Abstract
BackgroundThe PRASE (Patient Reporting and Action for a Safe Environment) intervention provides a way to systematically collect patient feedback to support service improvement. To provide a sustainable mechanism for the PRASE intervention, a 2‐year improvement project explored the potential for hospital volunteers to facilitate the collection of PRASE feedback.ObjectiveTo explore the implementation of the PRASE intervention delivered in collaboration with hospital volunteers from the perspectives of key stakeholders.DesignA qualitative case study design was utilized across three acute NHS trusts in the United Kingdom between March 2016 and October 2016. Ward level data (staff interviews; action planning meeting recordings; implementation fidelity information) were analysed taking a pen portrait approach. We also carried out focus groups with hospital volunteers and interviews with voluntary services/patient experience staff, which were analysed thematically.ResultsWhilst most ward staff reported feeling engaged with the intervention, there were discordant views on its use and usefulness. The hospital volunteers were positive about their involvement, and on some wards, worked with staff to produce actions to improve services. The voluntary services/patient experience staff participants emphasised the need for PRASE to sit within an organisations’ wider governance structure.ConclusionFrom the perspective of key stakeholders, hospital volunteers facilitating the collection of PRASE feedback is a feasible means of implementing the PRASE intervention. However, the variability around ward staff being able to use the feedback to make changes to services demonstrates that it is this latter part of the PRASE intervention cycle that is more problematic.
Highlights
Improving the safety of health care remains a challenging task, with little evidence to suggest that the NHS is getting safer,[1] and estimates of adverse events remaining static over the past quarter of a century at approximately 1 in 10 hospital admissions.[2]
We aimed to explore the implementation of PRASE in collaboration with hospital volunteers from the perspectives of these key stakeholders, to gain an in-depth understanding of each ward’s PRASE journey, and a collective account of implementation
The implementation team facilitator recorded ward Action Planning Meeting (APM).C At the start of APMs, the implementation team facilitator confirmed with the participants that they were happy for the meeting to be audio recorded for evaluation purposes
Summary
Improving the safety of health care remains a challenging task, with little evidence to suggest that the NHS is getting safer,[1] and estimates of adverse events remaining static over the past quarter of a century at approximately 1 in 10 hospital admissions.[2]. Healthcare organisations globally have implemented a variety of different mechanisms to gather patient feedback, with some becoming routinely collected, such as the friends and family test within the United Kingdom. Such routine feedback gathering has not to date been designed to elicit the patient view on the safety of their care, despite it being widely accepted that patients can willingly and meaningfully provide such views to healthcare providers.[7,8]. Conclusion: From the perspective of key stakeholders, hospital volunteers facilitating the collection of PRASE feedback is a feasible means of implementing the PRASE intervention. The variability around ward staff being able to use the feedback to make changes to services demonstrates that it is this latter part of the PRASE intervention cycle that is more problematic
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