Background
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.
Support for the Quality Mark
The Quality Mark is being developed by
a partnership of organisations including:
The Quality Mark is supported by:
|