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What exactly do doilies, ballet dancers and jelly have to do with Quality Improvement and how can they possibly reduce harm for residents living in care and nursing homes?

The Prosper project is working with residential and nursing homes across Essex, to reduce the number of falls, pressure ulcers and UTI's through the use of Quality Improvement methodology - not only improving system performance and professional development, but also changing behaviours -

encouraging creative thinking to tackle the problems and then using measurement to guide improvement.

PROSPER interventions include;

  • Small changes lead to big improvements. Building care staff capability using Quality Improvement methodology of PDSA cycles (plan, do, study, act), SMART aims and driver diagrams. Testing simple interventions such as 24hr falls clock, compact mirrors to check Pressure Ulcers, Hydration Umbrellas, silicon doily's to signify prompting of fluids, decorated walking frames for people living with Dementia and imaginative ways with Jelly to name but a few. It also encourages reflective practice, looking at systems, procedures and staff education to identify areas where improvements could be made. 
  • Measurement for improvement purposes. Making data collection and analysis core to everyone's role, with staff taking ownership and knowing the bigger picture. Using the Safety Cross and monthly mapping data tool to first identify the focus for a SMART AIM then track whether a change has brought about an improvement.
  • Culture is Key. Changing behaviour by empowering care staff to think creatively and act differently, giving them the permission to try new things and education on falls, pressure ulcers and UTI's.  Our Prosper Champion Study Days and Community of Practice events provide an opportunity for Managers & care staff to share ideas, network with other homes and learn new skills.

Prosper has now expanded into Adult with Disability services as well as for Older People Residential Care and Nursing Homes 

This initiative inspired ideas such as Pimp My Zimmer and Light My Night.  

Video of Pimp my Zimmer   

Video of Light My Night     

Prosper was originally funded by the Health Foundation as part of its Closing the Gap in Patient Safety projects. An evaluation of the first two years was undertaken by UCLPartners: 

Prosper Evaluation Report

Royal Society of Medicine

BMJ: Assessing the Safety Culture of Care Homes


Winners of the National Patient Safety Awards 2019 for Improving Care for Older People

Winners of the National Patient Safety Award 2016 for Changing Culture in Patient Safety.


If you would like to be part of Prosper please email Prosper@essex.gov.uk

Every month the team produces the Prosper Newsletter to keep you informed of latest news and future activity.

Last updated: 03/04/2024