Safe Resident Handling Safe Resident Handling for Administrators: for Administrators:

Making the Business CaseMaking the Business CaseUniversity of Oregon, Labor Education and University of Oregon, Labor Education and

Research Center (LERC) and Oregon Occupational Research Center (LERC) and Oregon Occupational Safety and Health Administration (OR-OSHA)Safety and Health Administration (OR-OSHA)

This material has been made possible by a grant from the Oregon This material has been made possible by a grant from the Oregon Occupational Safety and Health Division, Department of Consumer and Occupational Safety and Health Division, Department of Consumer and

Business ServicesBusiness Services

AcknowledgementsAcknowledgementsMaterials for this presentation material made possible Materials for this presentation material made possible

byby

Oregon OSHAOregon OSHA

Veterans Health AffairsVeterans Health Affairs

SAIF CorporationSAIF Corporation

HumanFitHumanFit

Oregon Nurses Association (ONA)Oregon Nurses Association (ONA)

University of Oregon, Labor Education and Research University of Oregon, Labor Education and Research CenterCenter

Back Injury Resource Nurses (BIRN)Back Injury Resource Nurses (BIRN)

National Institute of Occupational Safety and Health National Institute of Occupational Safety and Health (NIOSH)(NIOSH)

Today’s workshop will addressToday’s workshop will address

• Why a Safe Resident Handling Why a Safe Resident Handling (SRH) Program is important(SRH) Program is important

• Why resident handling is Why resident handling is hazardoushazardous

• Injury StatisticsInjury Statistics• Why SRH programs succeed or Why SRH programs succeed or

failfail• Program costs and benefitsProgram costs and benefits• How to measure and evaluate How to measure and evaluate

SRH programsSRH programs

Learning ObjectivesLearning Objectives

By the completion of this class you should be able By the completion of this class you should be able to:to:

• List costs of developing and implementing SRH List costs of developing and implementing SRH programprogram

• List benefits of SRH programList benefits of SRH program

• Identify common reasons programs failIdentify common reasons programs fail

• List components of a successful SRH programList components of a successful SRH program

Importance of SRH ProgramsImportance of SRH Programs

• Research from Research from numerous sources has numerous sources has shown there is no safe shown there is no safe way to manually lift or way to manually lift or move a dependent move a dependent residentresident

• Resident handling Resident handling injuries are costly for injuries are costly for the companythe company

Why is Manual Resident Why is Manual Resident Handling so Hazardous?Handling so Hazardous?

• Physical demands of Physical demands of the workthe work– Job exceeds physical Job exceeds physical

demands of individualsdemands of individuals

• Poor equipment and Poor equipment and facility designfacility design

• Poor work practicesPoor work practices

• Individual characteristicsIndividual characteristics– Age, past injuries, physical Age, past injuries, physical

condition, leisurely condition, leisurely activitiesactivities

What are work-related What are work-related musculoskeletal disorders musculoskeletal disorders

(MSDs)?(MSDs)?• Overuse syndromes, repetitive motion Overuse syndromes, repetitive motion

disorders, cumulative trauma disorders, disorders, cumulative trauma disorders, soft tissue injuriessoft tissue injuries

• Disorders of the nerves, ligaments, Disorders of the nerves, ligaments, tendons, muscles, discs, bursa, cartilage, tendons, muscles, discs, bursa, cartilage, or jointsor joints

• Acute, chronic or cumulative injuriesAcute, chronic or cumulative injuries

• Work contributes to, or worsens conditionWork contributes to, or worsens condition

• Examples are carpal tunnel syndrome, Examples are carpal tunnel syndrome, degenerative joint disease, strains, degenerative joint disease, strains, sprains, disc herniations, and sciatica sprains, disc herniations, and sciatica

What are risk factors for MSDs?What are risk factors for MSDs?

• Risk factors for MSDs include:Risk factors for MSDs include:– Awkward postures (bending, Awkward postures (bending,

twisting, reaching, stooping)twisting, reaching, stooping)– Static posturesStatic postures– Heavy liftingHeavy lifting– Sudden shift in loadSudden shift in load– Repetitive activitiesRepetitive activities

• Risk is increased in magnitude by combining risk factors

• Risk increased by repetitive exposure – cumulative trauma

How dangerous is long term How dangerous is long term care?care?

