safe patient handling policy and sph ergonomics teams...

SPH Training Series – Session 3

Safe Patient Handling Policy and SPH

Ergonomics Teams (Committees)

Western New York Council on Occupational Safety & Health (WNYCOSH)

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does not necessarily reflect the views or policies of the U.S. Dept. of Labor, nor does mention of trade names, commercial products, or

organizations imply endorsement by the US Government.

Safe Patient- Handling Policy/ Team Building/ Staff Training Performance, Monitoring and Evaluation

AGENDA:

Safe Patient- Handling Policy

Introduction and Overview: Task vs. Process

Team Structure and Composition

Establishing Ground Rules

Developing an Agenda

Group Process Roles

Methods of Group Decision Making

Conflict Resolution Skills

Multiple Intelligences

Gap Analysis

Introduction to Safe Handling

OBJECTIVES:

SPH Team participants will be able to:

Develop a SPH Policy Develop a meeting agenda

Define the duties of each of the group process roles

Identify the stages of group development

Discuss how Multiple Intelligences affect communication

How to achieve SPH Ergonomic Team consensus

Section 1:

Developing a SPH Policy

Section 3

Safe Patient Handling Policy

Safe Patient- Handling Policy

SPH Policy Objectives

SPH Roles

What Does a Bad SPH-SPH Policy look

like?

SPH Policy Outline

Section 3: Safe Handling Policy

SAFE HANDLING POLICY

Policy: “A principle or rule to guide decisions and achieve rational outcomes.”

SPH Policy: “A policy and practice that creates a safe environment for patients and health care

workers by eliminating hazardous manual lifting tasks. Transferring and repositioning patients is

accomplished by using new technologies in mechanical lifting and repositioning devices.”

NYS Zero-Lift Task Force


SPH PROGRAM OBJECTIVES

Question: What do you want your program to achieve?

To increase quality of care


SPH PROGRAM OBJECTIVES

SAMPLE: What do you want your program to achieve?

To increase quality of care To perform safe/comfortable mechanical

Lifts/transfers for s To reduce the frequency of manual

lifting/transferring and repositioning To reduce and prevent caregiver work-related

injuries To reduce lost work time hours related to staff

injury or fatigue

Section 3: Safe Patient Handling Policy

ROLES AND RESPONSIBILITIES: MANAGEMENT

Question: What does your policy need to say about Management’s

responsibilities for you to achieve your objectives?

Administration shall support implementation of this policy and promote a Culture of Safety


ROLES AND RESPONSIBILITIES: EMPLOYEES

Question: What does your policy need to say about the Employee’s


Use approved mechanical lifting/transferring devices for transfers


ROLES AND RESPONSIBILITIES: SPH/ERGO TEAM

Question: What does your policy need to say about your Team’s


The SPH/Ergo Team shall support implementation of this policy and promote a Culture of Safety


GOOD VS. BAD POLICY

GROUP ACTIVITY #1

Page 3 of Student Workbook Guide


SPH HANDLING POLICY: SAMPLE OUTLINE

Policy Objectives Roles and Responsibilities Protocols

Assessment Care and Management Safety Infection Control Complications/Reportable Incidents

Compliance Documentation Procedures

Section 2:

Teams

Team Meetings

Team Structure

Section 2: Team Meetings

TASK VS.

PROCESS TASKS are the actions, decisions

and discussions of the group.

PROCESS is how the work of the group is performed.


TASKS OF THE GROUP - EXAMPLES

Preparing an agenda, identifying issues

Discussing an issue

Developing selection criteria & making decisions

Determining a plan of action


GROUP PROCESS ACTIVITIES - EXAMPLES

Listening and responding

Methods for making decisions

Group climate

Meeting flow


GROUP PROCESS

PROCESS ISSUES BLOCK

WORK ON TASKS

Section 2: Team Meetings – SPH Team Structure & Composition

How a Team (Committee) Is Structured Under NYS SPH Law

Size of team variable Ratio of Labor to Management (equal) Minimum of one (1) non-managerial nurse

and 1 direct care worker on SPH Team Two co-chairs: one (1) management and one

(1) frontline worker or non-managerial nurse


Do we have people in the Team who can accomplish the Team’s tasks?

The stakeholders needed to make SPH work

Representatives of relevant groups (union, management, CFO, PTs/OTs, nurses, CNAs, et cetera)

Different shifts/units


Committee Meeting Schedule/Times:

Regular intervals (bi-monthly/monthly)

“As-Needed”

“Emergency” basis

During working time

During non-working time

Paid straight-hourly time


Your SPH Team’s Tasks:

Set criteria for evaluations to determine what equipment is used

Set criteria for performance of risk assessments of the environments/job tasks and needs

Ensure equipment is set up, functioning

Provide initial and on-going training

Set up a process for incidence investigation

Recommend equipment acquisition

Minimally, a program assessment


Minutes of Team Meetings:

Designate someone to take/distribute minutes Document issues brought up A record of any agreements made at the

meeting and actions/recommendations made Use as a measurement tool to gauge extent of

implementation of Team’s actions


The Team’s Authority:

Advisory only?

