Patient Safety in the Home: Assessment of Issues, Challenges, and Opportunities

Carpenter D, Famolaro T, Hassell S, Kaeberle B, Reefer S, Robins C, Siegel S. Patient Safety in the Home: Assessment of Issues, Challenges, and Opportunities. Cambridge, MA: Institute for Healthcare Improvement; August 2017. (Available at ihi.org)

The health care system continues its shift away from its historically predominant focus on inpatient care, driven by economics, demographics, patient preference, and technology. Yet, patient safety in the home care setting is less well understood than patient safety in other settings.

Challenges related to patient safety in the home are wide ranging and include fragmentation of care; household hazards; ill-prepared family caregivers; limited training and regulation of home care workers; inadequate communication among patients, caregivers, and providers; and misaligned payment incentives.

Background

The Institute for Healthcare Improvement / National Patient Safety Foundation, with support from the Gordon and Betty Moore Foundation, contracted with Westat to evaluate research on patient safety in the home and identify gaps. Based on a scan of peer-reviewed and grey literature and subject matter expert interviews, the project examined safety issues in the home, including challenges, funding mechanisms to support safe home care, and conceptual frameworks that seek to structure these disparate issues. This report concludes with opportunities for research to advance the science of patient safety improvement in the home.