Wednesday, March 26, 2014

Management Support

One of the most important aspects of any safe patient handling program is support from the top levels of hospital administration. Employees appreciate knowing that managers care about their well-being and are much more likely to follow safe patient handling policies if management stands behind them. In Beyond Getting Started: A Resource Guide for Implementing a Safe Patient Handling Program in the Acute Care Setting*, a product developed through a previous Alliance between OSHA and the Association of Occupational Health Professionals, management leadership — combined with employee participation* — is listed as a key component for establishing a safe patient handling program.
At hospitals that have successfully reduced patient handling injuries, it is common to find administrators who support and promote a culture of safety. While weighing the benefits of investing in safe patient handling policies, procedures, training, and equipment, however, hospital administrators may need to fully understand how these investments impact their bottom line. Read OSHA's "Safe Patient Handling Programs: Effectiveness and Cost Savings*" to learn more.

Several case studies have shown that the initial capital investment in programs and equipment needed to safely handle patients can be recovered in two to five years, particularly when equipment purchases are coupled with training and policies to produce a lasting impact. Although there can be considerable equipment, training, and infrastructure costs associated with implementing safe patient handling, hospitals with successful programs have found that the long-term benefits far outweigh economic costs. Those benefits include:
  • Reduced injuries
  • Decreases in lost time and workers' compensation claims
  • Increased productivity
  • Higher quality of work life and worker satisfaction
  • Staff retention
  • Better patient care and satisfaction
Management support should encompass more than just the workers responsible for direct patient care. Departments such as laundry, maintenance, and engineering are vital to supporting safe patient handling, from maintaining equipment and supplying clean slings to troubleshooting facility design issues. It is also a good idea for management to talk to and collaborate with employees' union representatives, where applicable, before launching or expanding a safe patient handling program.

The following resources provide a business decision analysis framework for making the business case for a safe patient handling program:
  • In 2010, the Health Guidelines Revision Committee, Specialty Subcommittee on Patient Movement, published a white paper on Patient Handling and Movement Assessments*. Chapter 3 discusses the various benefits of instituting a patient handling and movement program, financing mechanisms, how to quantify the total costs and benefits for a particular facility, and the opportunity this creates to formulate new patient handling and movement alternatives that can increase the value of a program.
  • Celona et al. (2010) have been working to apply a value-driven enterprise risk management (ERM)* at Stanford University Medical Center. They assert that the total value potential of safe patient handling programs can be better understood, managed, and increased using a value-driven approach to ERM.

Thursday, March 20, 2014

MSD Assessment

The first step in addressing the issue of patient handling is to assess the size and nature of the problem. Comprehensive reporting of worker injuries helps ensure that you have the data available to develop your hospital's safe patient handling program. Here are some steps you can take to assess your safe patient handling concerns and needs:
  1. Review injury data for your facility. Injury data can be a useful diagnostic tool. Such data include the OSHA 300 Log; the OSHA Form 301 (Injury and Illness Incident Report); workers' compensation claim summaries; internal incident, investigation, and corrective action reports; and employee turnover and recruitment data. OSHA already requires many workplaces (including any hospital with more than 10 employees) to use the OSHA 300 Log to report serious job related injuries and to complete the Form 301 for every recordable injury. Recording an injury or illness in accordance with OSHA regulations is not a violation of the Health Insurance Portability and Accountability Act (HIPAA). The OSHA 300 Log and Form 301, available on OSHA's website, help to identify work areas or tasks where injuries frequently occur.
  2.  
  3. Examine your overall injury rates and see how you compare to others. Administrators and safety managers can use OSHA's self-assessment checklist* to examine your hospital's injury rates and compare them with national averages and high-performing hospitals. You can also visit the Bureau of Labor Statistics to learn more about injury and illness rates in hospitals and other workplaces nationwide.
  4.  
  5. Examine your patient handling injury rates and start to pinpoint areas of concern. Use OSHA's patient handling self-assessment tool* to review and reflect on the number, nature, and cost of patient handling injuries in your hospital.
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  7. Be proactive. A more forward-looking approach, to be used in combination with reviewing injury and illness records, is to be proactive in identifying potential problems that have gone unnoticed, before they result in injuries*. Observations of workplace conditions and work processes, job analyses, workplace surveys, and worker interviews are common proactive methods for identifying problems before they result in injury.

Friday, March 14, 2014

Reduce injuries, save money and improve patient care

A Safety and Health Management System

A safety and health management system (also known as an injury and illness prevention program) is a proactive, collaborative process to find and fix workplace hazards before employees are injured or become ill. Almost all successful systems include six core elements:

• Management leadership
• Employee participation
• Hazard identification and assessment
• Hazard prevention and control
• Education and training
• Program evaluation and improvement

Many hospitals already have these elements in place to comply with Joint Commission requirements for patient safety, and some have adopted a related set of “high reliability organization” concepts. It is a natural fit to extend the same principles to employee safety.
Fourteen hospitals participate in OSHA’s Voluntary Protection Programs (VPP), which require an effective safety and health management system. They have consistently kept injury rates below the national average. In general, the average worksite in VPP has
a Days Away, Restricted, or Transferred case rate that is 52 percent below the average for its industry.

Safe Patient Handling

Your hospital can address the biggest cause of workplace injuries with a comprehensive program to promote safe lifting, repositioning, and transfer of patients. Safe handling programs can include:
• Equipment, which can range from ceiling-mounted lifts to simple slide sheets that facilitate lateral transfer
• Minimal-lift policies and patient assessment tools
• Training for all caregivers or for dedicated lifting teams on properuse of the equipment

Several states require hospitals to implement safe patient handling programs, and more are considering it. Many tools, resources, and best practices are available to help you build or enhance your program.

By implementing a minimal-lift policy and other safety initiatives, Cincinnati Children’s Hospital reduced lost time days by 83 percent in just three years.

After investing $800,000 in a safe lifting program, Stanford University Medical Center saw a five-year net savings of $2.2 million. Roughly half of the savings came from workers’ compensation, and half from reducing pressure ulcers in patients.

Tampa General Hospital’s lift teams have used mechanical lifting equipment to reduce patient handling injuries by 65 percent and associated costs by 92 percent.

By implementing a safe handling program, a small hospital in South Carolina cut turnover of older nurses by 48 percent and saved $170,000 on associated costs.

Thursday, March 6, 2014

Workplace injuries and illnesses come at a high cost

When an employee gets hurt on the job, hospitals pay the price in many ways - some obvious, some not.

$15,860: the average workers' compensation claim for a hospital injury between 2006 and 2011, according to a national survey of roughly 1,000 hospitals.  Another data source suggests an average cost of $22,300 for claims involving lost time, compared with $900 for non-lost-time claims.  If your hospital self-insures (as a majority do), you will bear the full cost.  If you do not, your claim experience can still affect your insurance premiums.

The average hospital experiences $0.78 in workers' compensation losses for every $100 of payroll. Nationwide, that means a total annual expense of $2 billion!

24 percent of nurses and nursing assistants changed shifts or took sick leave to recover from an unreported injury.

$27,000 to $103,000 Estimate cost of replacing a nurse, including separation, recruiting, hiring, orientation, and training.  Some estimates also account for lost productivity while a replacement is hired and trained.  Injuries and stress are common reasons why nurses leave the profession.

Safer caregivers mean happier patients. Studies have found higher patient satisfaction levels inhosptals where fewer nurses are dissatisfied or burned out.  Patients who are handled with lifting equipment report an improved feeling of dignity - particularly bariatric patients.

8 of 10 nurses say they frequently work with musculoskeletal pain.