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The culture of safety is strong at VNA Health, an in-home health care organization based in Santa Barbara, CA, providing home health care, palliative care, and hospice care. Working with both Joint Commission Resources and the Joint Commission Center for Transforming Health Care, VNA Health has continued to grow through a variety of projects aimed at improving their safety culture.

In April 2019, VNA Health implemented a culture of safety staff survey as a way of establishing a baseline measurement and finding opportunities for improvement. Says Mara Sorkin, CHC, Director of Compliance and Safety.

“Our agency leadership has always taken patient and staff safety really seriously. For example, we educate our staff about our incident reporting process; we document, investigate and resolve all our recorded incidents; we report our safety events to both our leadership team and our quality and compliance committee of our Board; and we offer a reporting hotline service for staff so they may anonymously report (by phone or online) their safety concerns.”


VNA Health Live WellKnowing that education doesn’t always translate into a culture of safety, the team decided to begin measuring it. They were surprised to find few if any safety surveys available for home health care agencies. Still, they forged ahead, modifying a hospital survey for their agency’s needs.


“We wanted to capture quantitative and qualitative data on our staff’s perception of our agency’s emergency preparedness since we’d recently survived several local disasters — wildfires, deadly debris flows and winter storm evacuations,” says Sorkin.


They shared the results with senior leadership, the Board of Directors and at an all-staff meeting. “We feel that transparent reporting is very important. We want staff at all levels to feel heard and that their concerns are being addressed.”

After a year and a half of consistent education and agency improvements, they repeated the survey in December 2020 to see how they had improved and also to track the staff’s perspective on how they responded to the pandemic. They were pleased with the changes since April 2019. A few notable improvements were:

Leadership demonstrates good cooperation between departments to resolve concerns” went from 57% in 2019 to 82% agree/strongly agree in 2020.

Leadership provides a work climate that promotes patient, staff and volunteer safety” changed from 79% in 2019 to 89% agree/strongly agree in 2020.

Leadership takes actions that show safety is a top priority” dramatically improved from 66% in 2019 to 91% agree/strongly agree in 2020.

Another patient safety tip that helped VNA Health during the pandemic was their close collaboration with the local public health department. The agency serves on the advisory committee for disaster healthcare coalition and was asked to participate in the region’s scarce medical resources committee to represent the local home health and hospice industry. The net result of synergy and collaboration was a win-win for the community: VNA Health was able to secure PPE for their staff and other facilities to ensure all patients at home were safe.

On a separate note, in the summer of 2020, VNA Health was approached to participate in a study with the Joint Commission Center for Transforming Health Care on using the Center’s falls tools in a home health care environment. “It was pretty exciting to be selected to help improve the safety and quality for our industry and our patients,” says President and CEO, Lynda Tanner, MSN, RN.

Along with several other agencies from across the country, the VNA Health team dove into the research phase only to find that there were not a lot of tools or research on preventing falls in the home health environment.

“As a result, we will be part of building those tools,” says Chief Operations Officer, Dusty Keegan, DPT. “We discovered that in a project like this, the Definition stage is the crux of the project. You can’t measure what you haven’t defined.”

“We feel that transparent reporting is very important. We want staff at all levels to feel heard and that their concerns are being addressed.”