SPH Training Series Session 3 Safe Patient Handling Policy and SPH Ergonomics Teams (Committees) Western New York Council on Occupational Safety & Health (WNYCOSH) This material was produced under grant number SH-24926-13 from the Occupational Safety and Health Administration, U.S. Dept. of Labor. It does not necessarily reflect the views or policies of the U.S. Dept. of Labor, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government.
Safe Patient- Handling Policy/ Team Building/ Staff Training Performance, Monitoring and Evaluation Safe Patient- Handling Policy AGENDA: Introduction and Overview: Task vs. Process Team Structure and Composition Establishing Ground Rules Developing an Agenda Group Process Roles Methods of Group Decision Making Conflict Resolution Skills Multiple Intelligences Gap Analysis
Introduction to Safe Handling OBJECTIVES: SPH Team participants will be able to: Develop a SPH Policy Develop a meeting agenda Define the duties of each of the group process roles Identify the stages of group development Discuss how Multiple Intelligences affect communication How to achieve SPH Ergonomic Team consensus
Section 1: Developing a SPH Policy
Section 3 Safe Patient Handling Policy Safe Patient- Handling Policy SPH Policy Objectives SPH Roles What Does a Bad SPH-SPH Policy look like? SPH Policy Outline
Section 3: Safe Handling Policy SAFE HANDLING POLICY Policy: A principle or rule to guide decisions and achieve rational outcomes. SPH Policy: A policy and practice that creates a safe environment for patients and health care workers by eliminating hazardous manual lifting tasks. Transferring and repositioning patients is accomplished by using new technologies in mechanical lifting and repositioning devices. NYS Zero-Lift Task Force
Section 3: Safe Handling Policy SPH PROGRAM OBJECTIVES Question: What do you want your program to achieve? To increase quality of care
Section 3: Safe Handling Policy SPH PROGRAM OBJECTIVES SAMPLE: What do you want your program to achieve? To increase quality of care To perform safe/comfortable mechanical Lifts/transfers for s To reduce the frequency of manual lifting/transferring and repositioning To reduce and prevent caregiver work-related injuries To reduce lost work time hours related to staff injury or fatigue
Section 3: Safe Patient Handling Policy ROLES AND RESPONSIBILITIES: MANAGEMENT Question: What does your policy need to say about Management s responsibilities for you to achieve your objectives? Administration shall support implementation of this policy and promote a Culture of Safety
Section 3: Safe Patient Handling Policy ROLES AND RESPONSIBILITIES: EMPLOYEES Question: What does your policy need to say about the Employee s responsibilities for you to achieve your objectives? Use approved mechanical lifting/transferring devices for transfers
Section 3: Safe Patient Handling Policy ROLES AND RESPONSIBILITIES: SPH/ERGO TEAM Question: What does your policy need to say about your Team s responsibilities for you to achieve your objectives? The SPH/Ergo Team shall support implementation of this policy and promote a Culture of Safety
Section 3: Safe Patient Handling Policy GOOD VS. BAD POLICY GROUP ACTIVITY #1 Page 3 of Student Workbook Guide
Section 3: Safe Patient Handling Policy SPH HANDLING POLICY: SAMPLE OUTLINE Policy Objectives Roles and Responsibilities Protocols Assessment Care and Management Safety Infection Control Complications/Reportable Incidents Compliance Documentation Procedures
Section 2: Teams Team Meetings Team Structure
Section 2: Team Meetings TASK VS. PROCESS TASKS are the actions, decisions and discussions of the group. PROCESS is how the work of the group is performed.
