Safe in your own home? – from a service perspective: A scoping review of important factors according to healthcare professionals in ensuring safe, public home healthcare
This summary encompasses 15 scientific studies conducted in Scandinavia between 2018 and 2023. The purpose of the summary is to identify, describe and summarise knowledge about the factors that healthcare professionals consider to be important for the provision of safe public home healthcare.
The following five thematic areas were identified:
- Person-centred interdisciplinary collaboration
- Competence development
- Organisational stability and flexibility
- Trust-based leadership
- Resource allocation
Person-centred interdisciplinary collaboration summarises how the included studies highlight the need for extensive changes in organisation and structure to ensure safe healthcare services to home-dwelling older persons. This includes changes to professional approaches and values, increased interdisciplinary collaboration, and a clearer clarification of responsibilities within and between service providers.
The studies indicate that extensive competence development is required in municipality-based home healthcare, both in terms of professional competence and leadership competence. To carry out satisfactory competence development, leaders will need to have an overview of each employee’s competence and competence development needs.
Safe services will require an organisation that provides flexibility to handle unforeseen events while ensuring service stability. Proposed measures include full-time positions and clear guidelines and procedures for service delivery and handling deviations.
Trust-based leadership refers to how the studies describe leadership of municipality-based home healthcare as extensive, challenging and complex, emphasising employee support, coordination and professional leadership as important elements. The need for leadership support and the strengthening of the leadership role are highlighted. A leadership style based on trust and proximity is emphasised, but is also described as having conflicting potential in relation to top-management’s need for control, efficiency and reporting.
Resource allocation is highlighted as a challenge in the services. Lack of time is identified as a hindrance to staying updated on knowledge, which poses a patient safety risk. A shortage of staff and/or a high turnover rate is a challenge, particularly when changing professional approaches. The included studies suggest that both service providers and recipients should have a more significant role in resource allocation.