Is patient safety in home care a myth?

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Statistics show that the chances of being harmed in an airplane are one in a million while there is a one in 300 chance of a patient being harmed while receiving health related care.

Harmful incidents that occur in the health care industry are known as Adverse Events, they are typically defined as unexpected and undesired occurrences which are directly associated with the care or services provided to a patient.

When you visit a hospital or clinic, are you looking to get sicker? Certainly not; but patient safety in the health care industry is a worldwide problem.

With hospitals, long term care facilities and retirement homes experiencing a surplus of patients; the world of health care is gradually shifting towards home care. As patients are discharged from the hospital, more and more are looking to receive continued care in their homes. Despite the limitations of our health care system, home care is increasingly becoming a preferred service. Based on a survey by the Ontario Home Care Association, about 88% of Ontarians prefer to be treated in their homes.

As our health care system moves towards home care one may ask, is care received in the comfort of one's home safe enough? Do home care organizations follow any patient safety procedures similar to hospitals and retirement homes?

In accordance with the Excellent Care for All Act 2010 (Ontario), home care organizations, like hospitals or long-term care facilities, are responsible for delivering the best quality care by placing the safety of a patient first.

Unlike hospitals, the home care environment may not witness life-threatening adverse events such as a surgery on a wrong part of the body but considerably serious adverse events can still occur. These events may result due to human errors, equipment failure, or poor living conditions. Some commonly witnessed adverse events are:

  • Medication errors
  • Injury from an injection needle
  • Experiencing falls due to wet floors, loose rugs or cables
  • Worsening wounds and ulcers due to lack of timely attention
  • Leakage from a patient's tubes or drains
  • Faulty medication pumps, wheelchairs and other medical devices

Adverse events are not only heart breaking for home care clients but also agonising for health care workers. Often clients and their families may worry about potential health problems that may occur due to the adverse event. While health care workers may experience fear, shame or guilt. The process of Disclosure of Adverse Events is recommended to promote a culture of safety, trust and quality improvement. Accordingly, a care provider must take responsibility for their actions, by speaking with the client when an adverse event occurs.

As a home care client, you can expect that the conversation regarding the disclosure of an adverse event will detail what happened, as well as explain the plan of care following the event. This will also be documented in your chart. You also have the right to request a transfer to another care provider or alternative care option if you are not satisfied with how an adverse event was handled.

In Ontario, safer and excellent care is not a privilege but our right; irrespective of who provides us the care.

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