Section 2: Team Meetings TASKS OF THE GROUP - EXAMPLES Preparing an agenda, identifying issues Discussing an issue Developing selection criteria & making decisions Determining a plan of action
Section 2: Team Meetings GROUP PROCESS ACTIVITIES - EXAMPLES Listening and responding Methods for making decisions Group climate Meeting flow
Section 2: Team Meetings GROUP PROCESS PROCESS ISSUES BLOCK WORK ON TASKS
Section 2: Team Meetings SPH Team Structure & Composition How a Team (Committee) Is Structured Under NYS SPH Law Size of team variable Ratio of Labor to Management (equal) Minimum of one (1) non-managerial nurse and 1 direct care worker on SPH Team Two co-chairs: one (1) management and one (1) frontline worker or non-managerial nurse
Section 2: Team Meetings SPH Team Structure & Composition Do we have people in the Team who can accomplish the Team s tasks? The stakeholders needed to make SPH work Representatives of relevant groups (union, management, CFO, PTs/OTs, nurses, CNAs, et cetera) Different shifts/units
Section 2: Team Meetings SPH Team Structure & Composition Committee Meeting Schedule/Times: Regular intervals (bi-monthly/monthly) As-Needed Emergency basis During working time During non-working time Paid straight-hourly time
Section 2: Team Meetings SPH Team Structure & Composition Your SPH Team s Tasks: Set criteria for evaluations to determine what equipment is used Set criteria for performance of risk assessments of the environments/job tasks and needs Ensure equipment is set up, functioning Provide initial and on-going training Set up a process for incidence investigation Recommend equipment acquisition Minimally, a program assessment
Section 2: Team Meetings SPH Team Structure & Composition Minutes of Team Meetings: Designate someone to take/distribute minutes Document issues brought up A record of any agreements made at the meeting and actions/recommendations made Use as a measurement tool to gauge extent of implementation of Team s actions
Section 2: Team Meetings SPH Team Structure & Composition The Team s Authority: Advisory only? Independent authority? Reactive? Involved in planning?
Section 2 Setting the Stage for Productive Meetings Bad vs. Good Meetings Ground Rules Agendas Key Roles Practicing Committee Role and Skills
Section 2: Setting the Stage for Productive Meetings GROUP ACTIVITY#2 Page 13 of Student Workbook Guide BAD MEETINGS GOOD MEETINGS
Section 2: Setting the Stage for Productive Meetings ESTABLISHING GROUND RULES: GROUP ACTIVITY #3 Page 15 of Student Workbook Guide Importance Commitment Examples
Section 2: Setting the Stage for Productive Meetings GUIDELINES FOR PITCHING A BETTER MEETING: PLAN the meeting INFORM the participants TARGET for a productive discussion CONTAIN the discussion HASTEN the completion of action steps
Section 2: Setting the Stage for Productive Meetings USING AGENDAS EFFECTIVELY Location, date and time Purpose Attendees Topics in order of presentation/time Pre-meeting assignments Contact the presenters Distribute the agenda
Section 3: Group Process Roles Group Roles Practicing Team Roles Group Development
Section 3: Group Process Roles KEY ROLES IN EVERY MEETING Primary Facilitator Secondary Facilitators Timekeeper Recorder/Note-taker
Section 3: Group Process Roles SPH TEAM S PRIMARY FACILITATOR: Guides group process Allows each member to be heard Suggests processes Keeps group focused on task
Section 3: Group Process Roles SPH TEAM S SECONDARY FACILITATOR Assists the Primary Facilitator with keeping the Team on task and helps guide the group process
Section 3: Group Process Roles SPH TEAM S RECORDER/NOTE-TAKER Key ideas recorded Accuracy check Use flip charts
Section 3: Group Process Roles SPH TEAM S TIMEKEEPER: Monitors timeframe to accomplish agenda tasks Keeps time check and provides update
Section 3: Group Process Roles SPH PARTICIPANT ROLE: Prep before the meeting Participate during the meeting Follow-up after the meeting
Section 4: Methods of Group Decision-Making Decision by Authority Decision by Authority with Advice Decision by Minority Decision by Majority Decision by Consensus Decision by Unanimity Steps for Reaching Consensus Interest-Based Decision Making
Section 4: Methods of Group Decision-Making WHAT DECISION-MAKING PROCESS CAN OUR SPH TEAM USE? Levels of Group Involvement: Decision by Authority Decision by Authority w/ Advice
Section 4: Methods of Group Decision-Making WHAT DECISION-MAKING PROCESS CAN OUR SPH TEAM USE? Levels of Group Involvement: Decision by Minority Majority Rule
Section 4: Methods of Group Decision-Making WHAT DECISION-MAKING PROCESS CAN OUR SPH TEAM USE? Levels of Group Involvement: Decision by Consensus Decision by Unanimity
