1 We Have Your Back A Worker Safety Collaborative An Initiative of the Florida Hospital Association WORKER SAFETY WEDNESDAY WEBINAR SERIES: LIFT TEAMS: MYTHS AND FACTS ABOUT LIFT TEAM PROGRAMS WEDNESDAY, NOVEMBER 1, 2017 2 WELCOME! 1
WHYB: Promoting workforce safety as an organizational priority in our hospitals 3 FOCUS AREAS: Safe patient lifting, handling and mobility Sharps injury and blood exposure prevention Workplace violence Finding solutions to reduce work stress, fatigue, and burnout WHYB: Promoting workforce safety as an organizational priority in our hospitals 4 FOCUS AREAS: Safe patient lifting, handling and mobility Sharps injury and blood exposure prevention Workplace violence Finding solutions to reduce work stress, fatigue, and burnout 2
Special Thank You to Our Sponsors! 5 6 LIFT TEAMS: Myths and Facts About Lift Team Programs MANON LABRECHE, PT, CEAS II MANAGER, LIFT TEAM & INJURY PREVENTION EMPLOYEE HEALTH SERVICES TAMPA GENERAL HOSPITAL 3
Objectives Definition of lift teams Review myths and facts of lift teams Describe TGH lift team program Describe benefits of lift teams Review components to make lift team successful 7 Tampa General Hospital (TGH) Tampa, Florida Level 1 Trauma Center: 1000 beds 6800 Employees Magnet Hospital Bariatric Center of Excellence Lift Team program for 15 years Lift team operate 24/7 Report to Employee Health Director IP Coordinator/Manager for 17 years 8 4
IP & Lift team Manager responsibilities SPH program development and growth Lift Team: Manage staff and program development Coordinate Educational classes Evaluate and implement patient lifting equipment and work with various vendors. National: speaker and committees 9 IP & Lift team Manager responsibilities Oversee IP/Ergonomic program: 200-300 individual computer ergonomic evaluations 20-30 job site assessments (pushing/pulling etc) Ergonomic educational program development Collaborate with employee health ARNP, WC case Manager and Therapy to help identify trends and develop IP programs Program outcomes 10 5
1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 11/1/2017 1.7 1.6 1.5 1.4 1.3 1.2 1.1 1 0.9 0.8 0.7 0.6 0.5 0.4 0.3 Workers Compensation Experience Modification Factor 1.0 = reflection of last 3 year experience vs. expected losses for like hospitals > 1.0 = worse than average < 1.0 = better than average * National Council of Compensation Insurance, Inc. 11 Question? SPHM programs for > 2-3 years Staff available within a few minutes to assist with SPHM tasks. Compliance with staff utilizing equipment consistently. Equipment is available, accessible, batteries charged, cleaned, in good working condition & slings available. Reduced Patient Handling injuries & cost by > 60% If you answered NO to any of the above questions, your facility may benefit from a lift team. 12 6
Typical barriers to SPHM programs Time to use equipment. Location of the equipment. Staff do not feel comfortable using equipment. Equipment not working or available. Administrative support $ Training Not taught in school Lack of buy in and support from nursing (culture change) 13 Where does a Lift Team fit in a SPHM program? Typical components of SPHM program: Equipment Training/education Champions (facility, peer leaders etc) Buy-in and support front line staff Administrative support Outcome measures Lift teams should be an adjunct to your SPHM program, it should not be the ONLY component. 14 7
Lift Teams 15 Definition of Lift Team Many definitions, preferred one is on liftteams.com 16 8
Myths vs Facts pertaining to Lift Teams Myths Hire a bunch of strong men to manually lift. Lift teams are not effective at reducing staff injuries. Why have a lift team if you have equipment and nurses are trained in using it? Lift teams cost a lot of money. You can either start a lift team OR purchase equipment Facts Lift teams should follow best practice and national guidelines and utilize equipment when indicated. Literature review shows that lift teams can reduce injuries by 60-80% and reduce cost by 80-90% Number one barrier to success of SPHM programs is buy-in and support of staff with using equipment. Lift teams help to reinforce and coach staff on use of lifting equipment. Most lift team programs have a ROI within 1-2 years. Lift Teams need equipment to move and handle patients safely. You need BOTH 17 Patient Handling Injury (PHI) Rate per 100,000 productive work hours 1999-2016 2.5 2 2 1.9 71% reduction since Lift Team 1.5 1.3 1 0.9 0.5 0.51 0.53 0.54 0.49 0.490.490.51 0.5 0.45 0.38 0.39 0.51 0.38 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 0.32 Prepared by Employee Health Services 18 9
Patient handling injuries External Medical cost rate per 100 employees 2001-2016 8000 7000 7347 6964 94% reduction of external medical cost since Lift team started 6000 6086 Rate/100 Employees 5000 4000 3000 3492 2000 1541 1000 941 425 529 687 577 567 385 435 0 208 0 97 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Prepared by Employee Health Services Excludes: internal and indemnity costs 19 TGH Lift Team program Started in March 2002 with 6FTE s Current Lift team staff (31 staff): Manager Injury prevention Coordinator (3 days/week ergonomics) 4 Lift Team Supervisors Data mgmt. coordinator 19 Lift Team tech 1 5 Lift Team tech 2 Lift team responsibilities: 1. Move & handle patients 75% 2. Maintenance and inventory of lift equipment (clean slings, assign 1-2 dept each) 25% 3. Educate on every call 20 10
