Orientation Program: Team Member Safety in the Community

1. The Community Environment: A Reflection of Society

A knowledge of the community is key to safety-related initiatives in providing home care visits to people in varying neighborhoods and areas. Sadly, we only have to watch the news to hear that there is another random shooter or other dangerous and scary event. This chapter seeks to help answer the question: what if? The Centers for Medicare and Medicaid Services (CMS) established national emergency preparedness requirements for all organizations, such as home care and hospice, participating in the Medicare and Medicaid programs. In the State Operations Manual (section 484.22) are the related Conditions of Participation for Home Health Agencies (HHAs). These became effective in November, 2017. The bottom line is that we have an important role to play and that we must be prepared, whether the emergency be caused by nature, such as ice storms, tornadoes, or hurricanes, or other situations, such as an active shooter situation.

2. The Windshield Assessment: Assessing and Observation by Driving Around

There is a method of assessing a neighborhood or community through an effective and detailed Windshield Assessment. This seemingly simple process can identify much information about a given neighborhood or area. This windshield assessment is accomplished to identify possible safety hazards and risks for both the clinicians and their patient populations.

3. Driving and Identifying Safety Concerns in the Community

The fundamentals for home visit safety begin on the road. This includes a car in good working condition, a method for getting roadside assistance, having a full tank of gas, not leaving your purse on the passenger seat where it can be seen, and not leaving patient records where patient information might be seen (HIPAA). This also includes looking around your car for safety concerns on getting in and out of the car. These and other common safety concerns will be addressed in this chapter.

4. Safety Hazards in the Patient's Environment of Care: The Home

There are a number of common and known hazards in homes. The home care clinician must have an awareness of their surroundings at all times in the community and in the patient's home. Hazards found in the home can include dangerous pets, smoking, poor structural maintenance, infestations, unclean homes, blood-borne pathogens, unsafe water, tripping hazards, and many more. Others include risks to personal safety from violence, stalking, and abuse.

5. Being Safety Aware and Minimizing the Risks

Sadly, there have been instances of home care clinicians walking into situations that resulted in death and injury. These are related to the practice environment. This chapter seeks to educate and help minimize such situations, when possible.