Best Practices for Ensuring Clinician Safety in Home Health
As the home health industry has grown, violence against caregivers has unfortunately become a significant concern, impacting the physical and mental health of clinicians, and contributing to burnout and high turnover rates that ultimately affect the quality of care delivered to patients.
In recent years, 65 percent of home care workers have reported experiences of verbal, physical, or sexual violence while performing their duties.1 On top of that, managing and preventing workplace violence can be especially challenging for agencies and staff due to the isolated nature of home health work. Unlike facility-based care, home health staff often work alone in unpredictable environments, increasing their vulnerability.
To protect workers, it’s essential for executive leadership to demonstrate a hands-on commitment to safety, one that reassures staff that their safety is prioritized alongside patient care. In this article, we’ll take a look at the scope and costs of violence in a home health setting, and what your leadership team can do to protect your workers.
The High Risk of Home Care Work
Did you know that being a home care worker is the second-most dangerous profession in the U.S., behind only law enforcement?2 In fact:
- Home care workers experience more than double the national rate of workplace injuries for all professions.3
- 75 percent of nonfatal workplace assaults occur in the healthcare and social assistance industries.4
- As many as 65 percent of home healthcare workers experience verbal abuse from patients.5
- 41 percent of home healthcare workers have reported sexual harassment.6
The Cost of Workplace Violence to Agencies and Staff
Workplace violence in home health is strongly associated with stress, depression, and burnout among nurses, along with high turnover rates.7 It also has far-reaching consequences that extend beyond the immediate safety and well-being of staff.
For leaders, it’s important to address this issue proactively because it directly impacts key operational metrics like costs, patient satisfaction, and the quality of care. When workers feel unsafe in a patient’s home or experience violence, this often leads to increased sick days, missed patient visits, and higher turnover. These disruptions not only strain staffing resources but can damage patient satisfaction and trust, leading to lower survey scores and potential harm to an agency’s reputation.
Best Practices for Ensuring Clinician Safety
Understand and Address Risk Factors
Understanding how and why violence occurs in home-based settings is key for developing effective prevention strategies. Common patient-specific risk factors include cognitive impairments, psychiatric conditions, and substance use disorders. Common situational and environmental risk factors include family members experiencing emotional distress, and external threats such as disruptive behavior or crime in the patient’s neighborhood.
Create a Culture of Safety
Workplace culture significantly influences how safety is perceived and prioritized. A culture that values clinician safety as highly as patient care can help shift the longstanding expectation that caregiving requires personal sacrifice. Leaders who prioritize safety encourage clinicians to prioritize self care as an integral part of delivering high-quality patient care.
When clinicians feel unsafe or unsupported, they are significantly more likely to leave their roles in pursuit of safer, less stressful work environments, which increases staffing challenges and disrupts patient care continuity. Transforming organizational culture includes normalizing open discussions about safety and reinforcing the concept that reporting identified hazards as well as more general concerns is both proactive and valued.
Promote Leadership Engagement
Ensure that safety is integrated as a core organizational value rather than a formality. Safety policies should be adaptable and relevant to the unique challenges of home health. Leaders must actively demonstrate their commitment to safety through visible actions and regular communication, beginning at the onboarding stage and continuing throughout the employee career journey.
Foster a Two-Way Dialogue
Encourage open communication and make it clear that employees can report safety incidents without fear of blame. Listening closely to the concerns of frontline workers using active listening strategies and acting on their feedback is essential for improving employee morale and understanding how to adjust and improve safety protocols.
Involve Frontline Workers in the Process
Include caregivers in safety committees to ensure that policies reflect the real-world experiences of those who face risks daily. Allowing staff to contribute ideas for safety improvements and ongoing training increases the relevance and effectiveness of policies.
Implement Regular Training and Education
Offer continuous safety training focused on verbal de-escalation, situational awareness, and basic self-defense techniques. Consider creating tiered training programs that provide in-depth instruction for those who encounter higher levels of risk.
Practice Effective Data Collection for Continuous Improvement
Develop systems for tracking safety incidents, near-misses, and employee feedback. Regularly reviewing this data can reveal patterns and trends that inform proactive adjustments to safety protocols and training.
Engage Community Resources
Engage local authorities in community safety efforts, particularly in high-risk neighborhoods, to help ensure faster response times during emergencies. This partnership can also promote greater awareness and protection for caregivers.
How Medbridge Helps
Medbridge offers a number of resources to help home health agencies understand and prevent violence against clinicians. These include:
New House Call Podcast Series: Protecting Our People
In this three-part series, Danielle Pierotti, PhD, RN, CENP, and Andrea Devoti, RN, MSN, MBA, discuss the role of leadership in preventing violence against home health workers. Learn more about the topics discussed in this article by listening to the series:
- Episode #1: The Scope of Home Health Care Workplace Violence
- Episode #2: Home Care Employee Risk Is Organizational Risk
- Episode #3: How Effective Leadership Can Reduce Violence Risk in Home Care
Course Series: Safety in Home-Based Care
In this three-part course series, presented by community mental health expert Quinn Tyminski, OTD, OTR/L, BCMH, home health clinicians learn the essential skills they need to navigate difficult situations and conversations, assess risk, and protect themselves.
- Safety in Home-Based Care: Communication Strategies
- Safety in Home-Based Care: Addressing Mental Illness
- Safety in Home-Based Care: Situational Awareness
Medbridge In-Home Essentials Solution
This comprehensive solution is designed to meet the needs of your entire home health organization. It offers effective onboarding, point-of-care skills training, continuing education, and refresher boosters focused on both clinical and soft skills for home health clinicians and leaders.
References
- https://nahc.org/wp-content/uploads/2024/02/Home-Care-Worker-Safety-Resource-Guide_FINAL.pdf
- https://www.mcknightshomecare.com/take-action-to-prevent-home-care-workplace-violence/
- ibid
- ibid
- ibid
- ibid
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4308913/
