75 and 48%
for people aged 60-75. These figures highlight the increasing
use of hospital services by people over 60 years of age. However it
has also been identified that older frail people are more
vulnerable to an adverse hospital outcome (Jarrett, Rockwood,
Carver, Stolee & Cosway, 1995).
When in hospital older people can suffer
cognitive decline and loss of mobility; resulting in impairment of
daily living skills. They are also at risk of developing continence
problems, pressure sores or healthcare acquired infections and
may become malnourished or dehydrated.
This only highlights the importance of older
inpatients receiving the very best quality, essential care in
a hope to reduce the chances of adverse outcomes for this
vulnerable group. Despite this,
Tadd et al. (2011) reported that hospital staff almost
unanimously agree an acute hospital is not the 'right place' for
older patients and acute wards are not 'fit for purpose' for
the treatment of older patients. In addition to this, the
Dignity and Nutrition Inspection Programme (2011) observed
staff speaking to older patients in a condescending or dismissive
way. However, this report also states that within a hospital it is
possible that one ward may be providing poor care whilst another is
providing good quality care.
With these findings in mind, the Quality Mark
has been developed for hospital wards to identify the standard of
care being delivered to older, frail patients and
highlight the ward's dedication to continuous improvement in
this area.
What is the Quality Mark?
The premise for the Quality Mark is that good quality care for
older people on a hospital ward requires:
The hospital/senior
management team:
- to identify the particular
needs of older people in the acute hospital setting and the risks
of admission;
- to understand basic care
requirements and acknowledge that high quality care for this group
of patients is a pre-requisite for achieving a good standard of
care overall;
- to support, enable and equip
ward managers to create a care environment that can meet the needs
of frail older people.
The ward manager and
lead clinician to lead, motivate and enable the
ward staff team to deliver high quality care to frail older
people.
The behaviours and actions of
the ward staff result in high quality care.
Patients and
carers to perceive all of the above coming
together into a positive experience of care.
The aim of this quality improvement
programme is to support and encourage wards to provide a
standard of care that can minimise or eliminate those risks arising
from an ill-informed or under-equipped approach to the basic care
needs of this group, which comprises up to two thirds of acute
hospital admissions.
The Quality Mark process assumes that the
multiple sources of data available at a hospital and ward level,
combined with ongoing feedback from patients, carers, staff and
ward managers, produce an overall picture of the quality of care in
which it is feasible to identify problems as they arise and to
highlight instances of good practice.
As a ward advances through the stages of the
Quality Mark, information on the wards' progress is made public,
including patient/carer satisfaction. This enables the spread
of good practice and encourages ongoing focus on quality
improvement in order to maintain an “elder friendly” status.
Support for the Quality Mark
The Quality Mark is being developed by a
partnership of organisations including:
The Quality Mark is supported by:
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