PRASE: Patient Reporting and Action for a Safe Environment

PRASE is system for collecting patient feedback about how safe they feel whilst in hospital. It is designed to help staff identify things that are working well, and areas needing improvement. Feedback is collected using a patient safety questionnaire and a reporting tool (PMOS-30 and PIRT). With the help of PRASE hospital volunteers, patient feedback is collected using electronic mobile devices. Once enough information has been collected, a ward report is produced and guidance is provided to help make action plans and monitor their successes. 

As a PRASE Volunteer I feel that I am making a positive contribution to the care and safety that patients receive during their hospital stay. It is also nice to know that the ward staff also feel that this is a very worthwhile project, and they fully support it .

The hospitals who currently have PRASE volunteers are Hull Royal Infirmary and Bradford Royal Infirmary.

If you would like to join one of these teams, you will need to contact their voluntary service department and apply to undergo the trust volunteer training, and also some training specific to PRASE.

To give you an idea of the responsibilities and requirements of the PRASE volunteer role, we have produced a brief guide.

We have also captured some thoughts from some of our current volunteers in a short video - coming soon!.

If your hospital does not currently use PRASE, but you would like to get involved, please contact Sally-Anne Wilson at the Improvement Academy, and we can explore your options.

PRASE involves trained hospital volunteers collecting patient feedback.

A questionnaire - the ‘Patient Measure of Safety’ (PMOS) is used to collect patients' feedback about their care. It is based on factors (Yorkshire Contributory Factors Framework) known to be important for safety e.g. communication, resources, ward environment. A ‘Patient Incident Reporting Tool’ (PIRT) is also used to allow patients to provide detailed accounts of their experiences (good or bad).

Once feedback is collected from approximately 20 patients on a ward, a feedback report is generated for the ward teams. The teams then consider the feedback and make changes to try and improve the quality and safety of the care they deliver.

If you would like a copy of the PMOS (44 or 30 versions) and PIRT tools, please contact Sally-Anne Wilson at the Improvement Academy.

There are several papers about PRASE for further background reading.

If you would like to discuss how to implement this in real life, please contact Sally-Anne Wilson at the Improvement Academy, who will be happy to arrange to chat.

The Improvement Academy can offer some support in the setting up of PRASE in Yorkshire and Humber.

PRASE is being used on:

  • 6 wards with the support of 9 PRASE hospital volunteers at Bradford Teaching Hospitals NHS Foundation Trust.
  • 3 wards at Hull Royal Infirmary with the support of 2 volunteers.

During the initial implementation phase, separate action planning meetings have been happening to respond to the patient feedback reports. We are now moving to the embedding and spreading phase of the project. We are currently looking at how PRASE can be integrated into the normal workings of a ward/unit, and used alongside the other metrics that are routinely collected, such as Friends and Family the Safety Thermometer. We are supporting front line teams to test, implement and measure change.

New reporting software is due to be on line by January 2017, which will allow the frontline clinical teams to directly access their own feedback reports (currently the reports are generated manually at the Improvement Academy). Teams using PRASE will be integral to the testing and refining of this reporting tool.

We are looking to recruit other sites in Yorkshire and Humber that are keen to listen to patients’ feedback and implement improvements.

To come!

What we know so far:

  • 86% of patients asked were happy to provide feedback.
  • Most staff were keen to receive the feedback.
  • Volunteers can effectively collect the feedback.
  • To maintain volunteer input, visible/tangible improvements are required.
  • Staff find it difficult to commit the time to enable the required improvements.
  • Recurrent themes in the feedback are around communication and delays in treatment.

Staff who have been involved in PRASE share their thoughts of the positives and challenges encountered in using PRASE, there is a short video in production.

We asked patients what was important to them about the quality and safety of healthcare and then we used this information to develop tools (PMOS questionnaire and PIRT reporting form) to capture patient feedback during their hospital stay. We integrated these tools with facilitated ward-based action planning cycles to develop the PRASE intervention (Patient Reporting and Action for a Safe Environment)– an intervention that can be used by any hospital ward as a way of generating patient-centred improvement in quality and safety.

PRASE has been tested in a 33-ward randomised controlled trial with hospitals in Leeds, Calderdale and Huddersfield, and Harrogate. We found that patients were happy to complete these tools providing they could not be identified. Patients were also keen for this feedback to be used to improve services. Staff welcomed this feedback.

We have conducted follow-up studies to explore how the feedback can be collected on a routine basis, and by whom

We were interested in the potential for volunteers to collect feedback so we teamed with 3 Hospitals (Bradford, Barnsley and Hull) to test this with funding from the Health Foundation.

We also received funding from Leeds Teaching Hospitals Foundation Trust to explore the potential for medical students to collect PRASE feedback. Students reported that the exercise had broadened their understanding of safety, and they valued the opportunity for talking more broadly to patients than they usually do.

We now have a wealth of resources, experience and guidance on all aspects of the PRASE intervention, as well as the supporting software. As we continue to support teams to use and refine these materials, we will present them on this website along with case studies of their use.

More about PRASE

We have a short video giving some more information about PRASE.

PRASE publications

Further information

Dr Sally-Anne Wilson – PRASE Project Manager sally-anne.wilson@bthft.nhs.uk.

Involving Patients in Safety

Find out more about how we involve patients in other safety initiatives.