Incidence rates, per 100 full time workers, of nonfatal Incidence rates, per 100 full time workers, of nonfatal occupational injuries and illnesses, BLS 2006occupational injuries and illnesses, BLS 2006

The Prevalence of MSDsThe Prevalence of MSDs in Oregon Health Care in Oregon Health Care

• MSDs (strains, sprains, MSDs (strains, sprains, herniations) accounted for herniations) accounted for half of the Oregon ADCs half of the Oregon ADCs between 2001 and 2005between 2001 and 2005

• Resident handling MSDs Resident handling MSDs made up 27.4% of total ADCsmade up 27.4% of total ADCs– Nurse aids = 32.6% Nurse aids = 32.6% – RNs 14.2%RNs 14.2%– Other health aides 5.9%Other health aides 5.9%

“Health care” includes SIC 80 (health services) and SIC 8361 (residential care) Oregon DCBS, IMD, July 2007

Resident Handling InjuriesResident Handling Injuries

• MSDs related to MSDs related to resident handling resident handling (2001-2005)(2001-2005)– Health aids - 167Health aids - 167– Nursing aids -2,371 Nursing aids -2,371 – RNs -881RNs -881

• Most frequent cause of Most frequent cause of injury: “bodily reaction injury: “bodily reaction and exertion” (63.2%) and exertion” (63.2%) which also includes which also includes overexertion and overexertion and repetitive motionsrepetitive motions

Oregon DCBS, Information Management Division, July 2007.

Resident Handling Injury Resident Handling Injury Statistics from Typical Oregon Statistics from Typical Oregon

LTC FacilityLTC FacilityYearYear # of # of

ClaimClaimss

Medical Medical CostsCosts

Time Loss Time Loss CostsCosts

Time Time LossLossDaysDays

Other Other Costs*Costs*

TotalTotalIncurredIncurred

20042004 1313 $27,239$27,239 $2,105$2,105 6161 00 $29,344$29,344

20052005 99 $16,231$16,231 $455$455 3131 19,21819,218 $35,905$35,905

20062006 44 $1,546$1,546 $856$856 2828 2,5002,500 $4,902$4,902

TotalTotal 3636 $52,562$52,562 $4017$4017 132132 21,71821,718 $78,29$78,2966

*Other costs include vocational rehabilitation, attorney fees, awards and settlements SAIF Corp data

How Costly are MSDs?How Costly are MSDs?

• Although insurance covers Although insurance covers somesome direct direct costscosts, , they are recouped by insurers in rate they are recouped by insurers in rate changes changes over time over time

• Indirect costsIndirect costs associated are generally associated are generally MOREMORE expensive than the injuries themselves and expensive than the injuries themselves and are are not coverednot covered

Cost of Resident Handling Cost of Resident Handling MSDs MSDs

in Oregonin OregonAverage resident handling injury costs $11,055 in Average resident handling injury costs $11,055 in

medical medical and indemnity costs over lifetime of the claimand indemnity costs over lifetime of the claim

$10,048.72$11,283.38

$9,062.05

$11,950.03

$16,090.02

$0.00

$5,000.00

$10,000.00

$15,000.00

$20,000.00

health aid licensedpracticalnurse

nursing aid otheroccupation

registerednurseOregon DCBS, Oregon DCBS,

Information Information Management Management

Division, July 2007Division, July 2007

What does Workers Comp What does Workers Comp Insurance Cover in Oregon?Insurance Cover in Oregon?

Direct Costs OnlyDirect Costs Only

MedicalMedical costs include costs include• Medical treatment of injuriesMedical treatment of injuries• Drug costsDrug costs

IndemnityIndemnity costs include costs include• Time loss costsTime loss costs• Temporary and permanent disability paymentsTemporary and permanent disability payments• Fatality costs/awardsFatality costs/awards• Vocational assistance costsVocational assistance costs• Settlement costsSettlement costs• Claim expense costsClaim expense costs

Oregon State Workers’ Compensation Division, SAIF Corporation

Patient Handling MSD Claim Patient Handling MSD Claim Covered Cost Components*Covered Cost Components*

Indemnity @ closure

Indemnity after

closure

Medical @ closure

Medical after

closure•Implicit within Implicit within “indemnity” costs, which “indemnity” costs, which comprise 55% of total comprise 55% of total claims cost, are time loss claims cost, are time loss and disability feesand disability fees

•Insurance does not pay Insurance does not pay for the costs associated for the costs associated with absenteeism and with absenteeism and presenteeism following an presenteeism following an injury.injury.

