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Home care is managed with extreme heterogeneity among Italian regions by healthcare and social services. Standardization and self-assessment of these activities can improve their quality and outcomes. The goal of the study is to develop and validate an accreditation tool that provides minimum standards for home care. A multidisciplinary group of health and social care professionals developed a new tool according to the Deming cycle, including 26 items for a total of 144 standards grouped in 6 areas: Organization&amp;governance (A1); Patient safety&amp;clinical risk (A2); Job description, knowledge and skills (A3); Communication&amp;information (A4); Integration tools in care processes (A5); Improvement&amp;innovation (A6). Between April and November 2019, 40 experts from Italian primary care and social services of Friuli-Venezia Giulia (FVG) and Veneto Regions were asked by email to evaluate the tool using Delphi methodology. Experts were asked to score each standard according to relevance and feasibility (RF) on a 1 to 9 point scale. RF and agreement among experts were considered good respectively when mean score was &amp;gt;7, and 70% of responses were greater than 7. A total of 21 experts' reviews were collected, with a response rate of 53%. Most responders came from the healthcare setting (71%) and FVG Region (86%). Globally, 101 standards (70%) were rated as good. RF mean and agreement resulted to be good for: A1 (7.6; 81%); A2 (7.4; 71%); A4 (7.5; 86%); A5 (8.0; 86%). More critical results were achieved concerning A3 (7.0; 52%) and A6 (6.5; 43%). Most standards were recognized as both relevant and feasible by experts, confirming the tool developed for home care accreditation. Agreement for Job description, knowledge and skills, and Improvement&amp;innovation areas seems harder to be achieved. The evaluation of detailed experts' comments would further improve the tool, and a pilot study will be implemented in the next future to test its reliability. Key messages The implementation of the home care accreditation could reduce inequalities among contexts, while helping quality and patient safety improvement outside healthcare facilities. The existence of a unique home care accreditation tool can foster the integration between health and social care while reducing hospitalizations.

How to scale up quality and safety program into home care: an accreditation tool proposal