Working Alone: The Risk of Lone Working with Home Healthcare Workers and the Effectiveness of Safety Voice in the Home Healthcare Industry

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Ogoegbunam, Kevin O

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East Carolina University


The purpose of this study was to investigate the risk of working alone (lone working) in the home health care industry and the benefits of implementing safety voice (speaking up behavior), to identify opportunities for effective intervention, with the goal to retain satisfied home healthcare. This study seeks to understand practical solutions to manage risks and improve both worker and patient safety. It is without a doubt that the employer must protect and take care of its employees by providing necessary facilities and ensuring the workstation is safe. However, most employees with a focus on lone working are spending much time in the field working all by themselves and most of the risks faced by these workers go unassessed, which places lone workers at higher risk of facing the safety risks given the fact that they work alone with no one to assist them in the workplace in case of an emergency. It is only logical to examine work organization in healthcare and home visiting healthcare specifically due to the emergence of home managed care, the priority given to cost containment, and conversions to for-profit healthcare institutions over the last two decades. Furthermore, the trend of moving long-term healthcare into the community represents a structural shift in the healthcare industry, which gives rise to the need of home health workers. Significant concepts emerged from this literature review on lone workers: risk perception of lone home healthcare workers; employee safety voice; organizations preventive and protective strategies for lone healthcare employees; and focus groups of home visiting health care providers. The results from this research will create awareness on the risk of lone working in general industry, with specifics in the home healthcare industry. Additionally, the results could be used to advise on efficient, safe lone-working measures and the use of employee safety voice to strengthen employee commitment to safe practices and awareness. The home healthcare workers (n=17) that contributed to this research were all selected because of their knowledge and experiences in the home healthcare industry. These participants have various career paths in the healthcare industry, ranging from physical therapists, occupational therapists to certified nursing assistants. All have substantial years of practical experience in delivering home health care to young patients and the aged communities. The participant's responses to the interview and survey question revealed the safety concerns, occupational hazards at the patient's home, and the need for employers to assess risk management on patients' home before these workers visit the homes.