Abstract
BackgroundThere is growing interest in the role of patients in improving patient safety. One such role is providing feedback on the safety of their care. Here we describe the development and feasibility testing of an intervention that collects patient feedback on patient safety, brings together staff to consider this feedback and to plan improvement strategies. We address two research questions: i) to explore the feasibility of the process of systematically collecting feedback from patients about the safety of care as part of the PRASE intervention; and, ii) to explore the feasibility and acceptability of the PRASE intervention for staff, and to understand more about how staff use the patient feedback for service improvement.MethodWe conducted a feasibility study using a wait-list controlled design across six wards within an acute teaching hospital. Intervention wards were asked to participate in two cycles of the PRASE (Patient Reporting & Action for a Safe Environment) intervention across a six-month period. Participants were patients on participating wards. To explore the acceptability of the intervention for staff, observations of action planning meetings, interviews with a lead person for the intervention on each ward and recorded researcher reflections were analysed thematically and synthesised.ResultsRecruitment of patients using computer tablets at their bedside was straightforward, with the majority of patients willing and able to provide feedback. Randomisation of the intervention was acceptable to staff, with no evidence of differential response rates between intervention and control groups. In general, ward staff were positive about the use of patient feedback for service improvement and were able to use the feedback as a basis for action planning, although engagement with the process was variable. Gathering a multidisciplinary team together for action planning was found to be challenging, and implementing action plans was sometimes hindered by the need to co-ordinate action across multiple services.DiscussionThe PRASE intervention was found to be acceptable to staff and patients. However, before proceeding to a full cluster randomised controlled trial, the intervention requires adaptation to account for the difficulties in implementing action plans within three months, the need for a facilitator to support the action planning meetings, and the provision of training and senior management support for participating ward teams.ConclusionsThe PRASE intervention represents a promising method for the systematic collection of patient feedback about the safety of hospital care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1919-z) contains supplementary material, which is available to authorized users.
Highlights
There is growing interest in the role of patients in improving patient safety
Randomisation of the intervention was acceptable to staff, with no evidence of differential response rates between intervention and control groups
Ward staff were positive about the use of patient feedback for service improvement and were able to use the feedback as a basis for action planning, engagement with the process was variable
Summary
There is growing interest in the role of patients in improving patient safety. One such role is providing feedback on the safety of their care. Within the UK, a series of recent reports all emphasized the need to elicit, understand and respond to patient feedback about care [1,2,3]. This focus has been mirrored internationally, with ‘Partnering with Consumers’ in Australia,[4] and ‘Better Together’ in the US [5]. The way health services asked for patient feedback was to focus on patient satisfaction and experience, but over the past decade, researchers and practitioners alike have begun to understand how patients may provide useful information to healthcare organisations about the safety of care [6,7,8,9,10]. We can measure patient concerns about specific safety issues but what has yet to be established is how or if these may be used to improve safety, or services more widely
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