1. Hospital pathways programme Listening to older people – understanding what matters Annie Laverty & Aileen Beatty

3. Dignity in Practice: An exploration of the care of older adults in acute NHS Trusts Win Tadd* Alex Hillman* Sian Calnan** Mike Calnan** Tony Bayer* Simon Read*

4. Environments designed to disorientate “One ward looked very much the same as another. If they’d moved me when I was asleep, I simply would not have known I’d been moved. It was like that.”

5. Organisational processes – main barriers to dignified care The perpetual movement of older people within and between hospital wards. The view that these patients should not be there anyway.

6. Core skill or specialism “We have forgotten the generalised humanity that we have to deal with. We want to partition everybody into their own ‘ism’ or their ‘ology’. What I’m trying to convey is that there are some aspects of patient need that we’re almost in denial about because somebody else specialises in it – but whoever it is, it ain’t me.” Trust Board member.

7. Influences on dignified care ‘Being addressed the way I want to be addressed. Being asked, not told. Having people working with me. Respecting my choices, my decisions. And if I’m able to control my situation, being allowed to do that without being judged and being seen as difficult – that is dignity.’

8. Access to assessment Dementia Delirium Depression Acute pathway algorithm

9. This is me

10. Expectations, hopes and fears Measure confidence levels Learning needs from staff viewpoint Reassurance

11. Practical solutions NutritionEnvironment

12. Intentional rounding Structured process where front-line staff regularly round on patients and reliably perform scheduled/required tasks Rounding with purpose - linked to an aim Measurable improvements

13. Improving the things that matter most

14. “ I just wanted to feel proud of the team and the care we provide here. Now I really am”

15. Our learning

16. Future plans Leadership for experience Systemic solutions Our quality strategy Trust board support for 3 year improvement plan

17. Thanks for listening Any questions ?