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The American Society for Healthcare Risk Management (ASHRM) is a 6,000+ professional membership group of the American Hospital Association (AHA) including members from risk management, safe patient handling, insurance, law, finance, and other related professions. ASHRM focuses on safe and effective patient care practices, preserving financial resources, and the maintenance of safe working environments, while promoting risk management strategies through education, recognition, advocacy, publications, networking with leading healthcare organizations and government agencies.
Due to the COVID-19 pandemic, ASHRM held their 40th Anniversary Conference (October 12-14, 2020) as a virtual event featuring a curated selection of ASHRM’s highest-rated sessions and keynotes. The organization accepted Atlas Lift Tech’s abstract submission authored by Linda Pryor, Annette Tuatagaloa, RN, MSN, CNS, Natalie Correll-Yoder, MN, RN, CCRN, CCNS, CCNS, Susan Gallagher, PhD, MA, MSN, RN, CBN, CSPHP and Karen K. Giuliano, PhD, RN, FAAN, MBA.
The abstract was selected and developed into a peer-reviewed poster written by Karen K. Giuliano, in collaboration with NorthBay Healthcare, to spotlight Atlas’ success with improving hospital patient safety while decreasing preventable patient and healthcare staff injuries, hospital-acquired conditions and readmissions, improving quality and implementing a culture of safety with technological innovation. This real-life case study is just one of many examples of how Atlas offers mobility solutions with a Safe Patient Handling and Mobility (SPHM) program along with expertly-trained Mobility Coaches using proprietary technology to effectively collect electronic data which patient safety professionals and risk managers use to apply within their organizations. Mobility Coaches have proven to help reduce injuries with healthcare workers, but equally as important, they have improved patient safety through in bed mobility.
Facility Assessment
You wouldn’t trust your doctor to recommend a therapy without a thorough examination. We believe the same can be said for suggesting a safe patient handling and mobility program. That is why we advocate a facility assessment right at the start.
MEET THE AUTHORS
- Dr. Karen K. Giuliano, PhD, RN, FAAN, MBA
College of Nursing/IALS Associate Professor, University of Massachusetts, Amherst MAKaren is a clinical outcomes researcher and a critical care nurse, with expertise in issues around patient mobility. The American Association of Critical-Care Nurses (AACN) recently selected Karen K. Giuliano, PhD, RN, FAAN, MBA, as its 2020 Distinguished Research Lecturer. AACN established the award in 1982 to honor nurses who make significant contributions to high-acuity and critical care research. The annual award recognizes research that changes or improves patient outcomes and advances nursing education and practice. Giuliano has published over 80 articles in more than 20 journals, and she is an invited speaker at numerous national and international conferences, including AACN’s annual National Teaching Institute & Critical Care Exposition.
- Linda Pryor
Director of Risk Management for NorthBay HealthcareLinda has held various positions with NorthBay Healthcare over the last 40 years including Administration, Risk Management and Corporate Compliance. She serves as one of the co-chairs for NorthBay’s Safe Patient Handling and Mobility Team which launched in September 2012. The program has been highly effective in reducing the frequency and severity of care staff injuries related to patient handling. - Natalie Correll-Yoder, MN, RN, CCRN, CCNS, CCNS
Clinical Nurse Specialist, Clinical Practice Manager for NorthBay Healthcare - Annette Tuatagaloa, MSN, RN, CNS
Acute Care Clinical Nurse Specialist for NorthBay Healthcare - Susan Gallagher, PhD, MA, MSN, RN, CBN, CSPHP
The Celebration Institute, Splendora TXSusan earned a Masters’ Degree in Nursing: Advanced Practice WOC Nursing from University of Southern California in 1995. She holds a Masters’ Degree in Religion and Social Ethics, and a PhD in Policy Ethics from University of Southern California. Dr Gallagher is certified in Bariatric Nursing and is a Certified Safe Patient Handling Professional. She is currently President of the Association for Safe Patient Handling Professionals, Associate Editor for Workplace Health and Safety (AAOHN), has served on a number of international boards and is a recognized speaker on skin and wound care, outcomes, bariatrics, ethics, risk and loss control across the globe. Susan is the author of more than 200 peer-reviewed articles, books and book chapters, including the 2013 ANA Implementation Guide to SPHM Standards, Bariatric SPHM and more.
