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Service Delivery Innovation Profile

Patient Lift Team Program Reduces Injuries and Boosts Productivity Among Nurses


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Snapshot

Summary

The patient lift team initiative employs three two-person teams of physically fit adults, working overlapping shifts, who assist with lifting immobile patients who need assistance in an 800-bed hospital. The program significantly reduced nurse injuries, increased nursing staff productivity, and was popular with patients and nurses.

Evidence Rating (What is this?)

Moderate: The evidence consists of comparisons of injuries and productivity among nursing staff before and after implementation, along with post-implementation testimonials from nurses and patients/family members.
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Developing Organizations

Miami Valley Hospital
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Use By Other Organizations


Date First Implemented

2004
April

Problem Addressed

Work-related musculoskeletal injuries are a common problem in the shortage-prone nursing profession.
  • A common problem: Approximately 40,000 back-related illnesses are reported by nurses each year.1 Anywhere from 35 to 80 percent of nurses sustain back injuries during their career from lifting patients,2 and at Miami Valley Hospital, these injuries are the single largest cause of lost workdays among nurses. As the nursing workforce ages, back injuries may well become more common.
  • Need for prevention: With a national nursing shortage, the need to keep bedside nurses free from injuries is vital.

What They Did

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Description of the Innovative Activity

The patient lift team program consists of three two-person teams who are "on call" to assist with lifting and repositioning immobile patients. Initially deployed on critical care and stepdown units in the hospital (areas with a higher proportion of work-related injuries), the program was later expanded to the entire 800-bed facility. In 2012 approximately 24,000 lift assists were completed. Key elements of the program are described below:
  • Patient lift teams: A set of three two-person teams work overlapping shifts and cover approximately 800 inpatient beds. Team members are physically fit adults who are full-time employees of the hospital.
  • Periodic evaluation and training: Each team member must successfully complete an initial physiological fitness test and undergo an annual evaluation and competency review to make sure that they maintain their skills. Both the initial test and the annual review are conducted by the hospital’s medical director of employee health. In addition, once every quarter an ergonomics expert observes the teams, offering training and advice as needed.
  • Unit coverage: Teams are available during day shifts, when most nurse injuries occur. Teams initially covered the critical care and stepdown units of the hospital, where many patients have significant mobility issues and thus need assistance (frequently leading to nurse injuries). The program was later expanded hospital-wide.
  • Provider education about using the teams: The nursing staff is taught how and when to use the patient lift program effectively. Guidelines on how to access the team and schedule lifts are posted in all hospital units. Nurses are instructed to contact lift team members via a wireless phone, which reduces delays in team response and helps team members to prioritize lifts based on real-time demand.
  • Scheduling lifts and activating the team: When patient lift team employees arrive for work, team members begin scheduling lifts for the day, with first priority given to the medical–surgical units and critical care units that are the primary users of the service. The team can be accessed any time via wireless phone for emergency lifts, helicopter offloads, and assistance in positioning patients for dressing changes or other procedures. Team members round through the hospital when not scheduled for a patient lift. During the first year of implementation, the patient lift team assisted with 10,070 patients, including 590 bed repositions. During a 12-month period from 2006 to 2007, the team provided more than 20,000 patient assists. Information provided in August 2014 indicates that the lift team remains on track having provided nearly 10,000 lifts during the first 6 months of the year.

Context of the Innovation

Miami Valley Hospital is an 848-bed regional referral and specialty center that has achieved “magnet status” in nursing with redesignation with magnet status in 2008. Miami Valley Hospital leaders consider nurses to be critical to the hospital’s success, and thus care deeply about their health and satisfaction, including their ability to remain injury-free at work. Analysis showed that back injuries were the single biggest cause of lost workdays among nurses at the hospital and that the problem was getting worse as the nursing staff aged. The patient lift program was developed in response to this analysis, with the goal of reducing the risk of injury and protecting one of the hospital’s most valued resources.

Did It Work?

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Results

A pre- and post-implementation comparison found that the patient lift program significantly reduced injuries and increased productivity among the nursing staff; post-implementation surveys also show that the program is popular with both patients and nurses. Key results are detailed below:1
  • Reduced injuries (and none when team is used): Back and shoulder injuries among nurses fell by 70 percent after introduction of the program. The rate of back injuries for nursing has decreased from 0.53 per 1,000 patient days at program inception to 0.18 per 1,000 patient days in 2013. Since the beginning of the program, there has only been one lift team member injury, which is a function of ongoing training, fitness requirements, and competency evaluations.
  • Enhanced productivity: Initially, the program freed up more than 800 hours of nursing staff time that was previously spent moving, lifting, or holding patients. In 2006, nearly 2,000 hours of nursing time were freed up. Information provided in August 2014 indicates that during 2013, the lift team provided more than 1,835 hours in assistance to nurses.
  • High nurse and patient satisfaction: Written testimonials from nurses, families, and patients suggest that both nurses and patients are highly satisfied with the program. Patients also report feeling "safe" when moved or assisted by the lift team.

Evidence Rating (What is this?)

Moderate: The evidence consists of comparisons of injuries and productivity among nursing staff before and after implementation, along with post-implementation testimonials from nurses and patients/family members.

How They Did It

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Planning and Development Process

Key steps in the planning and development process include the following:
  • Analyzing the problem: An interdisciplinary team researched the problem and explored the feasibility of a patient lift team. This research included an extensive literature review and interviews with nurses at other organizations using lift teams.
  • Funding proposal: The team developed a funding proposal, which was submitted internally to senior hospital leadership.
  • Piloting the program: The team piloted the program on a small scale.
  • Expanding the program: Based on the success of the pilot, the hospital approved the expansion of the team hospital-wide.

