No Place Like Home: Advancing Safety in the Home

The Institute for Healthcare Improvement and NPSF present an in-depth report on advancing the safety of care in the home.

The home is the primary site of care for many patients, and health care provided in the home is expanding as a result of rising health care costs, a rapidly growing older adult population, personal preference, and technological innovations.  However, patient and workforce safety in this setting is less well understood than in other settings.

Care recipients generally prefer to be at home and may have more autonomy in their own environment than in other settings. Care in the home is not without its challenges, however, and that may affect care recipients and everyone who supports them. Existing data suggest that preventable harm is an important concern in this setting. Home care workers and family caregivers may also experience physical and emotional harm as they provide care.

The Institute for Healthcare Improvement (IHI), with support from the Gordon and Betty Moore Foundation, is completing a two-phase project to better understand the
scope of patient safety issues in the home and identify strategies and best practices for improvement. In phase I, IHI enlisted a research organization to complete a
landscape analysis of the topic, which comprised a literature review and feedback from semi-structured interviews conducted with subject matter experts. Building on this work, in phase II IHI convened a, multidisciplinary expert panel to consider the challenges and opportunities related to advancing patient safety in this area and develop strategic recommendations for moving forward.

The panel’s recommendations are outlined in a forthcoming report, No Place Like Home: Advancing the Safety of Care in the Home.

Most notably, the panel identified five guiding principles to advance the safety of care in the home, as well as recommendations and specific strategies and tools to put each of these principles into action:

  • Principle 1: Self-determination and person-centered care are fundamental to all aspects of care in the home setting.
  • Principle 2: Every organization providing care in the home must create and maintain a safety culture.
  • Principle 3: A robust learning and improvement system is necessary to achieve and sustain gains in safety.
  • Principle 4: Effective team-based care and care coordination are critical to safety in the home setting.
  • Principle 5: Policies and funding models must incentivize the provision of high-quality, coordinated care in the home and avoid perpetuating care fragmentation related to payment.
IHI Patient Safety Congress
To hear a preliminary overview of report findings, please join us for the following break out session:
Workshop D2: Advancing the Safety of Care in the Home Setting: Findings from an Expert Panel
Friday, May 25, 2018 | 8:45 a.m. – 9:45 a.m.

Webcast: Advancing Safe Care in the Home Setting
To learn more about the full report and recommendations, join us for a complimentary webcast next month where expert panel co-chairs Alice Bonner and Stephen Muething will discuss new recommendations for advancing patient safety in the home setting. Continuing education credits available.
June 14, 2018 | 1:00 p.m. – 2:00 p.m. EST
Register and learn more here

Featured Speakers
Alice Bonner, PhD, RN
Massachusetts Executive Office of
Elder Affairs

Stephen E. Muething, MD
Co-Director, James M. Anderson Center
Professor of Pediatrics
Michael & Suzette Fisher Family
Chair for Safety
Cincinnati Children’s Hospital Medical Center

Tejal Gandhi, MD, MPH, CPPS
Chief Clinical and Safety Officer,

This project and webcast are funded by the Gordon and Betty Moore Foundation.The Institute for Healthcare Improvement (IHI) and the National Patient Safety Foundation (NPSF) began working together as one organization in May 2017. The newly formed entity is committed to using its combined knowledge and resources to focus and energize the patient safety agenda in order to build systems of safety across the continuum of care. To learn more about our trainings, resources, and practical applications, visit