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Who will data be collected from?
The Quality Mark establishes
how 'elder-friendly' a ward is by collecting data from different
groups of people:
-
Patients and their carers/family members report
their experience of the quality of essential care provided on the
ward.
-
Members of the ward team rate their morale, the
quality of leadership and teamwork on the ward and whether they
have the necessary skills, time and resources to meet the care
needs of frail older people. They also participate in structured
observations of care interactions.
- The
ward manager evaluates the access to specialist clinical
services for patients on the ward (continence care, dietary and
nutritional advice, physiotherapy etc) and the provision of support
services (cleaning, maintenance and supplies).
- A
lead clinician evaluates the support provided by the
hospital from the point of view of a member of the ward team.
-
Hospital governors provide an external,
independent view of the quality of the ward environment and of the
food provided for patients.
- The
senior managers of the hospital/trust provide evidence
that the board has shown leadership with respect to the care of
frail, older people and has reviewed information about the quality
of the care provided by the hospital to this group of
patients.
The assessment tools
The Quality Mark will
collect data from multiple sources to create a picture of how
‘elder-friendly’ a hospital ward is. The data will be collected in
three ways:
- Data
extraction from already existing tools, such as Patient
Environment Action Team Assessments (PEAT). This will create a
base of information about hospital and ward management.
- Questionnaire
feedback will provide information about how enabled the
ward and staff are to provide ‘elder-friendly’ care within the
hospital and how the patients find their inpatient experience.
- Observations of
staff and patient interactions.
The table below provide
information about the tools the Quality Mark will use and how the
information will be collected.
The Quality Mark structure
The Quality Mark is a 3
stage process. Wards must work through each stage to reach level 3.
Below is a brief outline of what is expected of a ward to complete
each stage of the process.
Each level of the Quality Mark follows
the same basic cycle. The diagram below shows a basic Quality Mark
cycle to achieve one level. The diagram includes guidance
of the length of time it should take to complete each step of
the cycle; however, these timings are flexible as some hospital
wards may require more time depending on the action points
identified. The diagram is explained in further detail
below.
Level 1 (Bronze)
At the point of sign up the
ward will submit contextual data and start working towards
achievement of the Quality Mark by completing a full set of
assessment tools, over a three month period.
Feedback will be received by month 5 and
will highlight areas for action planning. The ward will then
develop and submit an action plan identifying its top priority
actions. At this point (approximately 9 - 12 months from sign up)
the ward should have reached Level 1, the diagnosis
and formulation stage, and this achievement plus the top action
points will be displayed on the project website.
Level 2
(Silver)
The ward has 9 months from
completing Level 1 to begin implementing their action plan and
to carry out a second round of assessment, (data collection will
take 3 months to complete). This second round of assessment should
identify progress that has been made since the first data
collection. A certain percentage of patient/carer feedback, based
on ward throughput, must be achieved. The results from all
assessment tools are then summarised into indicators, which will be
received 2 months after data submission. This summary information
about the ward is made available on the project website. At
this point (approximately 18 - 24 months from sign up) the
ward should have reached Level 2.
Level 3
(Gold)
Over the next 9 months a
ward can work towards Level 3, by carrying out further assessment,
taking 3 months to complete, and providing evidence of completion
of the original action plan and improvements being made. At
this stage, the patient/ carer feedback is expected to demonstrate
high levels of satisfaction, and the ward will continue to
meet the percentage of feedback required established for Level 2. A
visit is made to the ward at this point to endorse the
achievement. The ward (approximately 27 - 36 months from sign
up) should have then reached Level 3. This information,
plus the updated indicators and ongoing patient/carer feedback on
satisfaction, is made publically available.
How much does it cost?
The Quality Mark aims to be an
affordable scheme to encourage the continuous improvement of the
care provided to older people.
The cost to sign up to the first cycle
in 2012 is £1,200 per ward for 12 months, which
includes 1 full day training programme for two members of staff,
from each ward, in the use of the PIE observation tool.
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