Resources Used and Skills Needed

  • Staffing: Six physically fit adults teamed in pairs to cover the over 800 beds in the hospital. Teams currently provide overlapping service from 5 a.m. to 2 p.m., 7 a.m. to 5 p.m., 4 p.m. to 12 a.m., and 10 p.m. to 5 a.m. As noted, the hospital's medical director of employee health oversees administration of the initial fitness test and annual competency review, while once a quarter, an ergonomics expert observes the teams.
  • Costs: The initial program with four full-time equivalents (FTEs) cost approximately $100,000 annually to cover salaries, education, and training. Additional funding has been received to cover the salaries of additional FTEs.
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Funding Sources

Miami Valley Hospital Foundation funded the initial pilot program and provided additional funds to allow for the expansion of the program throughout the hospital.end fs

Adoption Considerations

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Getting Started with This Innovation

  • Select staff carefully: Vital attributes for the lift team position include excellent communication skills, critical-thinking skills, and the ability to work under pressure.

Sustaining This Innovation

  • Expect and plan for high turnover: Turnover tends to be high among patient lift team members because most applicants and team members also attend school. For example, in 2010, the hospital has experienced increased turnover related to transfers and school scheduling, which has required increased hours for orientation.
  • Collect data: Information provided in 2010 indicates that in 2009, the hospital upgraded the lift team hand-held computer devices to allow real-time data collection. Data is downloaded monthly and provides information regarding nursing units using lift team services, types of assist, and other productivity measures.
  • Target recruitment efforts: This position is very attractive to young individuals who are interested in getting experience in the hospital setting and who also want to earn resources and other benefits to support related educational endeavors. Many current Miami Valley Hospital lift team members are pursuing health-related degrees and training programs, including a PhD in physical therapy, a nursing degree, and emergency medical service and firefighter training.
  • Encourage lift team members to share their knowledge: Lift team members often teach nurses and other staff safe lifting techniques, which can be used by staff during mandatory evacuations and evacuation training. Team members very much enjoy teaching and sharing the proper mechanics for moving patients.
  • Continue training and evaluation, especially in light of turnover: Information provided in August 2011 indicates that lift team turnover remains high due to transfers to other positions within the hospital; program developers are examining work schedules and other issues to improve retention. Given turnover, training, medical evaluation, competency testing, and monitoring adherence to policies and procedures remain effective and necessary components in maintaining a successful lift team program over time.

Spreading This Innovation

Miami Valley Hospital representatives have consulted with approximately 15 hospital organizations to offer guidance in setting up lift teams, including six hospitals that have sent representatives to visit the facility to obtain information and round with the teams. Miami Valley Hospital will send essential materials (e.g., job descriptions, evaluation tools, orientation materials) to any organization interested in developing a lift team program. Information provided in August 2011 indicates that the hospital representatives have consulted with approximately eight hospital systems over the past year that are considering implementation of a lift team after seeing the project described on the AHRQ Web site; the hospital is continuing to provide job descriptions, procedures, and other information as needed.

A report and materials on the Miami Valley Hospital program were also shared at a conference involving "magnet-status" hospitals, held in Atlanta in 2007. This project was presented at the 2008 Summer Institute on Evidence-Based Practice in San Antonio, TX.

Use By Other Organizations


Additional Considerations

Program benefits have exceeded the expectations of those who developed it at Miami Valley Hospital. Patients sometimes return to the hospital just to visit team members who assisted in their care. Every department, from surgery to outpatient oncology, reports having benefited from this service. On some units, periodic reminders are required to use the lift team to prevent injury.

More Information

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Contact the Innovator

Pat O’Malley, PhD, RN, CNS, CCRN
Nurse Researcher in the Center of Nursing Excellence
Miami Valley Hospital
1 Wyoming Street
Dayton, OH 45409
Phone: (937) 208-4518
E-mail: pomalley@premierhealth.com

Innovator Disclosures

Dr. O'Malley reported having no financial interests or business/professional affiliations relevant to the work described in this profile.

References/Related Articles

Ohio nurses get a lift and reduce injuries. Reflections on Nursing Leadership. 2006; Second Q.

Miami Valley Hospital "Lift Team" pilot a success: nurses reduce injury, increase productivity. Miami Valley Hospital press release. Available at: http://www.miamivalleyhospital.org/mvhdefault.aspx?id=10770

O'Malley P, Emsley H, Davis D, et al. No brawn needed. Nurs Manage. 2006;37(4):26-34. [PubMed]

Footnotes

1 O'Malley P, Holly E, Davis D, et al. No brawn needed. Nurs Manage. 2006;37(4):26-34. [PubMed]
2 Ohio nurses get a lift and reduce injuries. Reflections on Nursing Leadership. 2006;Second Q.
Comment on this Innovation

Disclaimer: The inclusion of an innovation in the Innovations Exchange does not constitute or imply an endorsement by the U.S. Department of Health and Human Services, the Agency for Healthcare Research and Quality, or Westat of the innovation or of the submitter or developer of the innovation. Read more.

Original publication: April 14, 2008.
Original publication indicates the date the profile was first posted to the Innovations Exchange.

Last updated: August 13, 2014.
Last updated indicates the date the most recent changes to the profile were posted to the Innovations Exchange.

Date verified by innovator: August 06, 2014.
Date verified by innovator indicates the most recent date the innovator provided feedback during the annual review process. The innovator is invited to review, update, and verify the profile annually.

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