Oregon DCBS, Information Management Division, 2007*Statistics cover 1997-2006, with 4012 total claims*Statistics cover 1997-2006, with 4012 total claims

DiscussionDiscussion

Is cost a barrier to Is cost a barrier to

implementing a SRH implementing a SRH

program at your facility?program at your facility?

Direct costs are the tip Direct costs are the tip of the iceberg!of the iceberg!

Direct Costs Direct Costs – Medical costsMedical costs– Time lossTime loss– Workers Comp premiumsWorkers Comp premiums

Indirect CostsIndirect Costs – Lost productivityLost productivity– Resident injury costsResident injury costs– Retention or retraining timeRetention or retraining time– Reduced moraleReduced morale– Break up work teamBreak up work team– Extra overtimeExtra overtime– Administrator time to manage claimsAdministrator time to manage claims– Punitive costs/timePunitive costs/time

Indirect CostsIndirect Costs

IndirectIndirectCostsCosts

Work stoppageWork stoppage

Poor moralePoor morale

Hiring/retraining costsHiring/retraining costs

Investigation costsInvestigation costs

Punitive CostsPunitive Costs

Clean-up, damaged material Clean-up, damaged material replacement costsreplacement costs

Decreased Decreased productivityproductivity

Fear of injuryFear of injury

Poorer worker- Poorer worker- management relationsmanagement relations

Orientation CostsOrientation Costs

Training timeTraining time

Material depletion Material depletion expenseexpense

Supervisor timeSupervisor time

Trainer timeTrainer time

Recruitment Recruitment costscosts

Legal costsLegal costs

Employee Employee benefitsbenefits

Documenting Documenting time losstime loss

Court timeCourt time

Attorney feesAttorney fees

Reports to state/regulatorsReports to state/regulators

FinesFines

Productivity ramp-upProductivity ramp-up

OvertimeOvertime

Compliance inspectionsCompliance inspections

SRH is Affordable!SRH is Affordable!

Wyandot County Nursing Home (Ohio)Wyandot County Nursing Home (Ohio)• Developed SRH program withDeveloped SRH program with

−Equipment (ceiling lifts, FEB, sit-stand)Equipment (ceiling lifts, FEB, sit-stand)−Ergonomic & equipment trainingErgonomic & equipment training−Worker participation in all aspectsWorker participation in all aspects−SustainabilitySustainability

• Transformed into a zero-lift facilityTransformed into a zero-lift facility• No MSDs in > 9-years!No MSDs in > 9-years!

Wyandot Costs & BenefitsWyandot Costs & Benefits• CostsCosts

– $140,000/year workers comp costs 3 years prior to SPH $140,000/year workers comp costs 3 years prior to SPH programprogram

– $251,000 on equipment over 4 years (1998-2001)$251,000 on equipment over 4 years (1998-2001)

• SavingsSavings– $100,000 workers comp costs$100,000 workers comp costs– $125,000 staff turnover costs (hiring time, training)$125,000 staff turnover costs (hiring time, training)

• Turnover decreased from 75% to 5%Turnover decreased from 75% to 5%– $55,000 payroll savings for sick-time and overtime$55,000 payroll savings for sick-time and overtime– $126,000 savings in cost of additional staffing not needed$126,000 savings in cost of additional staffing not needed

• BenefitsBenefits– Enhanced moraleEnhanced morale– Increased productivityIncreased productivity– Better quality care (attracted and hired best workers)Better quality care (attracted and hired best workers)

$$406,000 - $251,000 = $155,000 savings over 4 years!406,000 - $251,000 = $155,000 savings over 4 years!

