Letter to the Editor - Importance of the Home Care Sector and the Critical Need for Research on Home Care
In an editorial earlier this year (Vol. 19, No. 1) Dr. Pringle eloquently described the importance of the home care sector and the critical need for research on home care. We applaud her commentary and are writing to share a recent initiative that identifies research priorities related to safety in home care. Patient safety has joined waiting lists as an issue of major concern in the healthcare sector. However, to date, much of the research on patient safety has focused on the institutionalized environment.
At a May 2006 invitational roundtable discussion co-sponsored by the Canadian Patient Safety Institute, VON Canada, and Capital Health (Edmonton), 40 key stakeholders from across Canada agreed that addressing safety in home care requires a major rethink of underlying assumptions and guiding frameworks that have been used to examine patient safety in the institutional environment. Roundtable participants concluded that research on safety in home care needs to: recognize that the safety of the client, family, unpaid caregiver and provider is inextricably linked; reflect the influences of an unregulated and uncontrollable home environment on the use of technology and the provision of care; and tackle the challenges of transitions, communication and continuity of care amongst an array of paid and unpaid providers. Overall, there was consensus that research on safety in home care is urgently needed including a national survey and in-depth qualitative studies to elicit the perceptions of what safety in home care means to those receiving and providing home care (Lang et al. 2006).
Nurses are poised to lead and contribute to research on safety in the home care sector. However, we suggest that several supports are required to promote and sustain research on safety in home care. First, the explicit identification of a home care focus in requests for proposals on patient safety will help to stimulate more research in this expanding sector. Second, it is essential that peer reviewers for patient safety research be versed in the home care sector and in the different research methodologies required to tackle questions in this domain. Advancing knowledge in this field will require both qualitative methods to deepen our understanding of the complex factors that may contribute to safety concerns, and quantitative methods to examine the effectiveness of strategies to improve safety in home care. Finally, educational institutions need to encourage graduate students to undertake research on patient safety and home care while clinical agencies should encourage students and faculty alike to join them in researching the many dimensions of the safety issues in home care.
About the Author(s)
Ariella Lang RN, PhD
CIHR-Postdoctoral Fellow, School of Nursing,
University of Ottawa
Nancy Edwards RN, PhD
CHSRF/CIHR Nursing Chair, School of Nursing and Department of Epidemiology and Medicine, University of Ottawa
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