Independent authority?

Reactive?

Involved in planning?

Section 2

Setting the Stage for Productive Meetings

Bad vs. Good Meetings

Ground Rules

Agendas

Key Roles

Practicing Committee Role and Skills

Section 2: Setting the Stage for Productive Meetings

GROUP ACTIVITY#2 Page 13 of Student Workbook Guide

BAD

MEETINGS

GOOD MEETINGS


ESTABLISHING GROUND RULES:

Importance

Commitment

Examples

GROUP ACTIVITY #3



GUIDELINES FOR PITCHING A BETTER MEETING:

PLAN the meeting

INFORM the participants

TARGET for a productive discussion

CONTAIN the discussion

HASTEN the completion of action steps


USING AGENDAS EFFECTIVELY

Location, date and time

Purpose

Attendees

Topics in order of presentation/time

Pre-meeting assignments

Contact the presenters

Distribute the agenda

Section 3:

Group Process Roles

Group Roles

Practicing Team Roles

Group Development

Section 3: Group Process Roles

KEY ROLES IN EVERY MEETING

Primary Facilitator

Secondary Facilitators

Timekeeper

Recorder/Note-taker


SPH TEAM’S PRIMARY FACILITATOR:

Guides group process

Allows each member to be heard

Suggests processes

Keeps group focused on task


SPH TEAM’S SECONDARY FACILITATOR

Assists the Primary Facilitator with keeping the

Team on task and helps guide the group process


SPH TEAM’S RECORDER/NOTE-TAKER

Key ideas recorded

Accuracy check

Use flip charts


SPH TEAM’S TIMEKEEPER:

Monitors timeframe to accomplish agenda tasks

Keeps time check and provides update


SPH PARTICIPANT ROLE:

Prep before the meeting

Participate during the meeting

Follow-up after the meeting

Section 4:

Methods of Group Decision-Making

Decision by Authority

Decision by Authority with Advice

Decision by Minority

Decision by Majority

Decision by Consensus

Decision by Unanimity

Steps for Reaching Consensus

Interest-Based Decision Making

Section 4: Methods of Group Decision-Making

WHAT DECISION-MAKING PROCESS CAN OUR SPH TEAM USE?

Levels of Group Involvement: Decision by Authority Decision by Authority w/

Advice



Levels of Group Involvement: Decision by Minority

Majority Rule



Levels of Group Involvement: Decision by Consensus Decision by Unanimity


WHAT IS CONSENSUS DECISION-MAKING:

The consensus method encourages: Difference of opinion and treats them as

important considerations

Consideration of all aspects of a problem

Consideration of all possible courses of action to solve it

Giving each person an equal chance to influence the outcome


WHAT IS CONSENSUS DECISION-MAKING:

The consensus method encourages: Fully utilizing the information and

experiences of each person on the Team

Integration of many points of view into a common solution


EIGHT STEPS TO A CONSENSUS DECISION:

Step 1: Group agrees on decision to be made Step 2: Everyone presents his/her view clearly

and logically but without excessive advocacy

Step 3: All relevant info and evidence is

reviewed, including minority opinion Step 4: Possible decision alternatives or options

are identified


EIGHT STEPS TO A CONSENSUS DECISION:

Step 5: Pros and cons of each alternative are examined

Step 6: Differences of opinion fully explored to try to resolve disagreements

Step 7: Group discussion leading to the selection of the most positive and least negative features

Step 8: Everyone agrees to endorse the final decision


GROUP ACTIVITY #4


Prioritizing Items from the Latest

Safety and Health Audit

Section 5:

Conflict Resolution Skills

Section 5: Conflict Resolution Skills

COLLABORATIVE CONFLICT RESOLUTION

Getting Beyond Positions to What People Really Want

CONFLICT RESOLUTION SKILLS: Getting Beyond Positions To What People Really Want

A vs. B

Issue Position Interest Reframe Options

Best Solution/Agreement

Section 5: Conflict Resolution Skills

Section 6:

Natural Stages of Group Development

Forming

Storming

Norming

Performing

Section 6: Natural Stages of Group Development

WHAT TO EXPECT WHEN TEAMS ARE FIRST FORMED:

Unproductive at first

Team members uncertain of roles

Personalities may not mesh well

Making decisions a struggle

HANG IN THERE! This Is Normal for All Groups –

Your Team Will Move On…

Forming

Storming

Norming

Performing


STAGES OF TEAM DEVELOPMENT:

