Leslie Pickett, PT

Ergonomics and Injury Prevention Specialist

Swedish Medical Center

Seattle, Washington

Washington State Governor’s Industrial Safety & Health Conference

Health Care PanelOctober 8, 2009

Ergonomics in the Healthcare Setting

Electronic Medical Records (EMR):

Pros: Cons:

• Time consuming / learning curb

• Equipment installation challenges

• Adequate number of available computers

• Hygiene• Training• ERGONOMICS!

Paperless system: save time hunting for charts

Quick access to medical records, lab results, imaging

Productivity / efficiency for staff

Decreased medical errors

Improved Outcomes

Increased Patient Satisfaction

EMR: Reasons for dissatisfaction

Poor Ergonomics

• Ergonomics in hospital setting is mostly based on single user “office set up” ergonomics.

• 24 / 7 user sites with need for adaptability

Poor Ergonomics

Five Rights of Computer Ergonomics

1. Right number of computers

2. Right location of computer

3. Right height adjustments

4. Right size monitor

5. Right resolution

Right Number of Computers

• No research to provide guidelines

• 1 fixed in every room vs. mobile?

Right Location of Computer

• Nursing stations only vs. in room only???

RN’s carrying around scrapes of paper with notes

Time lag in entering information

Physicians hunting down RN’s (instead of charts) to find info.

Right Monitor Size

• Eye changes starting in the 40’s.

• Larger monitors help decrease eye strain and fatigue.

• Decrease need to scroll down

• Research shows increase in productivity with larger monitor.

Right Computer Resolution

The higher the resolution the smaller the text

WOW – COW - COS

• Mobile computing : > 20 manufacturers now vs. 3 15 years ago.

WOW – COW - COS

Problems:

Heavy to push Small screen size Cumbersome design (can’t get into a room) Epidemiology problems Can’t sit ergonomically Cost

WOW – COW - COS

Solutions

Smaller footprint Height adjustable surface = 99% of employees for

both sit and stand Battery Meter 20” monitors Dispensing Systems (i.e. Pixis) integrated Reliable hardware and power charge

Medication Dispensing System Challenges

WOW – COW - COS

• All stake holders should have a voice• Explore types of carts that meet your needs• Laptop vs. regular cart• Hand held tablets that also mount on carts

COW – WOW – COS Ergonomics

• Should fit at least 5th – 95th percentile

• Keyboard– Standing height: 36-46”– Sitting height: 21-28”

• Screen height (from top):– Standing height: 48-60”– Sitting height: 40-53”

Cornell University Cart Evaluation Form

• http://ergo.human.cornell.edu/cutools.html

Patient Room or Wall Mounted Computers

Challenges

– Space – Positioning / Adjustability– Power and cables– Hygiene– Hardware Costs

Wall Mounted Challenges

Wall Mounted Challenges

Wall Mounted Challenges

Wall Mounted Guidelines

50” track (best for sit / stand option)

Keyboard: 28” mount from floor (28-39” range)

34” track (primarily for standing)

Keyboard: 36” from floor (36-47” range)

Medium height task stool must be used with 34” track.

Other areas of concern in the Healthcare System

• Imaging: PACS – Picture Archiving and Communications Systems

• EICU

• Surgery monitors for closed surgeries

Employees are a hospital’s most valuable asset!

Investment in good ergonomics keeps staff healthy and productive and facilitates good patient care!