title: The patient reporting and action for a safe environment (PRASE) intervention: a feasibility study.
abstract: 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. 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.
  
  
  
  We 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.
  
  
  
  Recruitment 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.
  
  
  
  The 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.
  
  
  
  The PRASE intervention represents a promising method for the systematic collection of patient feedback about the safety of hospital care.
authors.affiliation: Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, England. Jane.o'hara@bthft.nhs.uk.|Leeds Institute of Medical Education, University of Leeds, Level 7 Worsley Building, Clarendon Way, Leeds, LS2 9NL, England. Jane.o'hara@bthft.nhs.uk.
authors.forename: Jane K
authors.initials: JK
authors.lastname: O'Hara
authors.affiliation: Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, England.|School of Psychology, University of Leeds, Lifton Place, Leeds, LS2 9JZ, England.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Lawton
authors.affiliation: Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, England.|School of Health Studies, University of Bradford, Richmond Road, Bradford, BD7 1DP, England.
authors.forename: Gerry
authors.initials: G
authors.lastname: Armitage
authors.affiliation: Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, England.
authors.forename: Laura
authors.initials: L
authors.lastname: Sheard
authors.affiliation: Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, England.
authors.forename: Claire
authors.initials: C
authors.lastname: Marsh
authors.affiliation: York Trials Unit, Department of Health Sciences, University of York, ARRC Building, York, YO10 5DD, England.
authors.forename: Kim
authors.initials: K
authors.lastname: Cocks
authors.affiliation: Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, England.
authors.forename: Rosie R C
authors.initials: RR
authors.lastname: McEachan
authors.affiliation: Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, England.
authors.forename: Caroline
authors.initials: C
authors.lastname: Reynolds
authors.affiliation: Department of Health Sciences/Hull York Medical School, Faculty of Science, University of York, Area 4, Seebohm Rowntree Building, Heslington, York, YO10 5DD, England.
authors.forename: Ian
authors.initials: I
authors.lastname: Watt
authors.affiliation: Yorkshire Quality and Safety Research Group, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, England.
authors.forename: John
authors.initials: J
authors.lastname: Wright
mesh_terms: D005240:Feasibility Studies; D005246:Feedback; D005260:Female; D006757:Hospital Units; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D010358:Patient Participation; D061214:Patient Safety; D006113:United Kingdom