Hospital survey shows satisfaction
Ergonomics is more than a way to lift patients. As Butler (PA) Memorial Hospital found, it can lift morale and employee satisfaction as well. The challenge is to overcome negative perceptions and convince staff that hospital administration is serious about reducing injuries, says Karen Bosley, RN, manager of the employee health service of the western Pennsylvania hospital.
In a five-question survey, she found employees did not feel they had adequate training or equipment. The survey indicated employees believed injuries were not a high priority to hospital administration. As a consequence, employees paid little attention to the ergonomic devices the hospital provided. "We found we had employee reluctance to take the time to either use the equipment or get additional staff [to help with a lift]," Bosley adds.
During the following year, the hospital spent $80,000 on equipment, developed a training program, and initiated an incentive program to reward employees who complied. Visible support for ergonomics was evident from administration. Injuries declined by 33%, and related medical costs were reduced by $123,000. Just as important, however, was the change in attitude, as demonstrated in a post-implementation survey. "It’s absolutely amazing," she says. "Now people think administration cares. They know they’ve gotten education. They know we’ve got equipment."
Ergonomics now has become one aspect of the hospital’s efforts to be an "Employer of Choice" — a hospital that has an edge in recruitment and retention. Butler Memorial actually began to investigate ergonomics because of concern over several serious injuries. It was not just the cost that concerned Bosley; although at $400,000 in workers’ compensation, the cost was significant. "We identified employees who had been injured previously, whose quality of life had been [permanently] changed." Employees had undergone back surgery, including fusions and diskectomy, due to work-related injuries, she says.
"They’re still working here, but they are not able to do the job they were doing before," Bosley points out. "They are RNs who will probably never be able to go back to the nursing job they did before. Most of them are in nonpatient care-related jobs, such as data collection or staff education. We didn’t want any other person to have to go through that. We wanted to see what we could do to prevent future injuries."
In July 2001, the hospital’s safety committee decided to create a subgroup to investigate the injuries and develop a plan of action. The committee included Bosley, the safety officer/risk manager, an ergonomist, an employee educator, a floor nurse, the physical therapy director, and the systems improvement manager.
The causes identified by the team are common ones: Employees used poor transfer and lifting techniques. The hospital had no policy defining safe lifting techniques. It lacked adequate equipment. Employees needed patient assessment tools to define when equipment should be used, and employees were reluctant to take the time to use equipment or get additional staff. Bosley and her colleagues wrote a policy and developed patient-assessment algorithms. But they knew that was just the first step.
The safety team sought strong administrative support as well as employee buy-in. She and her colleagues were able to get a commitment for $80,000 to purchase equipment — and the team agreed to be accountable for results. They assured administrators they would achieve a reduction in lifting injuries by at least 25% and a savings of $100,000 in related costs. "We really were adamant that we could do it," Bosley stresses. "We asked for this money and asked for a chance to prove that we could make a difference."
The survey of 1,500 employees provided a way to measure another outcome: employee satisfaction. The safety team was very hopeful it would improve after the intervention.
Staff and managers were an integral part from the start of the program. Employees helped evaluate and select the lifting equipment. They acted in a video that became the training tool for the lift devices. Supervisors added ergonomics to their annual staff competency testing. Additionally, the hospital’s ergonomist went to office workstations to make adjustments and improve comfort.
They also faced a common challenge: How do you keep employees motivated to use the equipment? Bosley uses an incentive program to reward staff who were observed using lifts, Hover mats, gait belts, or other ergonomic items. Employees receive $5 gift certificates for pizza, ice cream, movie theaters, and other local stores, along with a congratulatory note.
"It wasn’t a great deal of money, but it’s made a tremendous impact," explains Bosley, who estimates she spent about $1,000 on the incentives. "People really do appreciate that they’ve been noticed." She adds that she was pleased recently when she learned of two employees who followed the appropriate lifting policy when a patient lost her balance and began to fall. The nurses eased her gently to the floor. Then, instead of manually lifting her, one stayed with her while the other got a lift. "They didn’t put their own backs at risk. The patient wasn’t injured, and neither were the employees. It’s a win-win."