Section 4: Methods of Group Decision-Making WHAT IS CONSENSUS DECISION-MAKING: The consensus method encourages: Difference of opinion and treats them as important considerations Consideration of all aspects of a problem Consideration of all possible courses of action to solve it Giving each person an equal chance to influence the outcome
Section 4: Methods of Group Decision-Making WHAT IS CONSENSUS DECISION-MAKING: The consensus method encourages: Fully utilizing the information and experiences of each person on the Team Integration of many points of view into a common solution
Section 4: Methods of Group Decision-Making EIGHT STEPS TO A CONSENSUS DECISION: Step 1: Group agrees on decision to be made Step 2: Everyone presents his/her view clearly and logically but without excessive advocacy Step 3: All relevant info and evidence is reviewed, including minority opinion Step 4: Possible decision alternatives or options are identified
Section 4: Methods of Group Decision-Making EIGHT STEPS TO A CONSENSUS DECISION: Step 5: Pros and cons of each alternative are examined Step 6: Differences of opinion fully explored to try to resolve disagreements Step 7: Group discussion leading to the selection of the most positive and least negative features Step 8: Everyone agrees to endorse the final decision
Section 4: Methods of Group Decision-Making GROUP ACTIVITY #4 Page 24 of Student Workbook Guide Prioritizing Items from the Latest Safety and Health Audit
Section 5: Conflict Resolution Skills
Section 5: Conflict Resolution Skills COLLABORATIVE CONFLICT RESOLUTION Getting Beyond Positions to What People Really Want
Section 5: Conflict Resolution Skills CONFLICT RESOLUTION SKILLS: Getting Beyond Positions To What People Really Want A vs. B Issue Position Interest Reframe Options Best Solution/Agreement
Section 5: Conflict Resolution Skills CONFLICT RESOLUTION SKILLS: Getting Beyond Positions To What People Really Want A vs. B Issue Position Interest Reframe Options Best Solution/Agreement
Section 5: Conflict Resolution Skills CONFLICT RESOLUTION SKILLS: Getting Beyond Positions To What People Really Want A vs. B Issue Position Interest Reframe Options Best Solution/Agreement
Section 6: Natural Stages of Group Development Forming Storming Norming Performing
Section 6: Natural Stages of Group Development WHAT TO EXPECT WHEN TEAMS ARE FIRST FORMED: Unproductive at first Team members uncertain of roles Personalities may not mesh well Making decisions a struggle HANG IN THERE! This Is Normal for All Groups Your Team Will Move On
Section 6: Natural Stages of Group Development STAGES OF TEAM DEVELOPMENT: Forming Storming Norming Performing
Section 6: Natural Stages of Group Development FORMING ( Infancy ): Tasks: Learn group process Set ground rules Small decisions
Section 6: Natural Stages of Group Development FORMING ( Infancy ): Issues of Inclusion Process: Heavy facilitation Member uncertainty Dependent Polite Powerless Resist change
Section 6: Natural Stages of Group Development STORMING ( Adolescence ): Tasks: Leader development Conflict Minor decisions Make changes
Section 6: Natural Stages of Group Development NORMING PERFORMING ( Adulthood ) Tasks: Use ground rules Share leadership Reach understanding Major decisions Create change
Section 6: Natural Stages of Group Development NORMING PERFORMING ( Adulthood ) Issues of Affection Process: Use of group process skills Coaching Independent Test power Bonding
Section 6: Natural Stages of Group Development YOUR ORGANIZATION S CLIMATE FOR SPH TEAMS: Force Field Analysis Purpose Achieving Change
Section 7: Overcoming Resistance to Change Forces for Changes Forces against Change Weakening the Forces against change
Section 7: Natural Stages of Group Development YOUR ORGANIZATION S CLIMATE FOR SPH TEAMS: Force Field Analysis NEW SPH POLICY & PRACTICES FORCES FOR CHANGE Vs. FORCES OF RESISTANCE TO CHANGE
Section 7: Natural Stages of Group Development YOUR ORGANIZATION S CLIMATE FOR SPH TEAMS: Force Field Analysis
Section 7: Natural Stages of Group Development YOUR ORGANIZATION S CLIMATE FOR SPH TEAMS: Force Field Analysis FORCES FOR CHANGE FORCES OF RESISTANCE Safe Handling Policy and Practice Purchase of Equipment Too Costly Not Enough Staff Not Assessable Not Necessary Et Cetera
Section 7: Natural Stages of Group Development YOUR ORGANIZATION S CLIMATE FOR SPH TEAMS: Force Field Analysis FORCES FOR CHANGE FORCES OF RESISTANCE Safe Handling Policy and Practice
Section 7: Multiple Intelligences GROUP ACTIVITY #5 Page 28 of Student Workbook Guide Theory of Multiple Intelligence Which Way are YOU Smart?
