Problem
CASE: Ergonomics in Practice J. Mac Crawford and Scheck McAlearney Riverlea Rehabilitation Hospital's administrators had recently begun to notice high levels of absenteeism, workers ' compensation claims, and time off from work linked to back and other injuries suffered by workers. Staff were prone to injuries when patients lost their balance while being moved, especially when staff was required to use their own bodies to prevent patient falls. Patients, in turn, could be injured when staff was unable to secure patients due to an overwhelming physical load or because of preexisting injuries or deficits in staff members ' physical strength. Tim Montana, the administrative director, expected that a new system of patient-lifting devices that was planned for installation at Riverlea could effectively reduce the number of workers ' injuries and associated workers ' compensation claims and absenteeism rates. The new system was expensive, but Montana believed the system's benefits would be worth the cost. Still, he wanted to ensure that the new lift system had been designed so patients could be placed in a harness and moved from a bed to a chair, the bathroom, or anywhere else in the room.
It was meant to be used consistently consistent use was apparently associated with reduced risk of injury to both staff and patients. To prove that the new lift system helped address the injury problems reported by Riverlea nursing staff, Montana enlisted a team of researchers from the local school of public health Montana wanted to be able to provide quantifiable evidence of the positive impact of the new system. During Montana's meeting with the team, Dr. Jason Terry, the lead environmental health services researcher, explained that the best approach to evaluating the impact of the lift system would be a longitudinal study of the health of Riverlea personnel. As Terry explained, the research team could first collect baseline information using existing injury data, and then it could supplement these data by collecting new information about work practices, shifts, and musculoskeletal symptoms among the target workers. After the installation of the new lift system hospital-wide, the researchers could collect follow-up data to assess the system's efficacy.
Montana convinced the rest of Riverlea's administrative team that a research study was justified and approved the budget request to support the investigation. Baseline data were collected before the lift system was installed, and plans for the follow-up assessment were made. However, Montana observed the implementation and initial use of the lift system at Riverlea and became concerned about the process. He and his team had seen evidence that many staff members were using the devices incorrectly, were using them intermittently, or were not using them at all. Well aware that improper use of the system would bias any research data collection process, Montana decided to ask the engineering department to check whether the lift system was operating as planned. After a week of study, the engineering personnel reported to Montana that the lifts themselves were functioning properly. Montana next asked individual staff members for their opinions about the lift system.
After only a handful of conversations, Montana realized that people had plenty of opinions about the lift system, and most were negative. Staff appeared unconvinced about the value of the lift system, and they instead were delighted to tell Montana stories about how they had managed to "workaround " the system to lift their patients in the " usual way ." Montana still believed that the lift system could positively impact Riverles, but he knew current use patterns were inconsistent and inappropriate. He knew he had to do something to intervene, but he didn't know where to start.
Task
Who should be accountable for the correct adoption and use of the new lift system? For different organizations considering installing a new lift system, what type of process would you propose to build staff support and buy-in for the system? Who would be the relevant stakeholders to include in planning for the new system's introduction?