•SAIF program implemented 9/17/2004SAIF program implemented 9/17/2004•19 facilities included19 facilities included

– acute care, skilled nursing facilities, assisted acute care, skilled nursing facilities, assisted living, residential care, and living, residential care, and developmentally/physically disabled group homesdevelopmentally/physically disabled group homes

•Client utilized zero/low lift program, with Client utilized zero/low lift program, with policies, in at least one facility or departmentpolicies, in at least one facility or department

SAIF Low Lift/SRH Program SAIF Low Lift/SRH Program

SAIF Low Lift/SRH Program SAIF Low Lift/SRH Program

Post Implementation YearPost Implementation Year Yr 1Yr 1 Yr 2Yr 2 Yr 3Yr 3

# Facilities reporting# Facilities reporting 1919 1414 88

% Reduction% Reduction

Lift/Transfer Claims OnlyLift/Transfer Claims Only

Accepted claimsAccepted claims 6565 6868 8181

Time loss days Time loss days 8080 9797 9393

Incurred costsIncurred costs 8484 9393 9393

All ClaimsAll Claims

Accepted claimsAccepted claims 3131 3636 6161

Time loss days Time loss days 4242 8080 9393

Incurred costsIncurred costs 3838 6969 8888

MSD injury prevention program MSD injury prevention program in nursing homes in nursing homes (Collins et al, 2004)(Collins et al, 2004)

InvestmentInvestment• $143,556 in equipment and $27,600 in training ($498 $143,556 in equipment and $27,600 in training ($498

and $77 per employee respectively)and $77 per employee respectively)• Trained 288 employees 1 ¼ hours each on equipment Trained 288 employees 1 ¼ hours each on equipment

useuse

ResultsResults• MSD claims reduced by 57% from 129 to 56MSD claims reduced by 57% from 129 to 56• Direct injury costs dropped from $441,670 to $277,061 Direct injury costs dropped from $441,670 to $277,061

yielding annualized saving of $54,870yielding annualized saving of $54,870• The 10 year net present value of the project at the time The 10 year net present value of the project at the time

of implementation was $594,605of implementation was $594,605• Accounting for capital maintenance, retraining, and Accounting for capital maintenance, retraining, and

training backfill, the adjusted recovery time on training backfill, the adjusted recovery time on investment = 3 + years, but ROI for some OR programs investment = 3 + years, but ROI for some OR programs < 2 yrs < 2 yrs

Making the Business Case for a Making the Business Case for a SRH ProgramSRH Program

Demonstrate the Financial Demonstrate the Financial Value of a SRH Program: Value of a SRH Program: A A

systems approachsystems approach• Define the problem and outline the goalsDefine the problem and outline the goals

– Too many injuries/costs associated with resident Too many injuries/costs associated with resident handlinghandling

– Need to implement ergonomics based SRH Need to implement ergonomics based SRH programprogram

• Determine solutionsDetermine solutions– SRH policySRH policy– Appropriate equipmentAppropriate equipment

• Collect data to demonstrate a changeCollect data to demonstrate a change– Injury rates & costs, indirect costs, etcInjury rates & costs, indirect costs, etc– Anticipated costs and benefits of solutionsAnticipated costs and benefits of solutions

• Cost justification analysisCost justification analysis– Return on investmentReturn on investment– Program effectivenessProgram effectivenessHumanfit, 2002

What are Costs versus What are Costs versus Benefits?Benefits?

Program BenefitsProgram Benefits• Reduced Work comp costsReduced Work comp costs• Reduced turnoverReduced turnover• Increased labor poolIncreased labor pool• Enhanced productivityEnhanced productivity• Improved moraleImproved morale• More resident care timeMore resident care time• Improved quality of careImproved quality of care• Decreased resident fall riskDecreased resident fall risk• Greater resident satisfactionGreater resident satisfaction• Reduced workplace violenceReduced workplace violence

Program CostsProgram Costs• Equipment costsEquipment costs• Installation costsInstallation costs• Maintenance Maintenance • Equipment suppliesEquipment supplies• Worker trainingWorker training• Equipment lifespanEquipment lifespan

Conduct an Economic Analysis Conduct an Economic Analysis

• Single yearSingle year– Cost/Benefit RatioCost/Benefit Ratio– Payback periodPayback period– Single year return on investmentSingle year return on investment

• Multi-year pay backMulti-year pay back

• Profit margin analysisProfit margin analysis

Humanfit, 2002

Cost/Benefit AnalysisCost/Benefit Analysis

• Cost/Benefit Ratio = Cost/Benefit Ratio = Dollar value of benefit Dollar value of benefit (gain/loss)(gain/loss) Dollar amount of costDollar amount of cost

