Hospital at home—safety for everyone!

I don’t know about you folks, but it seems like lately I’ve been hearing more about the expansion of the Hospital at Home concept, as the healthcare industry faces the challenges of dealing with patient volume under somewhat limiting/limited circumstances. As I’ve noted over time, I have yet to visit a hospital that was big enough to handle the increasing patient volumes, never mind the stuff you need to take care of those patients. (Somehow, I don’t think miniaturization is going to be the solution, but that’s a conversation for another day.) There are a fair number of complexities in being able to be allowed the privilege of providing care to acute patients in their homes (you can see a bit about that here).

But the prompting for this particular thought piece (such as it is) was a recent story about OSHA fines relating to a healthcare worker’s death in a patient’s home. This occurrence didn’t involve care for an acute care-level patient, but it still begs the question of how to manage the personal safety and security of caregivers who are providing services outside of the four walls of a hospital or other formal healthcare facility. Cover this with the overarching concerns related to workplace violence, it can make for a very challenging landscape for healthcare safety and security professionals. While we can certainly provide education to staff engaging in the delivery of care within the community at large, is it even possible to provide a threat assessment for all these potential care environments? We know all about the vulnerabilities within our own organizations, but how do we manage the environments of others for whom there is little, if any, ongoing oversight?

I don’t know that there’s any reason to think that the Hospital at Home concept will not continue to expand, so I guess we’re going to have to get creative in how we provide for the folks delivering “future” care. Anyone have any bright ideas? Let’s hear ‘em!


About the Author: Steve MacArthur is a safety consultant with Chartis Clinical Quality Solutions (formerly known as The Greeley Company) in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at

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Healthcare Staff, Workplace safety