Mapping a Research Agenda for Home Care Safety: Perspectives from Researchers, Providers, and Decision Makers

Macdonald, Marilyn; Lang, Ariella; MacDonald, Jo-Anne

doi:10.1017/s0714980811000055

Cited by 17 publications

(17 citation statements)

References 35 publications

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“…System problems such as equipment availability, continuity of care, training of HSWs, and communication difficulties were identified from the outset of the research conducted by this team 11,[20][21] and continue to surface in our research. It is important to note that these issues were also highlighted in the recent Health Council of Canada report on home care priorities for seniors in Canada 22 as well as recent studies by the Nexus project.…”

Section: Findings Related To Relevant Literaturementioning

confidence: 96%

Researching Triads in Home Care

Lang

Macdonald

Storch

et al. 2013

Home Health Care Management & Practice

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Home care demand in Canada has more than doubled in recent years. While research related to safety in home care is growing, it lags behind that of patient safety in institutional settings. One of the gaps in the literature is the study of the perceptions of home care triads (clients, their unpaid caregivers, and paid providers). Thus, the objectives of this qualitative study were to describe the safety challenges of home care triads and to further understand the multiple dimensions of safety that contribute to or reduce safety concerns for these triads. Findings indicate that clients, unpaid caregivers, and providers struggle in the home care system. Home care models that are client centered need to be considered to provide seamless, quality, sustainable home care.

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Section: Findings Related To Relevant Literaturementioning

confidence: 96%

Researching Triads in Home Care

Lang

Macdonald

Storch

et al. 2013

Home Health Care Management & Practice

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“…The number of comorbid conditions and the level of dependency greatly increased the risk of experiencing an adverse event. Patients can also be victims of abuse from family members, which might not always be readily apparent to care providers (MacDonald et al 2011 ).…”

Section: Adverse Events In Home Carementioning

confidence: 99%

“…There is also the possibility that home care staff may transmit infections between homes, particularly when patients have been discharged after contacting MRSA or C-diffi cile. Hand washing provides some protection but cleaning equipment in the home environment is challenging (MacDonald et al 2011 ).…”

Section: The Home Environment As Risk Factormentioning

confidence: 99%

Safety Strategies for Care in the Home

Vincent

Amalberti

2016

Safer Healthcare

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Patient safety has evolved and developed in the context of hospital care. The understanding we have of the epidemiology of error and harm, the causes and contributory factors and the potential solutions are almost entirely hospital based. Safety in home care is likely to require different concepts, approaches and solutions. Safety in this context has however been barely addressed and yet care provided in the home will soon become the most important context for healthcare delivery.The term 'home care' can encompass a variety of residential settings in which people are cared for by family, nurses and other professionals. In this chapter we use the term in a more restricted way to refer to the care of people in their own home, with varying degrees of informal and professional support. We focus on people with illnesses, usually chronic conditions, who are either living independently or being supported in their own homes by family or professional carers. Much healthcare is already delivered in the patient's home and this form of provision is growing rapidly. The benefi ts of home based care have been widely discussed, but the risks have not been fully articulated. In this chapter we fi rst briefl y summarise the background to the expansion of home care and then consider the nature and challenges for patient safety and the strategies that might help us manage risk in the home. An Ageing Population and the Expansion of Home CareMore than 20 % of citizens in developed countries will be over 65 in 2020. These people, while enjoying better quality of life than previous generations, will suffer from a variety of long term conditions. As we discussed earlier, patients with cancer, heart disease, dementia, renal and respiratory disorders may now live for decades with their disease. The most common causes of disability however are due to sight and hearing disorders which affect very large numbers of people and are particularly pertinent to safety in the home. As well as an absolute increase in the numbers of older people, there will also be a considerable relative increase. The socalled 'support ratio' -the ratio of people of working age to those over 65 -will

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“…Although a growing body of research [7,9,[19][20][21][23][24][25][26][27]] has begun to highlight the complexity and multidimensionality of home care safety there is a dearth of understanding of safety issues from the perspectives of clients and caregivers themselves, as well as from the providers who are responsible for managing and coordinating palliative care at home. As such, the research question guiding this study was: What are the experiences, challenges, and insights of adult clients, their unpaid family/caregivers, and their paid providers, regarding safety in palliative home care?…”

Section: Introductionmentioning

confidence: 99%

Client, caregiver, and provider perspectives of safety in palliative home care: a mixed method design

et al. 2015

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Background: Palliative care clients with complex needs are increasingly choosing to remain at home for their care. Home represents familiarity, presence of supportive family and friends, potential for normalcy and, a safe haven. The palliative care literature although robust is hardly ever linked with safety and home care. Patient safety has been focused predominantly on institutions without a corresponding level of research or safety initiatives in the home care sector. Although a growing body of research has begun to highlight the complexity and multidimensionality of home care safety there is a dearth of understanding of safety issues from the perspectives of clients, caregivers, and paid providers who are responsible for managing and coordinating palliative home care. The aim of this study was to describe the experiences, challenges, and insights regarding safety for adults receiving and providing palliative home care services. Methods: Mixed method design was used to capture the multiple meanings and influences on the broadened conceptualization of home care safety including emotional, social, and functional safety. There were three types of participants in this multi-site study namely palliative home care clients, caregivers, and paid providers. Individual interviews (n = 33) were conducted in the client's home followed by a photo "walkabout" to describe their daily experiences and routines. Focus groups, three with experienced professionals (n = 25) and two with home support workers (n = 11) were also conducted. Results: This study supports the broadened conceptualization of home care safety namely that: the safety of the client and caregiver are inextricably linked; the home is an unregulated and uncontrolled site for providing palliative home care in contrast to hospitals or other institutional settings; and clients and caregivers have the autonomy to live and take risks in their own home. Conclusion: To ensure quality in palliative home care and to mitigate safety risks the client and caregiver(s) should be considered as the unit of care; caregivers need to be better prepared and trained to manage the complexity of issues; and regular assessments are imperative to monitor and detect changes in the unit of care and their changing needs while respecting their autonomy to make less than safe choices.

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Mapping a Research Agenda for Home Care Safety: Perspectives from Researchers, Providers, and Decision Makers

Cited by 17 publications

References 35 publications

Researching Triads in Home Care

Researching Triads in Home Care

Safety Strategies for Care in the Home

Client, caregiver, and provider perspectives of safety in palliative home care: a mixed method design

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