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Abstract Background Many older people live at home, often with complex and chronic health and social care needs. Integrated care programs are increasingly being implemented as a way to better address these needs. To support older people living at home, it is also essential to maintain their safety. Integrated care programs have the potential to address a wide range of risks and problems that could undermine older people’s ability to live independently at home. The aim of this scoping review is to provide insight into how integrated care programs address safety risks faced by older people living at home - an area that is rather underexplored. Methods Safety was conceptualised as preventing or reducing the risk of problems, associated with individual functioning and behaviour, social and physical environments, and health and social care management, which could undermine older people’s ability to live independently at home. For this scoping review a systematic literature search was performed to identify papers describing integrated care programs where at least one intervention component addressed safety risks. Data were extracted on the programs’ characteristics, safety risks addressed, and the activities and interventions used to address them. Results None of the 11 programs included in this review explicitly mentioned safety in their goals. Nevertheless, following the principles of our conceptual framework, the programs appeared to address risks in multiple domains. Most attention was paid to risks related to older people’s functioning, behaviour, and the health and social care they receive. Risks related to people’s physical and social environments received less attention. Conclusion Even though prevention of safety risks is not an explicit goal of integrated care programs, the programs address a wide range of risks on multiple domains. The need to address social and environmental risks is becoming increasingly important given the growing number of people receiving care and support at home. Prioritising a multidimensional approach to safety in integrated care programs could enhance the ability of health and social care systems to support older people to live safely at home.

Introduction: While many different factors can undermine older people’s ability to live safely at home, safety as an explicit aspect of integrated care for older people living at home is an underexplored topic in research. In the context of a European project on integrated care, this study aims to improve our understanding of how safety is addressed in integrated care practices across Europe. Methods: This multiple case study included thirteen integrated care sites from seven European countries. The Framework Method guided content analyses of the case study reports. Activities were clustered into activities aimed at identifying and managing risks, or activities addressing specific risks related to older people’s functioning, behaviour, social environment, physical environment and health and social care receipt. Results: Case studies included a broad range of activities addressing older people’s safety. Although care providers felt they sufficiently addressed safety issues, older people were often concerned and insecure about their safety. Attention to the practical and social aspects of safety was often insufficient. Conclusions and discussion: Integrated care services across Europe address older people’s safety in many ways. Further integration of health and social care solutions is necessary to enhance older people’s perceptions of safety.

Background: Many older people live at home, often with complex and chronic health and social care needs. Integrated care programs are increasingly being implemented as a way to better address these needs. To support older people living at home, it is also essential to maintain their safety. Integrated care programs have the potential to address a wide range of risks and problems that could undermine older people's ability to live independently at home. The aim of this scoping review is to provide insight into how integrated care programs address safety risks faced by older people living at home - an area that is rather underexplored.Methods: Safety was conceptualised as preventing or reducing the risk of problems, associated with individual functioning and behaviour, social and physical environments, and health and social care management, which could undermine older people's ability to live independently at home. For this scoping review a systematic literature search was performed to identify papers describing integrated care programs where at least one intervention component addressed safety risks. Data were extracted on the programs' characteristics, safety risks addressed, and the activities and interventions used to address them.Results: None of the 11 programs included in this review explicitly mentioned safety in their goals. Nevertheless, following the principles of our conceptual framework, the programs appeared to address risks in multiple domains. Most attention was paid to risks related to older people's functioning, behaviour, and the health and social care they receive. Risks related to people's physical and social environments received less attention.Conclusion: Even though prevention of safety risks is not an explicit goal of integrated care programs, the programs address a wide range of risks on multiple domains. The need to address social and environmental risks is becoming increasingly important given the growing number of people receiving care and support at home. Prioritising a multidimensional approach to safety in integrated care programs could enhance the ability of health and social care systems to support older people to live safely at home. [ABSTRACT FROM AUTHOR]

