PRESENTED BY APRIL 18, 2018
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1 PRESENTED BY APRIL 18, 2018 The University of Texas MD Anderson Cancer Center Houston, Texas
2 Duke Health: Moving from SPH to SPHM Tamara James, MA, CPE, CSPHP Ergonomics Director Occupational & Environmental Safety Office Duke University & Duke Health
3 Title Objectives 1. Discuss the background of SPH at Duke and the motivation for moving to SPHM. 2. Identify strategies to gain buy-in for SPHM programs. 3. Understand options and the value of including mobility assessments in SPHM programs EHSSENTIALS
4 Title Background 3 Hospitals (~1500 beds) Level 1 Teaching Hospital - Durham 2 community hospitals - Raleigh and Durham >68,000 admissions 2018 EHSSENTIALS
5 Title Background Nearly 400 clinics statewide >3.6 million outpatient visits 2018 EHSSENTIALS
6 Title Workforce Profile Nurses growing older average age is 50 years old Nursing shortage Workload, burnout retirements nursing school enrollment 2018 EHSSENTIALS
7 Title Patient Profile 1 out of every 2 adults has chronic illness >80% over age 65 have at least one 1 in every 3 adults obese 1 in 5 youth obese (BMI>30) 7.4 million people have mobility impairments Baby Boomers - every 7 seconds one turns EHSSENTIALS
8 Title SPH at Duke Partnership Ergonomics and Nursing Selling point: Patient satisfaction (Press Ganey) Implemented in 2004 in adult in-patient units Various types of equipment available Expansion two sister hospitals radiology, labor & delivery, pediatrics, OR, periop & pacu, ED, morgue 2018 EHSSENTIALS
9 Title SPH/SPHM at Duke Program enhancements in 2015 Stronger Partnership Ergonomics/Nursing ANA SPHM Interprofessional Standard Focus on patient mobilization 2018 EHSSENTIALS
10 Title Strategies for Buy-in and Success Nursing-led program ANA Standard - roadmap Equipment/supplies Systems approach Resources 2018 EHSSENTIALS
11 Title Nursing-led Program ACNO for Quality health system lead Facility champions Employee safety/ergonomics role 2018 EHSSENTIALS
12 1. Establish a Culture of Safety 2. Implement and Sustain a SPHM Program 3. Incorporate Ergonomic Design Principles to Provide a Safe Environment of Care 4. Select, Install, and Maintain SPHM Technology 5. Establish a System for Education, Training and Maintaining Competence 6. Integrate Patient Centered Assessment, Care Planning, and Use of SPHM Technology 7. Include SPHM in Reasonable Accommodation and Post Injury Return to Work 8. Establish a Comprehensive Evaluation Program
13 Title ANA Standard Patient safety vs. staff safety Falls/Pressure Injuries/skin tears Compromised quality of care Patient-Centered vs. Equipment-Centered Care Plan EMR/EHR 2018 EHSSENTIALS
14 1. Establish a Culture of Safety 2. Implement and Sustain a SPHM Program 3. Incorporate Ergonomic Design Principles to Provide a Safe Environment of Care 4. Select, Install, and Maintain SPHM Technology 5. Establish a System for Education, Training and Maintaining Competence 6. Integrate Patient Centered Assessment, Care Planning, and Use of SPHM Technology 7. Include SPHM in Reasonable Accommodation and Post Injury Return to Work 8. Establish a Comprehensive Evaluation Program
15 Title Early Mobilization Benefits Mobilizing patients earlier results in positive patient outcomes: reduced length of stay fewer ICU readmissions decreased ventilation duration fewer days of bed rest improved walking distance (Morris, et al. 2008; Perme, et al. 2014) 2018 EHSSENTIALS
16 Title Mobility Status Benefits Mobility status important Patient care is bed-centric Rapidly lose muscle mass/deconditioned Must know mobility status to avoid falls 2018 EHSSENTIALS
17 Title Mobility Assessments Many patient mobility assessment tools developed (Boynton, et al. 2014) Identify/encourage use of appropriate patient lifts to reduce healthcare worker injuries (Flanders, et al. 2009) 2018 EHSSENTIALS
18 Title Mobility Assessments Current state of Mobility Assessments? Benchmarking Survey Conducted by Duke Nursing and Ergonomics 2018 EHSSENTIALS
