• aged;
  • caregiver;
  • institution;
  • quality of care;
  • time series design

This study is part of a project that aimed to increase the participation of informal caregivers in the hospital care for elderly patients. The staff who worked in the wards that were studied created activity programmes for caregivers and changed their ward policies to encourage the participation of the caregivers. In addition, quality assurance programmes were developed and primary nursing was introduced to ensure individualized, need-based and family centred care. In order to explore the changes in perceived quality of care, and to test the differences in care quality between the study and the control wards (i.e. two wards in a university hospital, two wards in a geriatric unit and two wards of a nursing home), the interrupted time series with a non-equivalent control group time series design was used. During periods of 2 months in 1991, 1992 and 1993 the data were collected from elderly patients (n= 97) and their informal caregivers (n= 369) using a structured questionnaire based on need theories. The results indicated that the quality of care was improved, especially in the study wards of the university hospital and of the nursing home. This care quality measure was found to be a useful tool for getting feedback from patients and their caregivers concerning care given. Aspects of nursing practice that needed to be improved were identified (i.e. poor communication between the patient, their caregiver and staff, and lack of support to the patient and caregiver by staff).