Running home healthcare operations in Dubai

Home care can be a standalone service or an add-on. Existing facilities such as clinics, hospitals, laboratories and long-term care facilities apply through Sheryan. A standalone home healthcare facility still has to meet DHA's design guidelines, and DHA treats it as a licensed facility with premises:

• The licence displayed at the central office or main facility
• A charter of patient rights and responsibilities at the entrance, in Arabic and English
• A list of active and non-active patients kept in the office
• Documented evidence of laboratory services, equipment maintenance, medical waste management, transfers and multidisciplinary decisions

Competition is worth a look too. In DHA's capacity plan, 52 home healthcare agencies completed its 2022 survey, and 40 of them were in sector 3. The plan also calls for expanding home care programmes for long-term care to meet growing demand. The data is several years old, so check it against what you find today.

DHA makes the facility responsible for arranging transport for professionals to conduct home visits, and for ensuring their safety. There must also be a policy on protecting and keeping staff safe.

The standard does not set vehicle types, routes or travel times. Those choices are yours, and this is our view of what to settle before launch:

• Service area: define it in writing. Dubai is large, and long journeys eat clinical capacity.
• Vehicles: decide on your own fleet, drivers or contracted transport, and who is responsible when a nurse is stranded.
• Parking and access: gated communities and towers can add time to each visit.
• Lone working: check-in times, a way to raise an alarm, and what staff should do if a home feels unsafe.
• Time: schedule travel, handover and record-writing, not just clinical minutes.

The medical director must also review incidents where staff were at risk, and put an improvement plan in place.

Your schedule has to reflect several rules at once:

• A physician's face-to-face assessment before any new patient starts
• The 1:3 ratio of registered to assistant nurses
• Registered nurse visits weekly or biweekly, depending on acuity, plus occasional unscheduled ones
• Staff working only within their scope and privileges
• Records completed within 24 hours

Telehealth can reduce journeys, as DHA says teleconsultations can complement in-person visits and reduce the need for frequent home visits. Those consultations must be fully documented and follow DHA's telehealth rules, and should be provided by a DHA-licensed physician. A facility also tracks telehealth use as one of its KPIs.

All medical equipment used in home care must be approved by MOHAP. You need a written plan covering:

• Acquisition and selection
• Tagging and inventory
• Breakdown and preventive maintenance
• Safety testing and performance checks
• Recall procedures
• Handling compressed gases

Equipment should be tested before use, with the result and a re-test date on record. Since kit travels between homes, also plan how it is cleaned between patients and how you keep track of what sits in which house.

Pharmareg UAE handles medical device registration if a product you want is not registered yet.

You need documented medical waste management to Dubai Municipality requirements, along with written infection control policies. The standard's appendix lists policies that include safely handling sharps and needles, handling clean and contaminated linen, and managing occupational exposure.

Hand hygiene follows DHA's Health Facility Guidelines. Keep safety data sheets for the chemicals you use, and train staff on them. Assistant nurses may also transport specimens such as blood and urine, so decide how samples stay safe and reach the laboratory on time.

Version 2 changed this from a recommendation. Standalone home healthcare facilities and home renal dialysis facilities shall be accredited within 24 months of getting their licence. Existing standalone facilities had a 24 month grace period from the date of publication.

Accreditation must come from an approved body such as JCI, Accreditation Canada, ACHSI or EIAC, with the certificate uploaded to Sheryan. For add-on home care services it remains recommended. Start early, because accreditors will want months of records showing that your systems work.