Worker Safety in Hospitals - Facilitating Change | Occupational Safety and Health Administration

Facilitating Change

Establishing and maintaining a successful safe patient handling program will likely require a culture change throughout the hospital. In Safe Patient Handling and Mobility: Interprofessional National Standards, the American Nurses Association recommends that employers and healthcare workers partner to establish a culture that emphasizes safety as the top priority above competing goals.

Profile: A Culture of Safety at St. Vincent's Medical Center
Bridgeport, Connecticut

Although St. Vincent's launched a safe patient handling program in 2005, the policy was not fully implemented, and lifts were not being used. When it reinvigorated the program in 2008, the hospital asked employees for input on equipment and trained them on its uses and benefits. A year later, the hospital saw a 56 percent reduction in patient handling injuries.

The hospital's focus on high reliability principles opened communication channels and encouraged speaking up about proper lifting. Associates are taught that it is “not part of the job” to get hurt handling patients. Associates share St. Vincent's culture of safety, and departments are proud of their safety records.

Profile: Changing the Mindset at AnMed Health
Anderson, South Carolina

When it comes to promoting the use of equipment by its clinicians, AnMed Health representatives said they found that patient safety was as attractive a benefit as worker safety; consequently, when staff saw how using the equipment improves both important goals, they were more likely to use it. Nurses and nurse aides also realized that use of the equipment positively affected their strength and endurance over the course of a shift.

According to ANA's standards, a culture of safety includes acknowledgement of the risk, a commitment to provide resources to consistently achieve safe operations, a blame-free environment where workers can report errors or incidents without fear, and an emphasis on collaboration across sectors and settings.

“High reliability” principles that go beyond equipment and procedures help create a prevention-based culture of safety, and in turn benefit patient safety as well. Worker involvement in every step of the process, including policy development, equipment selection and placement, education, and evaluation, will help ensure a successful program and safety for all.

Modeling safe patient handling behaviors is key to facilitating change. Along with overall safety coordinators, many hospitals have dedicated safety champions or “coaches” on each floor or unit to encourage their colleagues to follow safe patient handling policies and procedures. These individuals continually remind and educate their peers about the program and promote a cultural mindset of safety. Nurse managers also can help to support and reinforce the program with staff.

Safe patient handling advocates often hear a lot of reasons why hospitals choose not to invest in mechanical lift equipment or other safe handling procedures and policies, or why equipment does not get used after they have made the investment. "Safe Patient Handling: Busting the Myths" provides facts that safety champions can use to promote safe patient handling.
The Joint Commission reprinted a 2013 feature from Healthcare Executive, "The Power of Zero: Steps Toward High Reliability Healthcare," about steps hospitals can take toward creating a culture of high reliability healthcare.
In 2008, the U.S. Department of Health and Human Services' Agency for Healthcare Research and Quality published Becoming a High Reliability Organization: Operational Advice for Hospital Leaders, which presents the thoughts, successes, and failures of hospital leaders who have used concepts of high reliability to improve patient care.

Worker Safety in Hospitals Caring for our Caregivers

Facilitating Change

Worker Safety in Hospitals
Caring for our Caregivers