September/October 2013


ANA Issues Standards for Safe Patient Handling as Foundation for National Drive to Improve Worker Safety


Eliminating manual handling will require consistent standards and commitment to a culture of safety.

The American Nurses Association (ANA) has published new national standards for safe patient handling and mobility that are designed to infuse a stronger culture of safety in healthcare work environments and provide a universal foundation for policies, practices, regulations, and legislation to protect patients and healthcare workers from injury.
The ANA publication, Safe Patient Handling and Mobility: Interprofessional National Standards, was developed by an interprofessional group of subject matter experts including nurses, occupational and physical therapists, safety and ergonomics experts, risk management specialists, and others. The Standards apply to multiple healthcare settings across the care continuum, such as hospitals, long-term care, rehabilitation, and hospice. The Standards provide a framework for establishing a comprehensive program to eliminate the manual handling of patients, tasks that commonly lead to injury for healthcare workers and patients.

The ANA convened the group of experts from more than 25 professional organizations, businesses and healthcare systems who identified the overarching priorities for the Standards. Karen A. Daley, PhD, RN, FAAN, president of ANA, said, “Safe patient handling and mobility requires a culture of safety as the standard way of doing business. This is not optional, especially when our patient population is getting heavier. It is not acceptable to continue unsafe practices that cause worker and patient injuries and diminished quality of care.”

The Standards are based on evidence of effectiveness in improving patient outcomes and reducing workers’ musculoskeletal disorders and include eight principles:
1.    Establish a culture of safety.
2.    Create a sustainable program.
3.    Incorporate ergonomic design principles.
4.    Develop a technology plan.
5.    Educate and train healthcare workers.
6.    Assess patients to plan care for their individual needs.
7.    Set reasonable accommodations for employees’ return to work post-injury.
8.    Implement a comprehensive evaluation system.

“Creating a safe patient care work environment is much more complex than simply providing technology to caregivers and presuming they’ll use it,” 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. “To address such complexity, we brought together an array of professionals from a variety of settings along with their differing perspectives and expertise to collectively develop standards that work for patients and healthcare professionals in all patient care settings.”

Healthcare workers continue to get injured from manual patient handling at an alarming rate. The U.S. Bureau of Labor Statistics reported that registered nurses suffered the fifth most injuries and illnesses related to musculoskeletal disorders in 2011 that involved missed work days, behind such jobs as truck drivers and laborers. Nursing assistants topped the list.

In ANA’s most recent Health and Safety Survey, 62% of more than 4,600 nurses who responded indicated that suffering a disabling musculoskeletal injury was one of their top three safety concerns. More than half experienced musculoskeletal pain that was caused or made worse by their job in a 12-month period, and of those, 80% worked frequently despite experiencing pain. More than 1 in 10 nurses were injured three or more times on the job within a 12-month period.

ANA launched an initiative a decade ago to eliminate manual patient handling. No broadly recognized government or private sector standards for safe patient handling and mobility exist, and regulations adopted in several states with safe patient handling laws are inconsistent.

HIE to Transform Clinical and Financial Outcomes in UK’s 3rd Largest City
Alere, Inc., an international healthcare technology company based in Waltham, Massachusetts, is collaborating with organizations in the United Kingdom to establish health information exchange (HIE) in Leeds, the third largest city in the UK. The HIE will support existing work on the delivery of a single electronic health record across all venues of care, tightly integrated with social care services. This will enable a patient’s entire care team to access comprehensive information and collaborate on care, and allow patients to engage with their care teams and take a more active role in their own health and wellness.

Leeds and Partners, an organization responsible for attracting investment to Leeds and serving as chair of the Leeds Innovation Health Hub (LIHH), is coordinating these efforts. The new collaboration aims to deliver the solution in phases, advancing work that is already in progress within the LIHH and delivering it at a lower cost.

In light of the challenges faced by health service providers and the innovative solutions required, policy makers have identified health as a fundamental driver of economic performance. The LIHH has been working to establish Leeds as the UK’s leading city for health and innovation, which could significantly improve services and increase jobs and investment.
Lurene Joseph, chief executive of Leeds and Partners and chair of the LIHH, said: “We have a long history of innovation here in Leeds. The strategic collaboration with Alere will allow the city to once again grasp the health and innovation agenda.”

Ron Zwanziger, CEO and chairman of Alere, said, “We are delighted to work with Leeds to help them build their vision for better healthcare in their city. The effort will electronically tie together disparate patient information for use by healthcare and social services providers, as well as for use by the patients themselves. Involving the patients directly in their own care—particularly those with chronic conditions such as congestive heart failure, diabetes, or patients being medicated with anti-coagulation therapy—will improve delivery of cost-effective outcomes.”

Reality Check: The Beryl Institute Revisits the State of the Patient Experience

The Beryl Institute Revisits the State of the Patient ExperienceThe Beryl Institute has published a major study of work being done in U.S. hospitals to improve the patient experience. Beryl performed a similar study in 2011, and compares the results from the earlier study to this year’s survey in The State of Patient Experience in American Hospitals 2013: Positive Trends and Opportunities for the Future, which is available for free download at (under publications).

Some of the study’s findings are portrayed in the infographic excerpted here. Overall, the results indicate that efforts to improve patient experience are maturing from an initial phase of recognizing that patient experience is important, beginning to understand what patient experience means, and dedicating resources (especially staffing) to the improvement effort to an action phase. It is not a surprise that implementing programs and sustaining the efforts to improve the patient experience is more challenging that just thinking about it. While optimistic about overall trends, Institute President Jason Wolf observes that some of the survey responses and trends in data from 2001 to 2013

…represent the hard reality that addressing patient experience is not an easy or soft process. It requires rigor and intentional action. The shift in scores represents a sense of reality that this issue is more challenging than some thought. The realignment of response here is not one of concern, but actually representative of a greater sense of awareness of the issue and the actions needed to address it. This resetting of understanding creates a stronger foundation for future action.