Match worker at hiring to prevent injuries

Hospital does functional assessment first

The first steps to prevent injury at Mercy Medical Center-North Iowa in Mason City occur even before an employee begins his or her job.

The hospital conducts a pre-employment functional assessment with an isokinetic machine — a device that measures muscle strength and endurance. As the potential employees press or pull against a bar, using their arms, legs, or trunk, the device varies the resistance to match the person's output.

The result is an objective way to determine a person's physical capabilities, says Steve Crane, PT, physical therapy manager. "It measures through the whole range of motion of the body. You can either perform the functions or you can't," he says. "It will demonstrate clearly what a person's output is."

Mercy Medical Center uses many measures to prevent employee injury, including lift equipment. An in-house ergonomist meets with all new hires to help them set up their work stations or to discuss their job's physical demands and ways to reduce hazards.

The functional assessment is one other important piece, says employee health nurse Jenean Wolterman, RN, BSN, MA. "The goal is to be able to better match the right person to the job so they're not injured," she says.

The hospital identified 44 job positions that are considered physically demanding, including food service and nursing. "We've targeted principally the areas of highest risk," says Crane.

Each job has been assessed and received a designation. For example, nursing is considered "light" physical demand, due to the use of assistive devices, although flight nurses must meet the "light-medium" level. Carpenters fall under the "medium" demand classification. (The lowest category is "sedentary" and the highest is "very heavy.")

About 15% of the people who undergo the functional assessment do not pass, says Crane. "It's difficult to have to deny someone [a job], but you also don't want to put them into work where they're going to get injured. The idea is to protect the employee," he says.

The ET2000, created by two physical therapists who now run Cost Reduction Technologies, of Davenport, IA, is a method to test core body strength, says company president Loren Arp, PT. Annual tracking shows that when it is used as a pre-employment tool, "98.3% of the time, the person works injury-free," he says.

Employers lease the device for a one-time fee of about $25,000. They also pay a fee per exam, at a rate that is based on issues such as volume. It may also be used to assess fitness to return to work after an injury. "If someone is returning to work after an injury, we want to determine what their abilities are so we can match them to their work or make reasonable accommodations," says Crane.

The functional assessments comply with the Americans with Disabilities Act requirements, he says. "If they're offered the job, we always have to look at whether a reasonable accommodation can be made," says Wolterman. "But if they physically aren't strong enough, that's got to be a first priority."

Mercy Medical Center conducts functional assessments for outside clients, which provides revenue and helps cover the costs of the machine, says Crane.

Meanwhile, it has tracked new employees who received the functional assessments. For example, nutrition services is a physically demanding job that involves lifting heavy items. In the past year, none of the new hires has suffered from a lifting injury, Wolterman says.

Learn more:

Steve Crane, PT, manager, Mercy Work Center at Mercy Medical Center-North Iowa, Mason City, IA. Phone (641) 422-5446.

Cost Reduction Technologies, Davenport, IA. Phone (563) 391-6995, or online at