TGH Lift Team job tasks 60%- Repositioning in bed 30%- Transfers in/out of bed to recliner, w/c, commode etc 10% Other: Pick pts off floor Vehicle transfers Lateral transfers Also Assist skin care team, PT/OT, radiology, ER, out-pt procedure areas, transport etc 21 TGH Lift team program Staffing: Day: 6-8 staff, night: 4-5 staff (plus a Supervisor for each shift) Designated lift team staff that round in all ICU units at scheduled times. Work alone in collaboration with nursing staff (unless bariatric patient or patient with special needs.) Nursing staff required to be in room with lift team Downtime: Maintenance and inventory of lift equipment: Each tech has a designated area: re-stock slings, launder cloth slings, re-stock hover mats, charge batteries, assure equipment in proper storage location etc Educate staff on use of lift equipment 22 11
Lift team hiring criteria Patient care experience preferred BUT no a must Dependable, reliable, MATURE Able to work independently Great customer service skills Good communicator Physical criteria: stand/walk 8-9 miles/day, no fitness test 23 Lift team orientation Trained by supervisors and IP Manager: 4-6 weeks training Back care: anatomy, risk factors, body mechanics Medical terminology and precautions Knowledge base: SPHM legislation, OSHA, NIOSH, ANA standards, TGH Policy Bariatric sensitivity Equipment training Equipment maintenance and inventory training Customer service training All techs: 8 hour annual training and 60 minutes monthly training 24 12
Lift team paging criteria Patients who require a lot of assistance to get in/out of bed (mod assist to dependent) Dependent patients who are > 150 pounds and need repositioning assistance. Bariatric care 25 TGH Lift Team Procedure Staff contact lift team via TGH portal Each lift team tech carries a hospital issued IPAD Select needed now or enter their rounding times Lift team answer pages in order unless 911 call or priority (commode transfer, procedure areas etc) 26 13
TGH Lift Team Procedure Nursing role: Must be present in the room Manage tubes and lines Inform team of precautions. Must have supplies in room prior to lift team arrival. Lift team obtain equipment Lift team waits 2-3 minutes if staff not ready Lift team try to engage nurse with equipment and educate on each call. Nursing responsible for making patient comfortable after transfer. 27 Lift team Documentation: Document in patient medical chart Post transfer method or equipment on magnet outside door and/or Flag in chart. 28 14
SPHM education Education: Training upon hire (3 hr class) Annual training New equipment training Unit based 29 Other SPHM Education Unit Peer leader program: LIFT Expert program (Leaders In Facilitating Transfers and repositioning) Part of our clinical ladder Meet quarterly for 2 hours Instructors: IP Manager and Lift team supervisors > 100 participants form various dept including: Nursing, ER, radiology, skin care, therapy, transport, procedure areas etc Worker s comp and IP talk for Managers: All new managers required to attend 2 hour class Offered 3 times per year and open for clinicians and supervisors Recommend attend every 2 years 30 15
Other SPHM education Educational sheets, bariatric guide, videos, equipment locations etc 31 Lift team coach at the bed side and reward staff Recognition programs: recognize staff who utilize equipment on their own or come up with creative solutions. Coaching at bedside with actual patients: lift team, IP Manager, therapy staff, LIFT Experts. Effective way to learn 32 16
TGH Patient lifting equipment Purchased ~2 million of equipment since 2002 (~$150,000 each year) Current equipment: Ceiling lift tracks over all ICU beds Ceiling lift tracks in ~50% of all other beds Most depts have: One Floor lift 1-2 Sit to stand device 1 Standing aid 1-4 hover pump Slide sheets Gait belts Variety of slings (butterfly, mesh repo, limb holding, transfer) 33 Benefits of Lift Teams Safe patient handling experts that assist with high risk tasks. They are the role models and lead by example. Assist with culture change along with buy in and support. Educate staff on the units with actual patients. 34 17
Benefits of Lift Teams Assist with overcoming equipment barriers Time factor: obtain and utilize the equipment Equipment maintenance: charge batteries and work with biomed when equipment not working. Equipment inventory: re-stock slings and other equipment Equipment accessibility: clean out equipment rooms and re-arrange 35 Benefits of Lift Teams Decrease pressure ulcers (perform turning rounds in ICU units) Increase patient satisfaction (follow pt during length of stay and get pts OOB more frequently) Decrease in falls during transfers in/out of bed. Nursing recruitment and retention More time for other Nursing duties. Increased morale Nurses state less daily back pain 36 18
