In this presentation, presented at the AAMHP conference in Melbourne, we explored overhead hoists and asked the question of how many manual handling problems an overhead hoist system can solve. I think we got to over 10.
We know manual handling injuries are a problem in the aged and disability sector.
Name: My name is Aideen Gallagher and I am the founder of Risk Managed.
Same: We offer workplace health and safety (WHS) consultancy to the health and disability sector.
Fame: We are known for keeping health workers injury free when caring for patients, that is helping them get out of bed, have a shower and moved into their wheelchair
Risk Managed has published our research in 10 peer review academic publications and presented our methodologies at over 30 conferences worldwide. We have worked with the Health Service Executive in Ireland as well as NSW Health and saved them hundreds of thousands of dollars in healthcare costs.
Everyday 50 health workers will have an injury resulting them entering the workers compensation system. That is one worker every thirty minutes.
Health services employ WHS advisors (such as occupational therapists and physiotherapists) to tackle these injuries. However, from our work with these advisors over the last ten years, we have found there are three dominant problems affecting them from keeping staff injury free:
Lack of Systems They don’t have systems for identifying when a procedure could result in an injury and what to do about it
Lack of training They don’t have the knowledge to keep staff injury free. Research has shown that many of them are inadvertently giving incorrect advice. These advisors only receive a total of 4 hours of manual handling training in University and there are no practical post-graduate options.
Lack of confidence Many advisors are recommending double the number of staff than they actually need when they have the right equipment. They are missing cost savings of over $40,000 per client per year.
Deep Pain Health services are hemorrhaging money paying out workers compensation insurance, using too many staff per client and low morale because of the high volume of injuries.
The Method At Risk Managed, we offer a 12-week programme called ‘Hoisted’ to provide WHS advisors the skills, confidence and resources to keep staff injury free. This includes face to face training, webinars and mentoring sessions.
Our method has three main principles:
Process: we help advisors to identify what is causing the injuries and how to practically prevent them.
Prescription: we teach health professionals how to choose and use equipment to get the best out of the resource so that only 1 not 2 staff are needed per patient care.
Facilitate: We facilitate we don’t tell. This way we harness the knowledge all these advisors already have and provide with a way to find out for themselves.
The Solution By creating knowledgeable, skilled and resourceful advisors health service can be injury free with lower insurance premiums whilst efficiently using staff.
The Why When I was three my Mum, who is a nurse, got an injury at work lifting a client off the floor. I see how that has prevented her from doing many activities she really enjoys in her life.
Like my Mum, health staff (someone else Mum, Dad, daughter or son) will go to work today with a vision to make a difference to the lives of people who were sick or have a disability. In the time it takes us to finish this pitchfest event today, five of them will have got an injury and entered the labyrinth of workers compensation scheme and end up with a life long disability themselves.
I believe that every health worker who gives their skills, energy and expertise to their job deserves to go home uninjured.
Today we are going to learn about the application of one of these principles – separating the gimmick from the gem
When I was three, my mum, who is a nurse, got an injury at work from lifting someone up the bed. I see how that has impacted her in her life and the things she wanted to achieve.
I believe that every care worker in Australia has the right to go home uninjured but pain free after work.
I believe that every person with a disability has the right to comfortable, dignified and respectful care.
But the main reason I do this is for families. Behind every person in care is a family that needs support. If we cant provide quality, safe and dignified care, we are letting them down
I believe Australian Healthcare Organizations can set a standard in terms of safe, efficient, respectful and dignified care
Risk management is the process we use to solve manual handling problems.
I feel this is the key to starting to be able to cope with the tsumani that is upon us in terms of the manual handling of the bariatric person.
In preparation for this talk, I talked to a number of key people around the world who have knowledge in bariatric care and many of them say they are still learning. There is so much unknown and we need a framework for making good effective and efficient decisions. We are still learning and we are continuing to learn and risk assessment is the process through which we are going to find the answers. I am going to challenge the way you engage with is today to determine if we can use it to enable as opposed to hinder function.
In terms of risk assessment, we assess it in terms of the likelihood of something happening and the severity of the event if it occurs. What is it? Risk? What is risk?
When we look at the word risk in the manual handling sector, it has many negative connotations (word cloud on slide) and you would kinda wonder who would ever want to work in it. When we look beyond that, for example in mental health, we get many positive words associated with risk we talk about opportunity.