Introduction: The topic of patient safety, which is traditionally viewed as preventing harm stemming from healthcare treatment, has been extensively researched in hospital and institutional settings. However, less attention has been given to addressing safety at home even though an increasing number of older people receive care and support at home, for example through integrated care programs. Care provided in the context of integrated programs for older people living at home differs from care in institutional settings in that it takes place in less controlled environments and often involves multiple health and social care providers as well as informal caregivers. Knowledge on safety in relation to integrated care is scarce. Therefore, this review aims to provide insight into how safety is currently being addressed in integrated care programs for older people living at home. Methods: This review adopted a multidimensionalperspective on safety, operationalised as reducing health risks by preventing predictable harm. These risks exist in various domains (e.g. patient characteristics and behaviour, patients’ physical or social environments, health and social care delivery). Papers describing integrated care programs where at least one intervention component explicitly aimed at safety were included in the review. Data were extracted on the safety components of the interventions and the domains they focused on. Results: Ten integrated care programs were included in the review. The extent to which these programs addressed safety varied. Programs addressed risks related to patient characteristics and behaviour (e.g. falls, substance abuse, medication adherence), or health and social care management (e.g. polypharmacy, care transitions). Several tools and interventions were used to promote safety, such as needs assessments, evidence based care plans, medication reviews and case management methods. There was generally less attention to risks related to patients’ physical and social environment, although one program specifically addressed home safety by providing a handyman. Discussion: The identified programstarget a variety of safety risks at different domains, and they differ in the extent to which safety is addressed from a multidimensional perspective. Currently, attention to safety is primarily focused on risks related to health care management and patient characteristics and behaviour, while risks related to people’s physical and social environments are less often addressed. Additional interventions, targeting specific safety risks, could be incorporated in integrated care programs in order to address safety more comprehensively. Conclusions and lessons learned: Only a few of the many integrated care programs for older people at home that are described in literature explicitly address safety. Within these programs, more attention is needed for the risks related to people’s physical and social environments. Limitations: Our review only included programs that explicitly addressed safety, as documented in the research literature. Therefore, we may have missed some programs that addressed safety if this was not clearly described in the literature. Suggestions for future research: Future research might focus on the effects of integrated care programs on the multiple domains of safety.

Introduction: The topic of patient safety, which is traditionally viewed as preventing harm stemming from healthcare treatment, has been extensively researched in hospital and institutional settings. However, less attention has been given to addressing safety at home even though an increasing number of older people receive care and support at home, for example through integrated care programs. Care provided in the context of integrated programs for older people living at home differs from care in institutional settings in that it takes place in less controlled environments and often involves multiple health and social care providers as well as informal caregivers. Knowledge on safety in relation to integrated care is scarce. Therefore, this review aims to provide insight into how safety is currently being addressed in integrated care programs for older people living at home. Methods: This review adopted a multidimensionalperspective on safety, operationalised as reducing health risks by preventing predictable harm. These risks exist in various domains (e.g. patient characteristics and behaviour, patients' physical or social environments, health and social care delivery). Papers describing integrated care programs where at least one intervention component explicitly aimed at safety were included in the review. Data were extracted on the safety components of the interventions and the domains they focused on. Results: Ten integrated care programs were included in the review. The extent to which these programs addressed safety varied. Programs addressed risks related to patient characteristics and behaviour (e.g. falls, substance abuse, medication adherence), or health and social care management (e.g. polypharmacy, care transitions). Several tools and interventions were used to promote safety, such as needs assessments, evidence based care plans, medication reviews and case management methods. There was generally less attention to risks related to patients' physical and social environment, although one program specifically addressed home safety by providing a handyman. Discussion: The identified programstarget a variety of safety risks at different domains, and they differ in the extent to which safety is addressed from a multidimensional perspective. Currently, attention to safety is primarily focused on risks related to health care management and patient characteristics and behaviour, while risks related to people's physical and social environments are less often addressed. Additional interventions, targeting specific safety risks, could be incorporated in integrated care programs in order to address safety more comprehensively. Conclusions and lessons learned: Only a few of the many integrated care programs for older people at home that are described in literature explicitly address safety. Within these programs, more attention is needed for the risks related to people's physical and social environments. Limitations: Our review only included programs that explicitly addressed safety, as documented in the research literature. Therefore, we may have missed some programs that addressed safety if this was not clearly described in the literature. Suggestions for future research: Future research might focus on the effects of integrated care programs on the multiple domains of safety. [ABSTRACT FROM AUTHOR]

Introduction: While many different factors can undermine older people's ability to live safely at home, safety as an explicit aspect of integrated care for older people living at home is an underexplored topic in research. In the context of a European project on integrated care, this study aims to improve our understanding of how safety is addressed in integrated care practices across Europe., Methods: This multiple case study included thirteen integrated care sites from seven European countries. The Framework Method guided content analyses of the case study reports. Activities were clustered into activities aimed at identifying and managing risks, or activities addressing specific risks related to older people's functioning, behaviour, social environment, physical environment and health and social care receipt., Results: Case studies included a broad range of activities addressing older people's safety. Although care providers felt they sufficiently addressed safety issues, older people were often concerned and insecure about their safety. Attention to the practical and social aspects of safety was often insufficient., Conclusions and Discussion: Integrated care services across Europe address older people's safety in many ways. Further integration of health and social care solutions is necessary to enhance older people's perceptions of safety., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2020 The Author(s).)