AUDIT OF HOME CARE SERVICES: GAPS IN THE LITERATURE AND PROPOSAL FOR A STRUCTURED INDIVIDUAL ASSESSMENT TOOL

• DOI: https://doi.org/10.22533/at.ed.13176526040510

• Palavras-chave: health audit; home care; quality of care; patient safety; assessment tool; oncology.

• Keywords: health audit; home care; quality of care; patient safety; assessment tool; oncology.

• Abstract:

  Introduction: Home care (HC) is expanding rapidly in Brazil, requiring systematic mechanisms for monitoring the quality of care. However, the literature highlights a shortage of objective, validated instruments adapted to the reality of national home care (HC) for populations receiving home care with varying levels of complexity. International accreditation manuals—such as the Joint Commission International (JCI) Standards for HC—serve as benchmarks of excellence, but their length and complexity make routine application as an individual audit tool difficult. Objective: To describe the scientific gap regarding audit instruments for HC and to present an Individual Audit Form developed for the systematic on-site evaluation of patients receiving home care. Methods: A narrative review of the literature on home care assessment and audit instruments, followed by a report on the experience of developing and applying the proposed instrument, based on JCI standards, ANVISA regulations (RDC 11/2006), Ministry of Health Ordinance 825/2016, and clinical evidence. Results: A predominance of instruments focused on the physical environment and fall prevention was identified, with a lack of comprehensive and standardized models for integrated care auditing in home care. The proposed instrument is organized into 12 domains—covering infrastructure, medical records, continuity of care, medication safety, emergency supplies, dressing management, oxygen therapy, and effective communication—with 93 objective assessment items (Compliant/Non-Compliant). Conclusion: The Individual Audit Form fills a significant practical and scientific gap, offering an objective, adaptable, and easy-to-apply tool for systematic quality monitoring in home care, with the potential to guide validation studies and clinical governance policies.