I have worked in both mental health and manual handling and both disciplines use a similar methodology – risk assessment.
However through working with risk assessment as well as the study and the teaching of it, I started to notice that in manual handling we get one type of use out of it but in mental health we use it twice.
I used to work in the crisis mental health team and we would see people in emergency when they were at their most vulnerable. Our role is emergency was to prevent harm to self or others so essentially we were bringing people from danger to safety. After someone went home from emergency we would work with them in a crisis capacity to keep going from danger to safety. Once someone stabilised we would move onto another process. This would be from safety to life. We would use risk assessment again to help someone take risks and start to live. With safety as a vital step of our risk assessment process we would use risk assessment to test risk taking out.
Getting back to risk being seen in a slightly broader light, risk can therefore describes risk assessment on a continuum where you get positives/enablers and negatives/barriers. Almost like a thermometer, when the temperature gets hot, you turn it down.
I think this is important because in mental health, risk assessment in engaged with all the time to test whether there are risks with a certain action with a client. If there are unwanted outcomes we control for them and enhance the positives. The key is that risk assessment is engaged with, not just when danger is present, but to test out options and check if they are merited.
Nelson, A., Matz, M., Chen, F., Siddharthan, Lloyd, J. & Fragala, G. (2005). Development and evaluation of a multifaceted ergonomics program to prevent injuries associated with patient handling tasks. International Journal of Nursing Studies 43 (2006) 717–733 Theis J.L., Finkelstein M.J. (2014). Long term effects of safe patient handling program on staff injuries. Rehabilitation Nursing 2014,39, 26-35. Garg, A., and Owen, B. (1992). Reducing back stress in nursing personnel: an ergonomic intervention in a nursing home. Ergonomics 35, 11: 1353-1375.
Chhokar, R., Engst, C., Miller, A., Robinson, D., Tate, R.B., Yassi, A., (2005). The three year economic benefits of a ceiling lift intervention aimed to reduce healthcare worker injuries. Applied Ergonomics. 36, 223e229.
Because we only ever engage with risk assessment when danger is present, our aim in manual handling has been to make things safe. We rarely look at making things efficient.
It is kinda like buying a ferrari and then driving it in third gear
Csikszentmihalyi (1997) discusses creativity in terms of effective problem solving, where divergent ideas are used to find workable solutions. He links creativity with risk, identifying that to be creative is to take a risk. In a clinical setting, where risk is regularly reduced to its harmful elements, a reluctance to engage with risk limits the extent to which a clinician can be creative in.(18)
I am therefore suggesting a new way of looking at risk assessment and suggesting a two-step process to risk assessment. Involving divergent thinking first to be creative in problem solving and using risk assessment to test out your ideas for safety.
Overhead hoists - one hoist, how many solutions?
How many solutions?
Aideen Gallagher &
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How health professionals can
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Due for publication late
• Client and care giver – purchased from istock
• Expert – purchased from istock
• Aideen and family in Monet’s Garden – personal photo
• Ferrari California – by Paul is licenced under flickr
creative commons 2.0
• Icon’s – copyright Risk Managed
• Gallagher, A. (2017).The Manual Handling Revolution. How health professionals
can achieve creative solutions for people with disabilities and their care givers.
Michael Hanrahan Publishing.
• Nelson, A., Matz, M., Chen, F., Siddharthan, Lloyd, J. & Fragala, G. (2005).
Development and evaluation of a multifaceted ergonomics program to prevent
injuries associated with patient handling tasks. International Journal of Nursing
Studies 43 (2006) 717–733
• Theis J.L., Finkelstein M.J. (2014). Long term effects of safe patient handling
program on staff injuries. Rehabilitation Nursing 2014,39, 26-35.
• Garg, A., and Owen, B. (1992). Reducing back stress in nursing personnel: an
ergonomic intervention in a nursing home. Ergonomics 35, 11: 1353-1375.
• Chhokar, R., Engst, C., Miller, A., Robinson, D., Tate, R.B., Yassi, A., (2005). The three
year economic benefits of a ceiling lift intervention aimed to reduce healthcare
worker injuries. Applied Ergonomics. 36, 223e229.