Skip to main content

Patient Safety: Pay Now or Pay Later

 |  By Alexandra Wilson Pecci  
   July 02, 2013

Some hospitals believe they can't afford investing in assistive technologies that improve patient safety and protect nurses from injury. Can they afford not to?

"If you think education is expensive, try ignorance."

That saying, generally attributed to former Harvard president Derek Bok, comes to mind when I think about how some hospitals view spending on tools for safe patient handling.

Technology, such as ceiling lifts, to assist in moving, lifting, and repositioning patients can prevent injuries among nursing staff and enhance the patient experience, yet some hospitals are reluctant to implement them.

The American Nurses Association contends the investment is well worth it.

Nurse safety was identified as one of the top five nursing issues for 2013 and ANA president Karen Daley told me back in January that the association was leading the way in developing national interdisciplinary standards for safe-patient handling. True to her word, they were released last week.

Suzy Harrington, DNP, RN, MCHES, the director of the ANA's Department of Health, Safety and Wellness, who moderated a conference call previewing the standards, hinted that the voluntary standards might soon have some teeth, saying, "We are anticipating some national legislation based on these standards very soon by congressman John Conyers (D-MI)."

The standards are:

  1. Establish a culture of safety
  2. Implement and sustain a safe patient handling and mobility (SPHM) Program
  3. Incorporate ergonomic design principles to provide a safe environment of care
  4. Select, install, and maintain SPHM technology
  5. Establish a system for education, training, and maintaining competence
  6. Integrate patient-centered SPHM assessment, plan of care, and use of SPHM technology
  7. Include SPHM in reasonable accommodation and post-injury return to work
  8. Establish a comprehensive evaluation system

During the call, Daley and other speakers made a strong case for the use of technology, such as ceiling lifts, to assist in moving, lifting, and repositioning patients. She said that musculoskeletal injuries are a primary reason healthcare workers leave direct patient care, adding that often healthcare workers don't get injured by a single event.  

Rather, most injuries are the result of the cumulative effect of lifting heavy loads day in and day out for years, which can lead to long-term disorders and disability, Daley said.  

She also cited 2011 U.S. Bureau of Labor statistics showing that nursing professions are among the top five occupations in the number of musculoskeletal disorder-related on-the-job injuries or illnesses that require missed days from work. In fact, nursing assistants topped the list, beating out laborers, janitors, and truck drivers.  

"We can't afford these losses and still meet the rising demands for healthcare services," Daley emphasized.  

The idea that losses from injuries add up financially for hospitals and the healthcare system at large is an important one for demonstrating the business case for implementing the new standards, including the use of technology.  

Robert Williamson, MS, BSN, RN, CWCP, director of associate safety at Ascension Health and the current president of the Association of Safe Patient Handling Professionals, said that the constant shuffling of work schedules to adjust for workers who have been injured takes not only a physical and emotional toll, but a financial one. He argues that the cost of lost worker productivity is much greater than the cost of technology to help prevent it.  

"We know that the resources that are spent managing and caring for these injuries are great," he said.

Beyond the physical and financial benefits of technology, Ronda Fritz, MA, BSN, RN, Safe Patient Handling Facility Champion at the VA-Nebraska-Western Iowa Health Care System, says that tools such as ceiling lifts and seated slings can help preserve patient dignity—and likely improve their satisfaction, too.

"Instead of calling four or five staff into a room to position or lift a patient of size, the healthcare worker simply uses a technology to safely and discreetly move them," Fritz said. "The first time we used the lift and sling to assist with an ultrasound procedure for a 640-pound patient, she cried tears of relief and thanked us for not embarrassing her by bringing in six extra sets of hands to position her and expose her. She stated that the technology used was comfortable and much more dignified."

Hospitals might bristle at the idea of investing much money in these kinds of technologies if they're already struggling financially. But the ANA says the investment is worth it. It also points to alternative, lower-cost technologies such as air-assisted lifting devices that are not as expensive as ceiling lifts.  

I'd also argue—and so do the ANA and other organizations—that healthcare workers have spent too long being the exception among industries that don't expect their workers to manually lift unreasonably heavy loads.

"Science tells us that a healthcare provider should not lift more than 35 pounds of a patient's weight under the best of circumstances," said Mary Matz, MSPH, CPE, CSPHP, chair of the SPHM Working Group and national program manager for patient care ergonomics at the Veterans Health Administration. "We all know that there are few patients that fall into that category."  

Anyone who's ever spent any time in a warehouse knows that although there's certainly lifting involved, workers regularly employ the use "technologies" to move heavier loads. I doubt whether any warehouse owner would object to buying a forklift because they're too expensive.  

"As nurses we've traditionally accepted manually moving patients as part of the job," Daley said. "In what other profession would a worker say, 'Let me boost up or move that little pile of hundred pound boxes?' They wouldn't. They would use some sort of technology to do the lifting."  

Alexandra Wilson Pecci is an editor for HealthLeaders.

Get the latest on healthcare leadership in your inbox.