Column: Workers' Comp

Evaluation Made Simple

By: | August 1, 2013

Peter Rousmaniere is a journalist and consultant in the field of work injury risk. He lives in Woodstock, Vermont. Peter can be reached at [email protected].

Work injury risks always prompt us to think through the entire cycle of work-related incidents, from injury through return-to-work. Then we circle back and put more focus on the hazard itself. Sometimes, though, to highlight safety opportunities, we might adopt the mind-set of the CEO.

That would mean to look broadly at the employer’s full process for producing a service or product and think about how safety improvements might transform operations, staffing and outcomes.

The risks of lifting and moving patients in a health care facility provide a case study on how looking at an entire service agenda works.  Even if you never need to be involved in patient lifting yourself, the lessons about framing problems and solutions are universal and deserve a few minutes of reflection.

Inside every patient lifting work injury lies a hidden improvement in patient care. Nursing aides, orderlies and hospital attendants suffer close to the highest rate of lost-time injuries among all major occupations. Patient lifting imposes the greatest risk of injury to these workers.

When hospitals and nursing homes radically redesign their patient lifting practices, in part by using mechanical devices, patients become more mobile and more satisfied with their care. With fewer work injuries, staff overtime declines.

According to Veterans Administration estimates, the correct use of patient lifting technologies produces a financial return that venture capitalists would envy. But a medical director of occupational risks at the VA warns that health care risk managers may never achieve these results without commiting to a “fundamental change” in processes.

If you were CEO of a health care facility, you’d want to know what that fundamental change entails. It’s important to remember that a partial commitment will result in variable degrees of patient care, staff buy-in and dollar outcomes.

But it’s not always easy for CEOs to get the information they need. From outside the facility, workers’ comp insurers do not show from claims data how improvements succeed or fail. Likewise, loss prevention specialists are too often dependent on sales pitches by lifting technology vendors to make the case.

A research paper published in January finally used an anonymous insurer’s claims data to show how successful patient lifting projects delivered great outcomes.

I asked Atlas Lift Tech, a San Ramon, Calif., firm, to devise a checklist to quickly but effectively evaluate a patient lifting proposal, along the lines suggested by the research article.

The firm’s president, Eric Race, prepared a protocol to forecast the patient care and financial impact of patient lifting changes, adjusted for the depth of commitment made by the organization. The protocol had to be reliable but simple enough for a facility’s director of nursing, head of safety, and COO to complete together within 10 minutes.

Michael Stack, an executive at AMAXX, offered to post the protocol on the firm’s website as a free download. It’s available here.

An expert in patient care worker safety, Guy Fragala, told me that a tool such as this protocol “can be a very useful aid to help senior leaders validate allocating funds for a needed investment in prevention.”

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