What makes a good hospital ward?
The views of the patients and their families are essentially important.
Three key components of high-quality ward care are important to patients: communication, staff attitudes and hygiene.
Communication
Patients are dependent on staff to keep them abreast of investigations and treatments – both results of previous ones, and information concerning ones that are planned.
They value prompt communication. At the same time, the recognise that treatment plans may frequently change; sometimes for reasons outside of their teams’ control.
It is important to patients to speak to one team member; and have that conversation disseminated promptly to the rest of the team – for example, on this good ward:
“I have found you’ll be speaking to one person – and it could be a nurse or a doctor or anybody else – and at the end of the day, everybody knows what I’m talking about. So you can communicate with (just) one person .. it’s a vital thing”
Staff attitudes
The second element of high-quality care is staff attitude. How staff go about their work – e.g. staff attentiveness, or ‘service’ – influences whether patients feel they are on a good ward.
Adjectives like ‘jolly’, ‘respectful’ and ‘helpful’ are used by patients to describe a good ward’s performance:
A good ward is helpful to patients, and feels human, not a machine .. you understand?”
I think it’s the attitude of people that makes a good ward. It’s the main thing.”
Thus, the manner of care delivery is more important than the resources available for it; and this largely defines the care experience.
The corollary of this, is the potential for a major change between one shift and the next, even on the same ward.
But on a good ward, there is little difference between shifts, i.e. there are not ‘good’ or ‘bad’ shifts:
Where it changes more than anything else is at night, when you have a complete change of staff. Sometimes the night staff that come on are absolutely fantastic, and are very engaged”
As well as analysing their own interactions with staff, patients and families are keen observers of the working relationships between different professionals on the ward.
Whether staff seem appreciative of each other’s efforts, or are openly disrespectful to one another, causes patients to wonder how they too are being treated:
You might think the more staff, the better the person feels, and that is not how I feel. Everything depends on the lower level(s) of staff they have working on the ward .. and if their position is respected by the doctors and more senior people”
Hygiene
In a similar vein, patients and families expect high standards of hygiene on a good ward. First of all, good hygiene is de facto evidence of a ward providing safe care, with little risk of iatrogenic infection.
Patients and families are very conscious of the possibility of hospital-acquired infection, understanding it as a major risk associated with inpatient care.
Minimising that risk relaxes patients, making it possible for them to focus on the acute medical or surgical issues at hand.
Secondly, good hygiene serves as a deeper marker of staff pride, diligence and attention to detail, all of which are reassuring:
“The cleanliness aspect, I think, is .. more important than people realise. It sets out a marker .. of the mindset of the ward, i.e. ‘we are proud of the place that we work in’.”
Summary
We have described what makes a good hospital ward, in the eyes of patients and their families. How does your ward perform on these criteria? We hope this has been helpful.
Other resource
The information in this article is based on this research paper: Pannick, 2019