Benefits of Lift Teams Decrease injuries (60-90%) Decreased lost and restricted work days Decreased worker s comp cost (80-90%) 37 2017 TGH Lift team survey results 885 respondents (75% RN s) Please rate the importance of the TGH Lift Team in performing your every day job duties (1 not important-10 extremely important) Overall score= 9.3 How has the lift team benefited you or your patients? 82% increased patient and family satisfaction 74% experience less back discomfort 66% patients get out of bed more frequently 65% patients get repositioned more frequently 59% patients fall less frequently when they get out of bed 57% have more time for other nursing duties 51% less fatigue at end of shift 38 19
Components to successful lift teams Equipment on each unit is crucial, Lift team should not manually lift. Manager and Supervisors for accountability, handle issues, enforce use of equipment, train etc. Training lift team to include knowledge base and customer service. Educational programs for staff & peer leader programs Management support Staff buy in & support Market lift team Track outcomes 39 Promoting your lift teams 40 20
Patient Handling Injuries R.N. Injury Rate per 100 RN s 2001-2016 5 4.5 4 3.5 4.35 78% reduction of RN s injuries since 2001 Rate/100 RN's 3 2.5 2 1.5 1 0.5 0 2001 2002 1.49 1.39 1.35 1.15 1.27 1.35 1.05 1.08 0.77 0.88 0.9 0.94 0.75 0.85 0.96 Prepared by Employee Health Services 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 41 1.8 Patient Handling Injuries (PHI) Low back injuries (rate per 100 Employees) 1999-2016 1.6 1.4 1.61 Lift team started 70% reduction in Low Back injuries since Lift team started in 2002. 1.2 1 1.05 0.93 0.8 0.6 0.4 0.2 0.52 0.55 0.43 0.39 0.41 0.39 0.42 0.3 0.23 0.31 0.34 0.32 0.19 0.24 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Prepared by Employee Health Services 42 21
Patient handling injuries (PHI) Lost work day (rate per 100 employees) 2001-2016 14 12 10 8 10.9 11.6 9.4 93% reduction of Lost work days since Lift team started in 2002 6 6.4 4 2 0.4 0.4 0.7 0.7 0.7 0.9 1.1 1.1 0.9 1.24 1.62 0.8 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Prepared by Employee Health Services 43 Summary Lift teams can be effective at reducing staff injuries and assist with promoting SPHM if set up correctly. Have all components necessary to assure success. SPHM & Lift team programs can have an impact on patient safety, patient satisfaction, skin integrity, nursing recruitment and retention etc 44 22
Lift team additional resources 45 Lift team website Liftteams.com FAQ, articles, blog, success stories 46 23
Join LinkedIn: lift team group 47 References Charney, W. (1997). The lift team method to reducing back injuries. A ten hospital study. American Association of occupational health nursing, 45 (6), 300-304 Charney W. Handbook of modern hospital safety, 2010 Donaldson A. (2000) Lift Team intervention: a six year picture Journal of healthcare safety, compliance and infection control.;4(2): 65-68 Kutash M, et al (2009) The lift team s importance to a successful safe patient handling program. Journal of nursing administration, 39 (4) : 170-175 Meittunen E et al. (1999) The effect of focusing ergonomic risk factors on a patient transfer team to reduce incidents among nurses associated with patient care. Journal of Healthcare safety, compliance and infection control.; 3 (7): 306-312 Nelson et al (2006) Development and evaluation of a multifaceted ergonomics program to prevent injuries associated with patient handling tasks. International journal of nursing studies, 43(6), 717-733 Short and Shea (2011) Lift teams; an effective strategy in safe patient handling. American Journal of safe patient handling and movement, 1 (1), 36-41 48 24
Questions More information or questions: Contact Manon via email: mlabreche@tgh.org 49 WHYB Events 50 December 5-6 WHYB Annual Worker Safety Conference The Westin Lake Mary, Florida Details and Registration at: http://www.fha.org/education-and-events/eventdetails.aspx?itemid=717 25
Webinar Evaluation Survey & Continuing Nursing Education 51 Eligibility for Nursing CEU requires submission of an evaluation survey for each participant requesting continuing education: https://www.surveymonkey.com/r/jhlvhrm Share this link with all of your participants if viewing today s webinar as a group Be sure to include your contact information and Florida nursing license number FHA will report 1.0 credit hour to CE Broker and a certificate will be sent via e-mail We would appreciate your feedback even if you are not applying for CEUs!! Web participants can stay logged in as the webinar closes to be redirected to the online survey (the link will also be provided in a follow up email) 52 THANK YOU! 26
53 WHYB Questions and Information 407-841-6230 whyb@fha.org 54 An Initiative of the Florida Hospital Association 27