Institute for Healthcare Improvement: 5 considerations for making home healthcare safer

A nurse holding the hands of an elderly patient
Home healthcare poses its own patient safety challenges that need to be addressed, according to a new report. (Getty/Rawpixel)

As more healthcare shifts into patients' homes, it's crucial to address the unique safety risks posed in that setting. 

Everything from the layout and furniture within patients' homes can vary widely and pose risks that providers may not be prepared for, Tejal Gandhi, M.D., the Institute for Healthcare Improvement chief clinical and safety officer told FierceHealthcare in an interview. 

She was among 30 healthcare experts to weight in on a new IHI report which offered guiding principles for making home healthcare delivery safer.

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Tejal Gandhi IHI
Tejal Gandhi

"This is exactly the time we need to be thinking about this as payment models and care models are changing," Gandhi said. "These are all good initiatives, but we just have to make sure we understand that there could be risks, and think about how we manage those risks."

The report highlighted other patient safety hazards, such as the fact patient homes may not be outfitted with crucial technology, such as internet access, according to the report. 

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The report also focuses on making sure caregivers and any visiting home health providers are included in care discussions and supported by clinicians. Gandhi said that family caregivers need to be fully informed on a patient's care plan and receive support to prevent against burnout when caring for a loved one. 

"We talked a lot in patient safety about the healthcare workforce—support the workforce so they can give better care to patients," Gandhi said. "I think it's a very similar analogy to say we need to support the caregivers." 

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Among the five principles for improving safety, the panel recommended: 

  1. Build from a patient-centered foundation.
  2. Create and maintain a safety culture within home healthcare.
  3. Develop measurement structures and learning tools to further safety and prevention.
  4. Use a team-based and coordinated approach.
  5. Ensure policies and payment models incentivize high quality, safety home health. 

Gandhi said one of the panel's goals was to make it clear that ensuring safety in home healthcare isn't just a problem for home health agencies, and it touches providers across the continuum of care. 

For example, improved hospital discharge planning can lead to a much safer and smoother transition to home, she said, and improved coordination between organizations at different points in the patient care journey can better inform primary care doctors and hospitalists about the services available in their communities. 

"The whole healthcare system is driving care into the home," Gandhi said, "so we really need to think about care across the whole continuum, not just the hospital."