No Lift Success Story

Banner Health dramatically reduced worker's compensation costs at two facilities with the use of mechanical lifts.

• By Hans Sigvardsson, Betty Bogue
• Jul 01, 2004

MANY hospitals today find their financial health in critical condition. Increasing worker's compensation claims, an ongoing nursing shortage, higher operating costs, and reduced government funding contribute to a challenging operating prognosis. To address this situation, progressive hospitals are developing new strategies that include the mandatory use of patient lift devices. This approach to patient lifting and transferring not only reduces employee injuries and improves patient care, but also allows hospitals to save millions of dollars in worker's comp costs. By achieving a solid return on their investment in quality patient lift equipment, hospitals achieve greater financial health, while addressing the national concern of ergonomics.

"The safety and health of our nation's workforce is a priority for my administration. Together we will pursue a comprehensive approach to ergonomics," President Bush said in March 2001 when he signed a joint resolution of Congress, disapproving OSHA's ergonomics standard and, at the same time, pledging to find a solution to ergonomically related problems. That solution was introduced April 5, 2002, when OSHA unveiled a plan to reduce ergonomic injuries dramatically. Two weeks later, OSHA announced health care would be the first industry directed by specific guidelines for ergonomics.

When it comes to ergonomics, hospitals are unlike any other type of employer. They are more labor intensive and spend most of their financial resources on "human capital." Health care workers are the backbone of their business and are charged with improving the health and well-being of patients, while ensuring their own safety.

The Bureau of Labor Statistics now classifies health care patients as a direct cause of on-the-job injury. A back injury occurs every 30 minutes among health care workers in America; nursing is one of the occupations at highest risk for injury. Eighty-seven percent of nurses report low back pain, 38 percent of nurses suffer back pain or injuries severe enough to require time off from work at some point in their careers, and 44 percent of injured nurses are unable to return to the nursing profession. The American Nurses Association's 2001 Nursing World Health and Safety Survey reported 76 percent of the 4,826 nurses surveyed believe unsafe working conditions interfere with their ability to deliver quality care. Furthermore, 88 percent said health and safety concerns influence their decision to continue nursing.

Uplifting News for Hospitals
Providing appropriate patient lift and transfer equipment, and processes to support their use, is an effective strategy hospitals can implement immediately. They can reduce employee injuries and compensation claims, improve patient care and caregiver safety, and boost staff morale and productivity. The bottom line is that hospitals can get a significant ROI from their investment in patient lift systems.

Approximate cost savings can be calculated in terms of the reduction of musculoskeletal disorders (MSDs) and complaints, especially the lower-back injuries sustained during standard manual lift-transfers. According to the U.S. Department of Labor, facilities can save an average of $27,700 each time a severe MSD is prevented. The argument can be made that money already being spent on MSDs in the form of worker's comp costs can be shifted to pay for the implementation of a no-manual-lift program--where all patient lifts are accomplished using mechanical equipment--to prevent such injuries. This can provide cost savings that fall directly to the bottom line, while eliminating the pain, suffering, and disability of injured caregivers (the most important reason to implement such a program).

One of the largest nonprofit health care systems in the United States, Banner Health operates hospitals and long-term care centers, plus offers an array of other health services in nine western and midwestern states. A few years ago, the risk management department at Banner Health's North Colorado Medical Center (NCMC) in Greeley, Colo., had a problem.

Like facilities nationwide, NCMC faced serious challenges arising from patient lifting and transfer injury:

• Rapidly growing expenses
• Permanent loss of employees because of incident-related or chronic back pain
• Increasing incident severity
• Negative impacts on employee morale
• Employee reluctance to report back pain (because of fear of reassignment)

New Equipment, New Approach
NCMC planners soon determined the only feasible solution was to eliminate all manual lifts and transfers of patients. That meant supplementing the few specialized mechanical lifts the hospital already had with a wide assortment of new, multipurpose models. But from what source? And how would the hospital deal with complex issues such as installation, training, and maintenance?

After due diligence, NCMC chose two suppliers to work together. One would supply all lifting equipment, and the other would furnish a program offering a systematic approach to purchasing, training, maintaining, and supporting a truly "safe lift" environment.

