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Patient Safety First case study

How postcards that asked four simple questions improved patient feedback on safety


A postcard that patients can use to give feedback on their hospital experience is the latest measure adopted by a trust since it signed up to Patient Safety First


Keywords Patient safety, Patient feedback, Patient experience

With the aim of keeping patient safety a priority, Scarborough and North East Yorkshire Healthcare Trust has introduced a number of changes. We introduced a “patient safety postcard”, which we give to each patient who stays or attends Scarborough and Bridlington Hospitals. It has four questions that require yes or no answers (Box 1), with space where patients can write about the care they received.

We came up with the idea after receiving positive feedback from patients who completed a similar postcard about the levels of privacy and dignity they experienced. There was evidence to suggest that patients were much more likely to fill in a postcard than a lengthy paper questionnaire.

Feedback from patients to date has been extremely positive. We have distributed over 500 cards and have received around half back so far. Of those who have responded, 86% have answered ‘Yes’ to every question.


Box 1. Patient postcard

  • Did you feel safe in hospital? Yes/no. If no, please give further details;
  • Were you given enough information in relation to your hospital stay/treatment? Yes/no. If no, please give further details;
  • Was a member of staff readily available when you needed them? Yes/no. If no, please give further details;
  • Do you feel the physical environment was safe? Yes/no. If no, please give further details.


Part of a bigger campaign

While knowing that patients feel safe coming to the hospital is important, this is just another step in the patient safety journey we have been building on since signing up to Patient Safety First in summer 2009.

We signed up to it because we saw it not as a campaign that promotes targets but one that focuses on the quality of patient care. We felt it was headline news among the healthcare profession and wanted to become part of it. The interventions that we have focused on include leadership and reducing harm from deterioration.

Changes resulting from the interventions

Key changes made since signing up include:

  • Introducing a mortality group – the group meets on a weekly basis to review all the deaths in the hospital and see if there was anything we could have done better to improve patient safety;
  • Undertaking a staff survey on patient safety – we asked staff for their views and ways in which they thought we could improve. This gave us a real insight into how we could help ourselves and others to drive changes forward and to improve on things we already had in place;
  • Patient safety advocates – each ward or department nominates a patient safety advocate who attends a monthly meeting with the other departmental advocates. This enables staff to share ideas and agree how these can be taken forward;
  • Piloting a new, user friendly modified early warning score chart system. This is used to recognise the early warning signs of deteriorating patients, thus triggering intervention. This has demonstrated a clear improvement when applying the IHI Global Trigger Tool as part of the Leading Improvement in Patient Safety programme (see;
  • The publication of a patient safety newsletter - this will be circulated every month to all trust staff. It will also be in the public areas so that patients and visitors can see what we are doing to improve patient safety across the trust;
  • Patient safety executive walkrounds – as part of Patient Safety First’s leadership intervention, walkrounds by members of the executive board have been arranged every month. An information leaflet to accompany the walkround will go out to all wards and departments. The chief executive is scheduled to give a presentation to all ward and department managers to ensure a clear understanding of the aims and objectives of these walkrounds.

Showing progress

We are now hoping to host an event at the end of this year or early next year to highlight the importance of patient safety, in partnership with colleagues from our strategic health authority and the Healthcare Quality Improvement Partnership. Focusing on clinical audit results and changes to patient safety, it will also give us the opportunity to outline the progress we have made so far.

As part of my role as clinical governance manager, I am responsible for auditing our progress so what we will be revealing is: this is where we were; this is where we are; and this is where we hope to be. It will be a chance to share the progress made and show staff and patients alike that we are passionate about improving patient safety.

At Scarborough, we are committed to providing patients with the best possible care and to ensure that their safety remains our number one priority.

AUTHOR Helen Noble, BSc, DipHealth, RM, is clinical governance and patient safety manager, Scarborough and North East Yorkshire Healthcare Trust.

For more information on Patient Safety First, click here.


Readers' comments (2)

  • Jon Harvey

    Great idea! The small and simple ones are always the best! One thought - why not ask for comments from the 'yes' answers too - understanding what people appreciate is also developmental! (And the staff get a welcome piece of positive feedback too!)

    Jon Harvey

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  • Very goog idea I would rather like the idea to give opportunity for patients to write a few words of thanks with some of their comments starting from a general statement rather than from questions such as .... Folllowing your stay at .... hospital our team hope you felt that your privacy, comfort and safety were highly regarded at all times. Please do not hesitate to make any comments in regards of this statement. Thanking you for your time and honesty.
    I don't know how practical it would be. It is just an extension of a brilliant concept and idea. Well done guys!

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