Background/context Dying Matters (2014) suggests that many of us would like to die at home (70%) but that the majority of us die in hospital (50–60%). Unfortunately, the experience of being treated with dignity and respect is lower in the hospital compared to other settings (VOICES 2014). We also know “How people die remains on in the memory of those left behind” (Dame Cicely Saunders). To help improve the memory and experience of the final hours in the hospital setting, a hospital trust, working with local hospices decided to implement the rose project. This was based on previous work done by Hospice Friendly Hospitals (Ireland) and The Royal's Alliance Bereavement Service.

Aim of the rose project “To promote dignity, respect and compassion at the end of life. The rose symbol is displayed when a patient is expected to die in the next few hours or when a patient has just died – to encourage an atmosphere of quiet and respect at this significant time. On seeing the symbol, staff should be considerate in their activity and in any encounters with people who may be grieving or distressed.”

Approach used Staff were involved in the development of guidelines relating to the use of the rose. Project aims were shared across the Trust and training was given across different staff groups (clinical and non-clinical). The project was supported with funding from League of Friends (£7500).

Outcomes The rose project was rolled out onto the wards throughout the Trust and the impact monitored.

Conclusions The roll out of the rose project at the hospital trust helped promote interest amongst all level of staff to encourage a caring, compassionate environment at end of life.

Application to hospice practice Aspects of the rose project could be adopted by inpatient hospice units and the concept shared with care homes/hospitals with which hospices work.