Halton Region: Redesigning Their Way to Injury Prevention

January 16, 2012

Albert Einstein once said, “Intellectuals solve problems, geniuses prevent them.” Halton Region’s Services for Seniors Division has always strived to be a Centre for Excellence; now they are looking to add “genius” to their list of credentials.

Healthcare workers have long been associated with a higher frequency and severity rate of musculoskeletal disorders/injuries (MSD/MSI). Workplace Safety & Insurance Board (WSIB) statistics stated that in 2010 the Healthcare sector reported 8,343 lost time injuries. Approximately 47% of all lost time claims reported in 2010 were due to MSD/MSIs.

Halton Region is looking to change those statistics, at least for its long-term care workers.  Halton operates three long-term care homes, employing over 800 staff, with more than half providing direct resident care. Personal Support Workers (PSW’s) make up the majority of the workforce, and incur a higher number of MSD/MSI. Halton chose its largest home, Post Inn Village, a 228 bed facility located in Oakville, Ontario to pilot an innovative approach to reducing MSD/MSI.

In June 2011, using the expertise of four PSW’s (labelled the “Change Team”), Halton Region embarked on identifying the underlying root causes of MSD/MSI and the associated tasks or duties.  The Change Team was then given the task of re-designing new processes to avoid the identified causes of injury.

The current PSW Work Redesign project utilizes the same participatory framework from the PSHSA EPIC (Ergonomic Program Implementation Continuum) program, which Halton piloted in 2009.  At the project launch, PSHSA provided training to the Halton Region Change team and steering committee on the participatory approach. This method is used to engage and empower not only workers but also managers, supervisors, and health and safety personnel to make decisions and solve problems as a team, effectively taking charge of injury prevention.

Halton Region felt it was important to integrate a Continuous Quality Improvement (CQI) approach, using LEAN Tools and Plan, Do, Study, Act (P.D.S.A) cycles to document efforts and provide quantitative data to support any decisions going forward.  The Waste Walk CQI tool helped to easily identify any inefficiency within the PSW role that led to wasted time, efforts or resources.  It became clear that inefficiencies equals opportunities for staff to “cut corners” in order to make up time or reduce any physical/mental strain. The focus is then centered on reducing or eliminating the inefficiencies and essentially giving back time, energy & resources.

To date, Halton Region has completed three P.D.S.A cycles on one 32-bed Resident Home Area at Post Inn Village.  They have trialed two fixed ceiling lifts (they currently use portable ceiling lifts in the home) as well as multiple transfer belts/aides, which were selected by the PSW staff.  The Change Team has also designed a quick reference one page Care Plan that illustrates all relevant care information that a PSW would need at a glance. This has proved highly beneficial for the part time and casual staff who do not consistently work with the same residents, making it challenging to familiarize themselves with each resident’s specific care needs.  Halton’s future P.D.S.A cycles will focus on storage locations for supplies as well as documentation stations for PSW staff. The pilot project is scheduled to run until March 2012. As the project progresses, PSHSA continues to be involved, providing support as needed through the regional consultants at the steering committee and the change team meetings.

Author and forward-thinking pioneer, Edward de Bono states, “We may need to solve problems not by removing the cause, but by designing the way forward even if the cause remains in place.”  Who better to re-design the PSW role, than the staff members that actually perform that job!? They are the subject matter experts, and once given the green light to trial new and creative ways to complete the same old task, there are no limits to the improvements that can be made.  Halton Region has found that staff are typically less resistive to change when they have been given an opportunity to participate in the process and contribute to the solution.

To learn more about this project, feel free to contact Patti Coates, CQI/Risk Management Manager at 905-825-6000 ext. 7422 or by email patti.coates@halton.ca.

Click here to learn more about our upcoming training sessions on the Participatory Approach to MSD Prevention.