19 Title Mobility Assessment Survey January June, 2015 Distribution Social Media Electronic Newsletters Association Membership s Word of Mouth 2018 EHSSENTIALS
20 Who Participated? > 110 Organizations
21 Banner Health Baptist Health South Florida BJC HealthCare Catholic Health Services of Long Island Children s Hospital of Wisconsin CHI Mercy Council Bluffs Cleveland Clinic Dignity Health Eisenhower Medical Center Genesis Health System Hanover Hospital Johns Hopkins McLaren Bay Region Nash Health Care- UNC Affiliate NorthShore University Health System Northwest Community Healthcare Northwestern Medical Center Overlake Medical Center RML Specialty Hospital Rochester General Hospital Royal Victoria Regional Health Centre SCL Health - Denver Sites Sharp HealthCare Spectrum Health St. James Healthcare Torrance Memorial Medical Center UCSF Medical Center UMC Health System UnityPoint Trinity Quad Cities University Of California Health University of Colorado Health University of Rochester Medicine University of Toledo Medical Center University of Wisconsin Hospital and Clinics Upstate University Hospital UVA MC
22 SPH Programs
23 Patient Mobility
24 Patient Mobility
25 Patient Mobility
26 Patient Mobility
27 Patient Mobility
28 Patient Falls
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30
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32 Fall 2015 Move Often Very Early Safely
33 Title Equipment/Supplies New inpatient equipment ($1.2M) Focus on mobility Expansion to clinics Focus on falls reduction All readily available - easy to access/use 2018 EHSSENTIALS
34 1. Establish a Culture of Safety 2. Implement and Sustain a SPHM Program 3. Incorporate Ergonomic Design Principles to Provide a Safe Environment of Care 4. Select, Install, and Maintain SPHM Technology 5. Establish a System for Education, Training and Maintaining Competence 6. Integrate Patient Centered Assessment, Care Planning, and Use of SPHM Technology 7. Include SPHM in Reasonable Accommodation and Post Injury Return to Work 8. Establish a Comprehensive Evaluation Program
35 Friction Reducing Devices
36
37 Active Standing/Walking Devices
38 Stand Assist Powered Lifts 800 lbs
39 Total Assist Powered Lift Floor-based
40 Total Assist Powered Lift Ceiling-mounted
41
42 Car Lifts
43 Air-assisted Transfer Devices Hoverjack CAMEL
44 Lifts in Decedent Care and Pathology
45 650 lbs Exam Tables
46 Exam Table Lift
47 Stretchers/Recliners/Stretcher-Chairs
48 1. Establish a Culture of Safety 2. Implement and Sustain a SPHM Program 3. Incorporate Ergonomic Design Principles to Provide a Safe Environment of Care 4. Select, Install, and Maintain SPHM Technology 5. Establish a System for Education, Training and Maintaining Competence 6. Integrate Patient Centered Assessment, Care Planning, and Use of SPHM Technology 7. Include SPHM in Reasonable Accommodation and Post Injury Return to Work 8. Establish a Comprehensive Evaluation Program
49
50
51
52 Title Systems Approach analyzes and elicits customer needs/functionality considers the complete problem understands all of the stakeholders 2018 EHSSENTIALS
53 Title Resources 1.5 dedicated FTEs in Ergonomics Facility and entity coordinators Monthly steering committee meetings One champion at all units/clinic Quarterly champion meetings Annual champion workshop Falls consolidation 2018 EHSSENTIALS
54 1. Establish a Culture of Safety 2. Implement and Sustain a SPHM Program 3. Incorporate Ergonomic Design Principles to Provide a Safe Environment of Care 4. Select, Install, and Maintain SPHM Technology 5. Establish a System for Education, Training and Maintaining Competence 6. Integrate Patient Centered Assessment, Care Planning, and Use of SPHM Technology 7. Include SPHM in Reasonable Accommodation and Post Injury Return to Work 8. Establish a Comprehensive Evaluation Program
55 Susan Avent Duke Health Acknowledgements Jennifer McIlvaine, Yeu-Li Yeung Duke Occupational & Environmental Safety
56 Questions? Tamara James LinkedIn: Hospital Ergonomics Safe Patient Handling
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