Background
Safe patient handling and mobility (SPHM) program management often relies largely on lagging indicators such as employee injury frequency, severity and cost. While lagging indicators are an important part of overall program management, they represent past performance, as such, are not useful for real-time program management. Conversely, leading indicators such as staff training, appropriate use of SPHM equipment, and evidence-based coaching during actual patient handling represent opportunities for real-time program management that can improve the safety of both patients and staff.
We implemented a SPHM program in one hospital which included Mobility Coaches and electronic tracking of patient handling tasks, using both leading and lagging indicators as outcome measures. Additionally, we collected a large sample of acute care mobility data.
Objectives
- Measure the program implementation leading SPHM equipment
- Measure the impact of program implementation on the lagging indicator of employee injury frequency and cost
- Gather a robust sample of leading indicators of staff training and appropriate use of data on the types and frequency of mobility tasks most commonly required in acute care that can be used as the foundation for SPHM program expansion
Methods
We implemented a SPHM program in one hospital using electronic data collection (using Lift Tracker software) and Mobility Coaches over a 12-month time period (6 months pre/post). Mobility Coaches provided standardized staff training in Five Area Body Exposure and appropriate use of technology-assisted mobility, supported by ongoing real-time coaching and assistance with mobility tasks. Data on staff training and use of SPHM data were collected.
Additionally, convenience sampling was used to collect data on types and frequency of patient mobility tasks for 12 months (January 2019-December 2019) at 4 hospitals in Northern CA. Data were collected by Mobility Coaches using Lift Tracker software.
Results
Objective 1: 100% staff training was achieved through a skills fair along with ongoing training as new staff were hired. Appropriate use of SPHM equipment over the 12-month implementation period was consistently 80% or over.
Objective 2: There was a reduction in employee injury severity, resulting in an overall cost decrease from $395,240.97 (SPHM program pre-implementation) to $29,596.94 (SPHM program post-implementation).
Objective 3: The mobility task leading indicator sample included a wide range of clinical units, including critical care, medical-surgical, ED, labor & delivery, and procedural areas.
Data on a total of 58,196 mobility tasks were collected, 65% of which were done in ICU requiring moderate to maximum assist. In-bed mobility represented the 89.5% (N=52,079) of the total mobility tasks, which are summarized in Table 1.
Conclusion
Through the implementation of our SPHM program using Mobility Coaches and Lift Tracker software, we were able to achieve high compliance with the leading indicators of both staff training and appropriate use of SPHM equipment. Program success was further supported by the substantial reduction in the lagging indicator of employee injury cost. Staff satisfaction was also high.
The mobility data provides a robust representative sample of acute care SPHM needs. The use of Mobility Coaches and real-time leading indicator data has helped to increase our understanding of the most important factors upon which to build an evidence-based SPHM program, and to facilitate the development of meaningful metrics and goals as the basis of impactful, cost-effective and sustainable SPHM program that will improve safety for both patients and staff.[accordion][accordion-item title="References"]
- Black, J. M., Salsbury, S., & Vollman, K. M. (2018). Changing the Perceptions of a Culture of Safety for the Patient and the Caregiver: Integrating Improvement Initiatives to Create Sustainable Change. Critical care nursing quarterly, 41(3), 226-239.
- Manuele, F. A. (2009). Leading & lagging indicators. Professional Safety, 54(12), 28.
- Reiman, T., & Pietikäinen, E. (2018). Patient safety indicators as tools for proactive safety management and safety culture improvement. Patient Safety Culture: Theory, Methods and Application, 183.
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