All lifts used at NCMC are powered by long-life batteries and directed by easy-to-use, hand-held remote controls; some models are rated for up to 660 pounds capacity. (The hospital plans to install 880-pound-capacity lifts in the future.) Mobile models are easy to move, fit under low beds, straddle mattresses on the floor, lift high enough for whirlpools, have a wheelbase that fits standard bathroom doors, and possess the capacity to pick patients up off the floor. The supplier offers more than 200 different sling configurations and accessories, for patients from children to obese adults to amputees; for needs including bed to chair/commode/toilet, to and from bath/shower/pool, to and from horizontal positions including the floor, standing or gait training; and for areas including surgery, ICU, back, and burn units.

Ergonomics programs that include the use of mechanical lifts to move patients can significantly improve the quality of patient care and safety of health care workers, while significantly reducing related injury costs. In facilities where the combination of mechanical lifts and the necessary processes have been put in place, lift-transfer injuries have been reduced by more than 90 percent. The program has been implemented in more than 200 health care facilities nationwide and has significantly reduced the number and cost of employee lift/transfer-related injuries. In addition to reducing employee injuries and related costs, a no-manual-lift program can improve the quality of health care services.

Results
Beginning in March 2001, Banner Health implemented a comprehensive safe-lift program in its NCMC Greeley facilities and the McKee Medical Center in Loveland, Colo. They received a variety of lifts tailored to specific needs.

The initial educational process, provided for the entire caregiver staff, emphasized real-life challenges in NCMC's day-to-day environment. Its aim: integrating use of mechanical lifts into all of the hospital's processes and procedures. Topics ranged from patient/resident assessment, to sling use, to changing lift batteries.

By June 1, 2001, the program had become mandatory for NCMC's direct care staff. Before the program's inception, employees had voiced significant doubts. They believed using mechanical lifts would inevitably take more time than manual lifting. Experience proved the opposite. Using lifts takes less time because equipment is always available. Caregivers don't waste time finding colleagues to assist with manual lifts. The program allows one nurse to easily lift most patients unaided, in minimal time. Productivity and safety gains are now widely accepted.

Today, the hospital identifies lift candidate patients on admission and supplies the appropriate sling to each patient's room. Mechanical lifts are readily available for immediate use throughout the hospital--two or three lifts on each unit. While the hospital uses floor lifts in general medicine and recovery units, overhead lifts are installed in the ER, radiology, and nuclear medicine departments.

Experience shows that stemming the tide of injury-related losses more than compensates for any capital investment required to institute a no-manual-lifts program. Banner Health's risk management department calculated mechanical lifts would significantly decrease these costly work-related injuries, and their positive estimates turned out to be prophetic.

Improvements directly attributable to the program were remarkable. In 2000, the last year before the program, NCMC had 60 injury claims with developed costs of $350,000. In sharp contrast, by 2002, reported injury losses had plummeted to only $6,290--a cost reduction of better than 98 percent. The NCMC experience agrees with analysis of the cost of employee lift/transfer injuries at 104 health care facilities using the program. They averaged a 90 percent reduction in employee lift/transfer injury claim cost for the first year and a 39 percent reduction in all employee injury cost.

In its presentation to management recommending the program, the risk management department also had shown how it would benefit such "soft" factors as staff morale, staff retention, and patient satisfaction. Banner Health garners many positive comments from employees, patients, and patients' families. Typical is a letter of thanks NCMC received from the family of a wheelchair-bound endoscopy patient. In the past, this individual had undergone a stressful series of manual lifts, needing teams of three or more caregivers each time. The family reported the patient was now very comfortable when lifted by a single nurse using the new equipment.

Looking Ahead
With the winning combination of new lifts, the "safe lift" program, enthusiastic management, and staff dedication, Banner Health has achieved truly astonishing results. At its pioneering NCMC facilities, it has revolutionized a painful and risky practice--the manual lift--that had remained largely unchanged since hospitals were invented.

This article originally appeared in the July 2004 issue of Occupational Health & Safety.