Barriers to Effective Health and Safety Risk Management Programs for the Home Healthcare Setting

Purpose: The home healthcare sector is the fastest growing sector in healthcare, with a projected 66% growth over the next 10 years. This large and diverse workforce has one of the highest occupational injury rates, yet our understanding of the occupational health risks in the home care setting is limited. To address these gaps, several funded studies are exploring this issue. Our research team is focused on risk and risk management in the urban home healthcare setting.

Methods: Data from both qualitative and preliminary quantitative procedures collected during three procedures (shadowing, in-depth interviews and focus groups) were analyzed to identify barriers to effective health and safety programs.

Results: Barriers were noted at three levels: individual, organizational and home environment. At the individual level, lack of awareness of basic programmatic elements and the health hazards commonly associated with home care were identified. At the organizational (agency) level, barriers included lack of: hazard assessments, safety personnel, safety policies and procedures, and evaluation of reduction interventions. At the home environment level, a general lack of awareness of the factors that could increase the risk of injury or illness in the home health provider were noted. At all levels, language, culture, and a lack of resources, appear to affect risk.

Conclusion: For certain segments of the home healthcare industry, basic elements of health and safety program may be lacking. Industry-wide awareness is a necessary first step in developing a widespread safety culture in this sector.