Example: Lateral transfer injuriesExample: Lateral transfer injuries

• Three injuries in past yearThree injuries in past year

• Average injury cost (direct) = $11,000 per worker x Average injury cost (direct) = $11,000 per worker x 3 = $33,000 (in potential savings)3 = $33,000 (in potential savings)

• Solution investment cost (2 air mats) = $10,000 Solution investment cost (2 air mats) = $10,000

• Benefit to cost ratio = 3.3Benefit to cost ratio = 3.3

Humanfit, 2002

The benefit is over 3 times the costThe benefit is over 3 times the cost

Payback PeriodPayback Period

Payback period in years = Payback period in years = CostCost Benefit (gain or loss)Benefit (gain or loss)

Payback period in years = Payback period in years = $10,000$10,000 = 0.3 = 0.3 yearsyears

$33,000$33,000 oror

4 months4 months

A 2-year (or less) payback on facility wide A 2-year (or less) payback on facility wide resident handling equipment is commonresident handling equipment is common

Humanfit, 2002

Single Year Return on Single Year Return on InvestmentInvestment

Return on Investment (ROI) = Return on Investment (ROI) = Gain or LossGain or Loss x x 100%100%

Investment costInvestment cost

ROI = ROI = $33,000$33,000 x 100% = 330% x 100% = 330% $10,000$10,000

Humanfit, 2002

Multi-year PaybackMulti-year Payback

• Issues to considerIssues to consider– Identify the lifespan of the equipment and Identify the lifespan of the equipment and

interest rate needed to pay for investmentinterest rate needed to pay for investment– Determine future versus present value of Determine future versus present value of

the dollar (inflation costs)the dollar (inflation costs)– Determine cost of capital (interest, Determine cost of capital (interest,

dividends, payment to providers of funds)dividends, payment to providers of funds)– Calculate savings in year 1 and subsequent Calculate savings in year 1 and subsequent

years with value discounted due to inflationyears with value discounted due to inflation

Humanfit, 2002

Profit Margin AnalysisProfit Margin Analysis

• Calculate the services that must be reimbursed Calculate the services that must be reimbursed to compensate for the loss of profit due to to compensate for the loss of profit due to injuries:injuries:

– Average profit margin for health care in the US is ~4%Average profit margin for health care in the US is ~4%

– Average cost of a back injury is ~$25,000Average cost of a back injury is ~$25,000

______Injury cost___Injury cost___ = = $625,000$625,000 Avg profit marginAvg profit margin

• This is the amount that has to be found through This is the amount that has to be found through service reimbursement or cost cutting to service reimbursement or cost cutting to compensate for loss of profit due to injury costs compensate for loss of profit due to injury costs for 1 back injuryfor 1 back injuryHumanfit, 2002

What should management know?What should management know?

Program Program Costs?Costs?

Injury Injury TrendsTrends

??

What Management Should What Management Should Know: Annual Costs and Know: Annual Costs and

BenefitsBenefits

0

50000

100000

150000

200000

1 2 3 4 5

Program Year

Cos

t

Expenses Benefits Saved Applications Completed

Assembling DataAssembling Data

Use injury data for direct costsUse injury data for direct costs

• OSHA 200/300 logsOSHA 200/300 logs• # incidents, lost work days, restricted # incidents, lost work days, restricted

work dayswork days• MSD type (strain, herniation etc.)MSD type (strain, herniation etc.)• Body part affectedBody part affected• By wing or unitBy wing or unit• % of total injuries that are MSDs% of total injuries that are MSDs• % MSDs related to resident handling% MSDs related to resident handling• % time loss on cases% time loss on cases

What Management Should What Management Should Know: Injury TrendsKnow: Injury Trends

$0.00

$20,000.00

$40,000.00

$60,000.00

$80,000.00

0 1 2 3 4Program Year

Cos

t

# MSDs Reported # MSD Lost Time Cases Cost of MSDs

Collect data before you start your SRH Collect data before you start your SRH program to assess trendsprogram to assess trends

• Lagging IndicatorsLagging Indicators– No direct correlation to daily activitiesNo direct correlation to daily activities– Difficult to directly influenceDifficult to directly influence