Tasks:

Learn group process Set ground rules Small decisions


FORMING (“Infancy”):

Issues of Inclusion – Process:

Heavy facilitation

Member uncertainty

Dependent

Polite

Powerless

Resist change


FORMING (“Infancy”):

Tasks:

Leader development

Conflict

Minor decisions

Make changes


STORMING (“Adolescence”):

Tasks:

Use ground rules

Share leadership

Reach understanding

Major decisions

Create change


NORMING – PERFORMING (“Adulthood”)

Issues of Affection – Process:

Use of group process skills

Coaching

Independent

Test power

Bonding


NORMING – PERFORMING (“Adulthood”)

Purpose

Achieving Change


YOUR ORGANIZATION’S CLIMATE FOR SPH TEAMS:

Force Field Analysis

Section 7:

Overcoming Resistance to Change

Forces for Changes

Forces against Change

Weakening the Forces against change




NEW SPH POLICY & PRACTICES FORCES FOR CHANGE

Vs.

FORCES OF RESISTANCE TO CHANGE




FORCES FOR CHANGE FORCES OF RESISTANCE

Safe Handling Policy and Practice

Purchase of Equipment Too Costly Not Enough Staff Not Assessable Not Necessary Et Cetera




FORCES FOR CHANGE FORCES OF RESISTANCE

Safe Handling Policy and Practice

Section 7:

Multiple Intelligences

Theory of Multiple Intelligence

Which Way are YOU Smart?

GROUP ACTIVITY #5


Section 7: Multiple Intelligences

DIFFERENT WAYS YOUR TEAM MEMBERS ARE SMART

The Theory of

MULTIPLE INTELLIGENCES

As defined by Howard Garner



Word Smart

Picture Smart

Body Smart

People Smart

Music Smart

Number Smart

Nature Smart

Self Smart



WHAT INTELLIGENCE DO YOU PREFER?



APPRECIATING OUR DIFFERENCES

SPH Ergonomics Team Meeting Role Play

GROUP ACTIVITY #6


Section 8:

SPH Evaluation, Competency,

Evaluation and Monitoring

Direct Care Worker and SPH Training

Competency Evaluation

Mentoring

Evaluating

Monitoring

3-Hr Staff Competency Training

By Unit in Groups of 15

Initial Competency Evaluation

Role of Preceptors/Evaluation

Retraining

Section 8: SPH Evaluation, Competency, Evaluation & Monitoring

OVERVIEW: STAFF TRAINING/MONITORING

FORMAT

Myths of “Safe Manual Handling”

Body Mechanics/NIOSH Lift Formula

Ergo Risk Factors (Pivot Transfer)

Anatomy of an Injury

SPH Philosophy Overview

Assessments/Care Plans


COMPETENCY TRAINING: 1 - 1 ½ HOUR CLASS

Sit-to-Stand Lifting/Slings

Full Mechanical Lift/Slings

Ceiling Lift/Slings (If Available)

Slip Sheets

Air Mats


COMPETENCY TRAINING: 2-HOUR HANDS-ON

3-Hour Competency Training Exam

Preceptor Evaluation of Caregiver

Annual Evaluation

Don’t Discipline – Coach. Retrain.


MONITORING FOR COMPETENCY

Schedule a day the equipment will be delivered on the floor

Go Live! Announce to the unit that they are now a SPH facility

SPH/Ergo Team holds a brief unit meeting

Obtain consensus on Park & Charge Areas

Label all equipment/slings

Explain rotation system for slings

Explain preceptor program/introduce

SPH/Ergo Team members, Point Person, SPH coaches, super-users


TRANSITION ONTO THE UNITS

Lead/Coach by Example

Observe/Discuss Mistakes

Evaluate Performance

Audits


MONITOR/LEAD/LEARN

Section 9

After Action Reviews

After Action Review: Getting at the Root Causes

The After Action Review Process

Practicing on AAR

Section 9: After Action Reviews

AFTER ACTION REVIEWS

A means for caregivers to share information with co-workers and supervisors about:

An injury that has occurred as a result of

handling

A near-miss incident

Failure to follow policy

Failure of equipment

An unexpected positive outcome


CONDUCTING AN AFTER ACTION REVIEW

Honest exchange

Informal and brief

SPH Point Person may lead

No finger-pointing: take a team approach

Focus on adjusting the program to prevent future incidents


THE AAR PROCESS

After Action Reviews Address:

What happened?

What was supposed to happen?

What accounts for the difference?

How to avoid a same future outcome?

What’s the follow-up plan?

GAP ANALYSIS

Section 10: Organizational Needs Assessment

Where We Are

Where We Want to Be

How We Get There

GROUP ACTIVITY #7 Page 28 of Student Workbook Guide

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