In Part 1, we discussed why Safe Patient Handling and Movement programs hold great promise to reduce patient and caregiver injury.
But is it that easy?
The well-publicized data surrounding successful safe patient handling and movement programs may suggest that implementation is a ‘sure bet.’ Unfortunately, that is not always the case. Ineffective programs usually fail quietly, and so it is important to seek to understand why some programs do not realize their promise.
In our experience, the principal reason is due to a lack of program infrastructure and ongoing follow up. As Mary Matz concluded in her analysis of the Veteran Administration’s VISN-wide safe patient handling and movement program:
“Although implementation of the SPHM Program was consistently related to decreasing injury risk and fostering staff empowerment and feelings of professionalism, and many positive comments were relayed regarding AAR, use of the Algorithms, and the BIRN program, these SPHM Program elements instituted as a part of the original research study were generally not well maintained.”
These comments, we think, highlight two things:
First, implementations need to account for the unique size, structure and culture of each facility; one size does not fit all. For this reason, a thorough risk assessment using the tools of decision analysis needs to be completed. If done right, this will shape the design of your program to ensure it delivers maximum value. As explained in this monograph, The Risk Authority applied this approach at Stanford Hospital & Clinics, which resulted in the investment in over $5million for safe patient handling in the new Stanford Hospital.
It’s much more than equipment
Second, formal program infrastructure must be established to provide accountability, support and integration of the various departments and people involved in the program.
Unfortunately, some hospitals have viewed the purchase of safe patient handling equipment as synonymous with implementing a safe patient handling program, only to find that when it comes to the decision between 30 years of nursing practice and using unfamiliar equipment, the 30 years of practice prevails.
This is because safe patient handling and movement at a fundamental level is about culture change, and as Eric is fond of saying, “you can’t buy culture.”
The interdisciplinary team
Understanding this, Stanford formed an interdisciplinary committee to provide the constant and committed attention and direction needed for program success.
The committee was made up of leaders from, for example, nursing, infection control, laundry, administration, contracting/purchasing and risk management, all who were viewed as essential to the success of the program. They met every week to report back to one another, discuss policies and opportunities, and used a ‘think tank’ approach for overcoming any obstacles that appeared along the way.
Over the first 5 years at Stanford, the safe patient handling program saw a variety of positive outcomes, including $2.5 million reduction in employee injuries, significant reductions in lost and restricted work days, and increases in patient referrals and employee satisfaction.
We believe the key to our success was the interdisciplinary committee, which met every week from the program’s inception, and stayed committed throughout the process.
In part III of this series, we’ll look at how to formulate the ROI business case to get your program started.
Edward Hall, Jr., MS, CSP is Chief Operating Officer of The Risk Authority, and was responsible for the role out of Stanford Hospital & Clinics’ safe patient handling program, which received the “Best Practice Award” for safe patient handling, granted by the Office of Veterans Affairs and Administration and the University of South Florida.
Eric Race is Founder & CEO of Atlas Lift Tech, the Safe Patient Handling and Movement solutions provider for Stanford Hospital & Clinics. Atlas’ “Lift Coach” model and proprietary software systems have been integral to the success of Stanford’s safe patient handling program.