In 2003, Woodstock General Hospital (WGH) was faced with ever increasing staff injuries due to patient handling. Change management was required in order to decrease the human and financial costs associated with workplace injuries.
WGH’s Occupational Health and Safety Department (OH&S) with the assistance of the Director of Ambulatory Rehabilitation evaluated and classified the musculoskeletal injuries of patient handlers.
Subsequently, a staff education program for patient handling was jointly developed and initiated by WGH and Arjo Canada, now ArjoHuntleigh, to assist in addressing current healthcare challenges: high injury rates, budgetary constraints, nursing shortages, and safety requirements.
This education program focused on three key outcomes
1) reductions in staff injuries and WSIB costs
2) comfortable, safe hospital stays for patients requiring lifting/transferring
3) staff and patient satisfaction.
Literature suggested traditional education in body mechanics and manual lifting was not evidence based in reducing injuries. Additionally, comments on patient comfort during manual transfers were not positive. Various educational models were examined and several critical components for a patient handling program were identified:
- Minimal Lift Policy Development
- Peer coaches in patient areas to support and train staff in achieving proficiency with lifting equipment
- Sustainable cultural change, focusing on enhanced patient handling safety
- Quality monitoring of injury rates/costs, satisfaction, safety indicators
In 2005, WGH contracted ArjoHuntleigh, an international manufacturer and supplier of patient lifting/transferring devices, and its Diligent Program to assist in implementing a program to reduce injuries. Although new in Canada, ArjoHuntleigh’s Diligent program had been implemented in 565 healthcare facilities in the United States, with substantiated outcomes since 2001.
Woodstock Hospital was the first, and continues to be the only Canadian hospital to contract Diligent. At Woodstock Hospital, the ArjoHuntleigh Diligent Program was given a customized name “Project Uplift”.
Project Uplift addressed the following:
- Minimal lift policy development
- ‘Train the Trainer’ program for Transfer Mobility Coaches (TMCs)
- Monthly on-site consultation days
- Financial guarantee of a 60 per cent reduction in WSIB costs
- Support for cultural change
Coincidentally, the development of Project Uplift coincided well with the MoHLTC funding announcement for lifting devices as part of the Ontario Nursing Strategy. By 2006, WGH had acquired 42 additional lifting devices. Project Uplift ensured staff training and support by Transfer Mobility Coaches.
ArjoHuntleigh’s training processes and tools, including mini-mobility assessments, algorithms and training quizzes were adopted by Woodstock Hospital. ArjoHuntleigh also provided team shirts for the TMCs, highlighting Project Uplift’s profile.
WH developed and implemented additional initiatives to enhance the program:
- Staff training and new staff orientation monitoring systems
- Lifting device supply systems (sling and maxislide availability, bariatric patient management, etc.)
- Monthly TMC “free lunch and learn” sessions hosted by OH&S staff and the ArjoHuntleigh consultant
- TMC newsletters, group email to facilitate information dissemination
- Project Uplift logo development
- Hospital and community-wide celebrations and publications of Project Uplift successes
After three years, Project Uplift achieved a 69 per cent reduction in staff injuries and a 99.7per cent reduction in WSIB costs related to lifting, transfers and repositioning. In addition, staff satisfaction was increased and patients receive care that addresses comfort, safety and quality of life. Staff innovation also came to the forefront with one of the transfer devices now being routinely used in mammography, an equipment role not previously identified by ArjoHuntleigh.
In 2012, Project Uplift continues to reap benefits in staff safety by reducing staff injuries and WSIB expenses as demonstrated by the chart below. Patient safety and comfort continues. As well, the call for increased safety continues to be further solidified with Accreditation Canada, identifying safety in many required organizational practices. Project Uplift keeps safety in the forefront at Woodstock Hospital.
Although Project Uplift is a contracted program, educational principles can be replicated by any hospital. Success is dependent on:
1) strong commitment from administration and management
2) training courses for Transfer Mobility Coaches addressing leadership skills
and lifting device clinical application
3) monthly/ongoing TMC support systems
4) staff training and monitoring systems.
Most importantly, the success of this program is reflective of the exemplary commitment from all levels of staff. Woodstock Hospital’s CEO and Board of Trust support a safe hospital environment, and are willing to put forth the time, energy and resources into safety programs such as Project Uplift.