A pioneering new program at Marin General Hospital (MGH) has improved patient safety while dramatically reducing injuries among staff members whose jobs involve patient handling. In the process, the program is saving the hospital hundreds of thousands of dollars in injury claims, work hours lost, and replacement staff costs.
Called the Lift Coach Program, the effort is part of the hospital’s Safe Patient Handling (SPH) initiative, which brings MGH in compliance with AB 1136, the “Hospital Patient and Health Care Worker Injury Protection Act”, enacted in 2012.
“Our Safe Patient Handling (SPH) program didn’t just respond to a new law; it forged a commitment to improve the experience of both patients and healthcare workers,” says Julie Lavezzo , Director of Safety, Security and Transportation at Marin General Hospital. “It was critical that we bridge the worlds of occupational health and patient safety, aligning with healthcare workers' core motivation to deliver exceptional care. This program helps our clinicians serve their patients better while avoiding injuries to themselves.”
The biggest cause of injuries to healthcare workers, according to the U.S. Department of Labor, is repeated manual patient handling activities, including heavy manual lifting associated with transferring and repositioning patients. Nursing aides, orderlies, and attendants had the highest rates of musculoskeletal disorders (including sprains and strains, with the shoulders and back most often affected) of any category of worker. In 2010 there were 27,020 cases nationwide, the equivalent of 249 per 10,000 workers, compared to an average of just 34 per 10,000 workers for all industries. Even construction workers had only a third as many injuries. The problem of lifting patients has continued to grow in the past 20 years due to the increasing weight of patients and the rapidly increasing number of older, sicker patients who require assistance with most activities.
MGH recognized this problem and the need to take action long before the passage of AB 1136, according to Ms. Lavezzo.
“In 2010 Marin General Hospital had 52 patient-handling injuries,” she says. “That’s not surprising given that the average nurse lifts 1.8 tons during an eight hour shift. Up to 12% of nurses leave the profession annually due to back injuries, one of the reasons why we are facing a potential 30% shortage of nurses by 2020. We knew we needed to do something now, and we were fortunate to have the critical element of senior leadership support.”
The hospital did own lift equipment, but it became clear that equipment alone was not enough to address staff needs. So MGH decided to work with Atlas Lift Tech, a Bay Area start-up that had developed a unique new approach to helping hospitals reduce injuries associated with patient handling.
“The usual training approach requires taking nurses off the floor—which is cost-prohibitive,” says Ms. Lavezzo. “The Atlas program involves bedside training and coaching. Their employees were local and committed to our success. And because we thought the problem needed an entirely new approach, we were willing pioneers,” she adds.
“Patient transfer and lifting devices are key components of an effective program to control the risk of injury to patients and staff associated with moving or lifting patients,” says Sandra Batt MSN, RN, Director of Education and Service Excellence, MGH, “so we need to make sure that caregivers understand how best to use them. Real-time education and training on the nursing units was geared towards assessment of hazards in the healthcare work setting, and selection and use of the appropriate equipment and devices, so caregivers can gain confidence, lift by lift. With the help of Atlas Lift Coaches, our staff has learned the equipment and how to employ proper body mechanics.”
The Atlas Lift Tech personnel also provide a variety of services that make life easier for hospital caregivers, providing an extra set of hands for nursing, managing equipment (slings that need to be laundered and returned to the floor), and making sure equipment is regularly maintained
The results have been impressive. “Our Board has been delighted with the results,” says Lee Domanico, CEO of Marin General Hospital. “We have reduced inpatient handling injuries from 52 in 2010 to 21 in 2011 and 22 in 2012,” he says. “We saw a 33% reduction in 2011 costs—and a 62% reduction in 2012 costs. Equally important, there was a 88% reduction in lost days—from 2,006 days lost in 2010 to just 251 lost days in 2012. Cost savings are estimated at over half a million dollars per year.”
“There’s no doubt this has improved patient care, too,” says Ms. Lavezzo. “Working with heavier and sicker patients, it is critical to insure that they aren’t developing pressure sores. Nurses are now better able to move them regularly in a safe and dignified way.”
In the past, such patients often were moved by a large team.
“Imagine you are a patient at your most vulnerable: dressed in a gown with tubes in you,” says Ms. Lavezzo. “Four people are going to lift you up so there will be eight hands all over your body, and it’s likely going to hurt. But now, a nurse and a lift coach can instead help you into a sling to be smoothly lifted up and transferred. It’s an approach that maintains patient dignity, safety and satisfaction.”
For more information or a physician referral, please visit www.maringeneral.org or call the Marin General Health Line at 1-888-99-MY-MGH (1-888-996-9644).