New Directions: Initial Steps Towards Elder-Friendly Hospital Wards

By Matron Karen Bowley
from the Dementia Project,
New Cross Hospital.


Ward D8 at New Cross Hospital are embarking on a project to improve care of the elderly services. RWHT staff are developing a number of ideas for improvements which were received in a Listening in Action event held on the ward. Some of these suggestions involve small changes with only minor costs while others entail larger projects that will require investment of one sort or other.

One of the simple small changes we have made already is to provide brightly coloured light weight cups for patient drinks. This enables patients to see their mugs easily and hold them more securely, giving patients more confidence to drink and thus improve hydration.

First Steps…

The name for the D8 quality improvement project was chosen from a selection of suggestions received in a competition for Dignity in Care Day on D8.

The name chosen is:

New Directions – the journey of a thousand miles begins with one step. (Lao-Tzu, 604 BC -531 BC).

The broad aims of the project are to work with patients, relatives and staff to improve services and outcomes for elderly patients, with a particular focus on:

  • Communication with compassion.
  • Assist patients to maintain independence, ensuring dignity.
  • Relieve pain effectively.
  • Encourage adequate nutrition.

This is in line with the “CARE campaign”, a joint drive by the Patients Association and Nursing Standard (RCN) magazine to improve fundamental patient care throughout the UK

The Quality Mark

Part of the project entails working with the Royal Colleges to define the quality of care for elder persons. The “Quality Mark for Elder-Friendly hospital wards” is a new initiative which seeks to identify the essential elements of care for older people on hospital wards and support staff to improve and gain recognition for the quality of care they provide. 

The scheme encourages consistent attention to essential care and continuous improvement through a three stage data collection cycle, during which wards put together an action plan, work on implementation and finally achieve their improvement goals.

Structure & Process

The Quality Mark creates an overall picture of how “elder-friendly” each ward is. This entails collecting information from patients, staff, the Ward Manager, a Lead Consultant, a team of Executives and senior hospital management. This information is collected through questionnaires and PIE, an observation tool developed specifically to look at the quality of care received by patients with dementia as it takes place.

Patient Feedback

Feedback from patients is a key component of the measurement of care quality. All older patients are asked to complete a brief questionnaire rating their comfort, food and drink, the support and help available from staff, and the respect shown for their privacy and dignity.

This is then linked to information provided by ward staff and leaders about morale and support for staff, skills and training, resources and the ward environment. Executives provide an outside perspective on the ward. Hospital level data provides information about the organisation the ward works within. D8’s Executive sponsor for the Quality Mark Project is Director of Nursing, Cheryl Etches.


The data collection is undergoing pilot in 6 pioneer Trusts; one of which is the Royal Wolverhampton Hospitals Trust (RWHT). Staff on Ward D8 at New Cross Hospital and on Ward 2 at West Park Hospital (Wolverhampton) are involved in giving out questionnaires to older patients, providing feedback via staff questionnaires, and undertaking observations of care.

The Ward D8 Manager, Sister Diane Williams, and Dr D’Costa at New Cross Hospital, working with the Ward 2 Sister, Althea Hibbert and  the consultant Dr Jawad at West Park Hospital, are leading the team in this work and will lead the action plan development.

Staff from the Trust are also invited to provide feedback on the process of implementing the Quality Mark and how it could best be used to improve practice.

For more information see:

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