• Leading IndicatorsLeading Indicators– Direct correlation to work activitiesDirect correlation to work activities– Easy to influence or controlEasy to influence or control– Predicts change in lagging indicatorsPredicts change in lagging indicators– Quality indicatorsQuality indicators

Know the TrendsKnow the Trends

• Lagging indicators Lagging indicators – OSHA 200/300 logsOSHA 200/300 logs– Workers comp claimsWorkers comp claims– First aid casesFirst aid cases– Use of temporary staffUse of temporary staff

• Leading indicators Leading indicators – Injury risk indicators (ergonomic assessment)Injury risk indicators (ergonomic assessment)– Employee surveys: symptom surveys & Employee surveys: symptom surveys &

satisfactionsatisfaction– Resident satisfactionResident satisfaction– Safety auditsSafety audits

Indicators of Worker Indicators of Worker Safety & HealthSafety & Health

Direct Costs MetricsDirect Costs Metrics

• Incident RatesIncident Rates– Used for comparison within facility and across Used for comparison within facility and across

the industrythe industry

• Lost Workday Case Incident RatesLost Workday Case Incident Rates

• Severity RatesSeverity Rates– Tracks changes in lost and restricted work daysTracks changes in lost and restricted work days

Incident RatesIncident RatesFollow SRH program progress by Follow SRH program progress by • Tracking incident rates over time and compare to Tracking incident rates over time and compare to

previous rates to give an idea of the program’s previous rates to give an idea of the program’s efficacy:efficacy:

IR = IR = (# of incidents per year) x (200,000 hrs of work)(# of incidents per year) x (200,000 hrs of work) (# of hours worked by employees)(# of hours worked by employees)

Ex: Ex: 3 MSDs x 200,000 hrs3 MSDs x 200,000 hrs = 3 = 3 100 employees x (50 wks x 40 hrs)100 employees x (50 wks x 40 hrs)

• Incident rates control for employee population Incident rates control for employee population change and employee hours worked so figures can change and employee hours worked so figures can be compared between facilities be compared between facilities

Lynda Enos, “Cost Justification of Ergonomics Programs,” Central Oregon Occupational Safety & Health Conference 2005

Severity RatesSeverity Rates

• Records of changes in injury Severity Rates (SR) can Records of changes in injury Severity Rates (SR) can provide information about whether or not the program is provide information about whether or not the program is reducing severity of injuries that still occur:reducing severity of injuries that still occur:

SR = SR = (# of lost or restricted workdays) x (200,000 hrs of (# of lost or restricted workdays) x (200,000 hrs of wk)wk)

# of hrs worked by target population# of hrs worked by target population

Ex: If MSDs keep 3 employees home for 20, 30 and 50 Ex: If MSDs keep 3 employees home for 20, 30 and 50 days, respectively:days, respectively:

SR = SR = (20 + 30 + 50) x 200,000(20 + 30 + 50) x 200,000 = 100 = 100 100 employees x (50 wks x 40 hrs)100 employees x (50 wks x 40 hrs)

Lynda Enos, “Cost Justification of Ergonomics Programs,” Central Oregon Occupational Safety & Health Conference 2005

Workers Compensation CostsWorkers Compensation Costs

• Calculate cost per MSD by type and total Calculate cost per MSD by type and total MSDsMSDs

• Calculate average costs of MSDs by type and Calculate average costs of MSDs by type and totaltotal– i.e. Injury cost/# MSDsi.e. Injury cost/# MSDs

• Look at trends over the last 3-5 yearsLook at trends over the last 3-5 years• Assess impact on Workers Comp premiumsAssess impact on Workers Comp premiums• Gather information fromGather information from

– Workers comp carrier (SAIF, Liberty Mutual, etc)Workers comp carrier (SAIF, Liberty Mutual, etc)– OR OSHAOR OSHA– Loss Run ReportLoss Run Report

Indirect Cost Estimates for Indirect Cost Estimates for MSDsMSDs

• Based on Oregon data, the average resident Based on Oregon data, the average resident lifting MSD in health care between 1997 and lifting MSD in health care between 1997 and 2006 cost $2006 cost $11,055 11,055 in medical and indemnity in medical and indemnity costs costs

• Federal OSHA’s “Safety Pays” model – these Federal OSHA’s “Safety Pays” model – these direct costs correlate with an indirect cost of direct costs correlate with an indirect cost of $12,500 yielding a total cost of $23,555$12,500 yielding a total cost of $23,555

• Indirect costs vary considerably depending Indirect costs vary considerably depending on many situation-specific conditionson many situation-specific conditions$afety Pays, OSHA, 1998

Successful SRH Programs Successful SRH Programs

What makes a What makes a SRH Program successful?SRH Program successful?

