Extrait

Background and aim Reports show that as many as one in ten patients are harmed while receiving hospital care. The recent NHS Mandate lists one of its core themes as: "treating and caring for people in a safe environment and protecting them from avoidable harm”, with the objective of reducing avoidable harm and embedding a culture of patient safety in the NHS by 2015. Strategies to improve safety have focused on developing incident reporting systems and changing systems of care and professional behaviour, with little involvement of patients. However, there has recently been a growing interest in involving patients in safety initiatives. Over the past three years, our research team at the Bradford Institute for Health Research have developed, tested and refined the PRASE (Patient Reporting and Action for a Safe Environment) intervention, which collects patient feedback about the safety and quality of care on hospital wards, and then uses this information as the basis for structured feedback to ward teams. The intervention has two related components – a survey of patients’ views of organisational safety (Patient Measure of Organisational Safety - PMOS) and a patient incident reporting tool (PIRT) for any immediate concerns or comments. The aim of study is to assess the effectiveness of the PRASE intervention at achieving patient safety improvements over a 12-month period. Who can participate? All patients aged 16 and over spending a minimum of two hours on the wards. What does the study involve? Hospital wards are randomly allocated to either the standard care or the intervention group. In this study we aim to recruit 2400 patients - over three time points, 800 at each time point - to give their feedback on the safety and quality of the hospital ward to which they have been admitted. Patient feedback about their experience of safety on the ward will be given to ward staff at the end of each time point through the format of a feedback report. Ward staff will then meet to consider the feedback in an Action Planning Meeting and make safety improvements or changes, as appropriate to the patient feedback received. Staff on intervention wards will be participants in a process evaluation - using qualitative methodology – to assess the fidelity of the intervention and to understand the experience of ward teams allocated to be in the intervention group. What are the possible benefits and risks of participating? The initially small study for PRASE has shown that patients value having their voices and experiences listened to and are pleased to be invited to take part in the research. Moreover, previous studies and our own pilot work have demonstrated that patients wish to discuss incidents, events and concerns. It is therefore anticipated this current project will be a positive experience for patients as it has been previously. In addition, patients involved in this project will be helping to inform the testing of a patient safety intervention which will most likely bring about local positive changes to the safety and quality of care delivered in the hospital wards in the intervention group. It is very unlikely that any significant risks or burdens should arise from participating in this research. The questionnaire tools used in this study are not onerous, taking on average 15 minutes of a patient’s time. For the staff involvement, we are asking staff to meet twice during a 16-month period, in a meeting which should last less than an hour each time. All participants will be advised that they can withdraw from the study at any time and decline to answer any questions they are uncomfortable with. Researchers will emphasise the strict confidentiality and voluntary nature of the research to all potential participants. As the nature of this research centres on patients' perceptions of the safety of their care, it is possible that some patients might raise issues regarding current unsafe or inappropriate practices that constitute an immediate safety concern for their care or that of others. The research team have developed a 'safety net' system that allows us to feedback important information to the ward – if the patient has not already made the ward aware – allowing them to act on the information in a timely and appropriate manner. The researcher will encourage the patient to inform a senior member of staff on the ward, or offer to inform a member of staff on behalf of the patient. Under our professional duty of care, if the researcher feels there is an immediate threat to the safety of the patient or others, the researcher we will be required to inform a senior member of ward staff. Where is the study run from? 33 hospital wards across three NHS hospital trusts in Yorkshire, England. The study is being led by senior researchers based at Bradford Teaching Hospitals NHS Foundation Trust (UK). When is the study starting and how long is it expected to run for? May 2013 to September 2014 Who is funding the study? National Institute for Health Research (UK) Who is the main contact? Prof. John Wright [email protected]

Critère d'inclusion

• Topic: Generic Health Relevance and Cross Cutting Themes; Subtopic: Generic Health Relevance (all Subtopics); Disease: Health Services Research

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