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Overview of the Quality Mark for Elder-Friendly Hospital Wards

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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:


Quality Mark Leaflet

This leaflet contains a summary of the information presented on this website. Click here to download.QM_leaflet_cover












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Tel: 020 3701 2682

Fax: 084 3659 3814


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