IHI Publishes Guide for Providing Safe Home Healthcare

Millions of people are recovering from acute illness or coping with chronic conditions in their own homes, but their care may not always be delivered under the safest of conditions, according to a new report from the Institute for Healthcare Improvement.

Care in the home is increasing due in part to rising healthcare costs, an aging population, patient preference and advances in technology that allow for some complex care to be administered locally.

Home care has its advantages—including greater autonomy for care recipients, lower risk of certain complications (such as sleep disruption) and lower costs—but IHI cautions that in order to achieve these benefits, healthcare providers must be cognizant of risks of harm in the home setting as well. Potential issues include injuries due to physical hazards or medical equipment, pressure injuries, infections, poor nutrition, adverse events related to medication or other treatment, potential abuse or neglect, and healthcare worker burnout.

To help promote safe, person-centered care in the home, IHI’s report outlined the following five guiding principles:

  1. Self-determination and person-centered care are fundamental to all aspects of care in the home setting.
  2. Every organization providing care in the home must create and maintain a safety culture.
  3. A robust learning and improvement system is necessary to achieve and sustain gains in safety.
  4. Effective team-based care and care coordination are critical to safety in the home setting.
  5. Policies and funding models must incentivize the provision of high-quality, coordinated care in the home and avoid perpetuating care fragmentation related to payment.

As the numbers of people receiving care at home continue to increase, we hope this report will serve as a useful reference for those committed to building on that foundation,” said Tejal K. Gandhi, MD, CPPS, chief clinical and safety officer for IHI.

—Adapted from “Health Care Services At Home Outpacing Attention To Safety,” by Joanna Clark, Institute for Healthcare Improvement, July 16, 2018.