• Management Management commitmentcommitment

• Employee involvementEmployee involvement• SRH policySRH policy• Education and TrainingEducation and Training• Worksite assessmentsWorksite assessments• Hazard identification Hazard identification • Medical managementMedical management• Program evaluationProgram evaluation• SustainabilitySustainabilityHumanfit, 2006

Successful ProgramImplementation

• Tracks project closelyTracks project closely– Identify projectsIdentify projects– Assign responsibilityAssign responsibility– Monitor progressMonitor progress

• Revisit goals and program plan oftenRevisit goals and program plan often• Maintain management supportMaintain management support• Maintain energy and enthusiasmMaintain energy and enthusiasm• Communicate, Communicate, Communicate!Communicate, Communicate, Communicate!

As program matures (after initial successes and high As program matures (after initial successes and high risk risk

hazards fixed) use employees teams to audit work hazards fixed) use employees teams to audit work areas areas

and solve problemsand solve problemsHumanfit, 2006

Why do SRH Programs Fail?Why do SRH Programs Fail?

• Lack of awareness of equipmentLack of awareness of equipment• No program plan or project managerNo program plan or project manager• Program plan not actively and consistently Program plan not actively and consistently

implemented and evaluatedimplemented and evaluated• No program coach or championNo program coach or champion• Mismatch between equipment, task, and Mismatch between equipment, task, and

resident needsresident needs• Program scope too limited e.g. only Program scope too limited e.g. only

administrative controlsadministrative controls

Humanfit, 2006

An Effective SPH Program isachieved when:

• Goals are metGoals are met• Early results are demonstrated and Early results are demonstrated and

commitment ongoingcommitment ongoing• SRH incorporated into environment of care SRH incorporated into environment of care

programs and the organizational cultureprograms and the organizational culture• A proactive program is developed whereA proactive program is developed where ergonomics principles are incorporated ergonomics principles are incorporated

intointo design/purchase of all equipment and design/purchase of all equipment and

processesprocesses

Humanfit, 2006

Facility of Choice (FOC) in Facility of Choice (FOC) in OregonOregon

• FOC certification will verify that a facility FOC certification will verify that a facility has met criteria for a sustainable SPH has met criteria for a sustainable SPH programprogram

• Marketing benefits include:Marketing benefits include:• Safe environment for workersSafe environment for workers

• Nursing staff change jobs less oftenNursing staff change jobs less often• Safe environment for residentsSafe environment for residents

• Residents cared for in safest way possibleResidents cared for in safest way possible

• Enhanced regulatory complianceEnhanced regulatory compliance• Improved facility efficiencyImproved facility efficiency

LTC facilities can apply for FOC certification LTC facilities can apply for FOC certification once SRH program criteria metonce SRH program criteria met

ResourcesResources• National Center for Patient SafetyNational Center for Patient Safety

– http://www.va.gov/ncps/http://www.va.gov/ncps/• Patient Safety Center of InquiryPatient Safety Center of Inquiry

– http://www.visn8.med.va.gov/patientsafetycenthttp://www.visn8.med.va.gov/patientsafetycenter/er/

• National Institute of Occupational Safety and National Institute of Occupational Safety and HealthHealth– http://www.cdc.gov/niosh/topics/healthcare/http://www.cdc.gov/niosh/topics/healthcare/

• OSHA (federal)OSHA (federal)– www.osha.govwww.osha.gov– http://www.osha.gov/SLTC/etools/nursinghome/http://www.osha.gov/SLTC/etools/nursinghome/

index.htmlindex.html• Oregon OSHA: Oregon OSHA: www.cbs.state.or.us/osha/www.cbs.state.or.us/osha/• SAIF Corporation: SAIF Corporation: www.saif.com/www.saif.com/

Wrap up & EvaluationWrap up & Evaluation