Putting the patient at the heart of patient safety Bradford Teaching Hospitals NHS Foundation Trust

Evidence suggests that as many as one in 10 patients are harmed while receiving hospital care, and that the majority of these incidents are preventable. There is a growing interest in involving patients in safety initiatives, and in their potential contribution to the quality and safety of their own care.

However, until recently there has been no evidence-based approach for the systematic collection of such feedback from patients in hospital ward settings.

The PRASE intervention was developed to address this need. The intervention provides acute health care providers with theory and evidence-based measurement tools for the routine collection of feedback on the safety of care from patients, as well as a framework for staff to interpret and act on that feedback.

PRASE data has previously been collected by research nurses. However, this Closing the Gap in Patient Safety project tested a novel approach of using hospital volunteers. The PRASE initiative was implemented across three NHS trusts in the Yorkshire and Humber region.

Evaluation of the project was carried out by the Bradford Institute for Health Research. It assessed the feasibility and acceptability of hospital volunteers collecting patient feedback on safety, and whether the data collected led to improved patient safety.

Evaluation methods used included focus groups with hospital volunteers and interviews with voluntary services, patient experience and ward staff.

The evaluation found that volunteers were able to successfully collect data from patients on safety; that their role was highly valued by staff; and that their contribution to the PRASE intervention was recognised. A significant investment of time was required initially to support recruitment, retention, management and support for volunteers.  

PRASE had the most success where relations were good between staff and volunteers, the feedback was timely, and staff met to consider the feedback from patients. Problems arose when the data were not timely, or when there was too much data and staff felt overwhelmed. 

The process of frontline staff acting on the patient feedback gathered by volunteers was found to be variable and complex, and difficulties in moving from measurement to action were a key constraint. This lack of action on the data, as well as the complex nature of the hospital wards, meant it was not feasible to determine the impact of PRASE on safety outcomes.

Further work is now required to focus on what can be done to support staff to engage with, and use, patient feedback.

Contact details

For further information about the project, please email Chioma Obasi, Bradford Teaching Hospitals NHS Foundation Trust or Jane O’Hara, Bradford Institute for Health Research.