Proactive Risk Monitoring in Healthcare (PRIMO) is a useful tool for identifying and monitoring factors that may contribute to patient safety incidents so that an effective action plan of improvements can be put into place. It is a proactive rather than reactive tool for patient safety and can be used to compliment already existing processes of incident reporting and analysis. 

In essence, it involves identifying problems in the pharmacy environment, asking staff to complete a questionnaire and producing an action plan. It should be a cyclical process so PRIMO should be undertaken, changes should be made and then PRIMO should be repeated.

The tool focuses on how people operate within their place of work, rather than the details of specific patient safety incidents. This may mean that pharmacy staff feel more comfortable using the tool than when they are exploring specific incidents. In addition, the questionnaire can be completed anonymously, which can help manage any possible fear of consequences.

All members of the team can be involved in the PRIMO process. This can help them to engage with the process and feel that they own it. It may help in overcoming any perceptions that PRIMO is purely a management tool. 

PRIMO explores a wide range of factors in the local work environment and therefore provides great depth and breadth of contributory factors to patient safety incidents. PRIMO can help pharmacy professionals understand more about the issues and themes that other incident analyses have already picked up.

This tool can be used to examine the work environment and practices across an organisation. An example of this is that it could be used to explore patient safety across different branches of a pharmacy. PRIMO could also be used to draw comparisons across different staffing groups, identifying differences in perceptions of safety across pharmacists, pharmacy technicians, pharmacy assistants and management. 

The tool can also be applied as a measure of improvement after implementation of changes to practice, which can prove useful.