Mayo uses quality approach to ergonomics
Mayo uses quality approach to ergonomics
Program reduces injury frequency, lost time
The Mayo Foundation in Rochester, MN, is one employer that decided not to wait for a federal standard before developing an ergo nomics program. "We’ve been working on the process of reducing back injuries for nursing staff during patient transfers and other activities for four years now," says Eric J. Meittunen, MS, safety coordinator for 7,000-employee St. Mary’s Hospital, the largest hospital in the Mayo system.
Although specific numbers are not available yet, "we have seen a reduction in the frequency of injuries, and our return-to-work program has reduced lost time for staff," he says.
Key to the ergonomics and safety program is a quality team approach that in the past three years has come up with a two-pronged action plan: implementation of patient lifting teams, and more coaching and reinforcement from peers.
The following six-step process was used to establish the quality team and allow it to function:
• Identify a project (based on the needs of the organization and the priority status).
• Establish the project.
• Diagnose the cause (of the problem).
• Remedy the cause.
• Hold the gains.
• Replicate the gains to other areas.
The ergonomics quality team, which Meittunen says is called TNT (Technique, Not Torture), is now on step four of the process. TNT is made up of a cross-section of 15 employees from nurse managers and staff nurses to escorts and orderlies, as well as clinical directors and representatives from administration and the safety department. About 10 additional interested staff are ex officio members. The group meets two hours every other week.
"Our mission is to resolve this issue of back injuries among health care staff due to patient transfers," Meittunen explains. "The initiative was not brought out as a safety issue, but was identified as important by the organization as a quality issue. What happens if we injure more health care employees, and we don’t have the replacements? What happens if these people are injured, because a back injury stays with you the rest of your life? It’s concern for the caregiver."
Lift teams prioritize work
For the first intervention, lift teams of specially trained orderlies are used on six units at St. Mary’s. They are called in to lift and transfer patients based on a system of priorities. The first priority is to lift patients who have fallen on the floor. The second is cart-to-bed or bed-to-cart transfers. Their third priority is to transfer patients from chair to bed and vice versa, and fourth is to move morbidly obese patients.
The coaching and reinforcement intervention is being piloted in three units of Rochester Methodist Hospital, a 4,000-employee Mayo institution. In the first unit, nurses, escorts, and orderlies receive the standard employee education with no change from previous years. In the second unit, more coaching on proper lift techniques and reinforcement from peers are added. Training from an external occupational safety consultant was added in the third unit, and Meittunen notes that certain "challenges" emerged from the latter intervention.
"Just to identify how difficult health care is to work with, the external consultant decided not to work with us any longer because of the challenges that were here. In health care, everyone is a professional in their unique area. That creates a challenge because it’s tough for somebody from the outside to come in and tell somebody else what to do. Also, patient care units are fast-paced environments, which means that it’s much more of a challenge for us to do our jobs safely. When we’re taking care of patients, sometimes we sacrifice ourselves for their safety," he says.
Results of the coaching and reinforcement program will be evaluated after the one-year program is completed.
Meittunen notes that TNT is one of the first quality improvement teams to be initiated by Mayo, and the only one still running.
"No one has found the exact answers to solving the problem of back injuries for health care employees," he says.
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