Section 7: Multiple Intelligences DIFFERENT WAYS YOUR TEAM MEMBERS ARE SMART The Theory of MULTIPLE INTELLIGENCES As defined by Howard Garner
Word Smart Section 7: Multiple Intelligences DIFFERENT WAYS YOUR TEAM MEMBERS ARE SMART Picture Smart Body Smart People Smart Music Smart Number Smart Nature Smart Self Smart
Section 7: Multiple Intelligences DIFFERENT WAYS YOUR TEAM MEMBERS ARE SMART WHAT INTELLIGENCE DO YOU PREFER?
Section 7: Multiple Intelligences DIFFERENT WAYS YOUR TEAM MEMBERS ARE SMART APPRECIATING OUR DIFFERENCES
SPH Ergonomics Team Meeting Role Play GROUP ACTIVITY #6 Page 32 of Student Workbook Guide
Section 8: SPH Evaluation, Competency, Evaluation and Monitoring Direct Care Worker and SPH Training Competency Evaluation Mentoring Evaluating Monitoring
Section 8: SPH Evaluation, Competency, Evaluation & Monitoring OVERVIEW: STAFF TRAINING/MONITORING FORMAT 3-Hr Staff Competency Training By Unit in Groups of 15 Initial Competency Evaluation Role of Preceptors/Evaluation Retraining
Section 8: SPH Evaluation, Competency, Evaluation & Monitoring COMPETENCY TRAINING: 1-1 ½ HOUR CLASS Myths of Safe Manual Handling Body Mechanics/NIOSH Lift Formula Ergo Risk Factors (Pivot Transfer) Anatomy of an Injury SPH Philosophy Overview Assessments/Care Plans
Section 8: SPH Evaluation, Competency, Evaluation & Monitoring COMPETENCY TRAINING: 2-HOUR HANDS-ON Sit-to-Stand Lifting/Slings Full Mechanical Lift/Slings Ceiling Lift/Slings (If Available) Slip Sheets Air Mats
Section 8: SPH Evaluation, Competency, Evaluation & Monitoring MONITORING FOR COMPETENCY 3-Hour Competency Training Exam Preceptor Evaluation of Caregiver Annual Evaluation Don t Discipline Coach. Retrain.
Section 8: SPH Evaluation, Competency, Evaluation & Monitoring TRANSITION ONTO THE UNITS Schedule a day the equipment will be delivered on the floor Go Live! Announce to the unit that they are now a SPH facility SPH/Ergo Team holds a brief unit meeting Obtain consensus on Park & Charge Areas Label all equipment/slings Explain rotation system for slings Explain preceptor program/introduce SPH/Ergo Team members, Point Person, SPH coaches, super-users
Section 8: SPH Evaluation, Competency, Evaluation & Monitoring MONITOR/LEAD/LEARN Lead/Coach by Example Observe/Discuss Mistakes Evaluate Performance Audits
Section 9 After Action Reviews After Action Review: Getting at the Root Causes The After Action Review Process Practicing on AAR
Section 9: After Action Reviews AFTER ACTION REVIEWS A means for caregivers to share information with co-workers and supervisors about: An injury that has occurred as a result of handling A near-miss incident Failure to follow policy Failure of equipment An unexpected positive outcome
Section 9: After Action Reviews CONDUCTING AN AFTER ACTION REVIEW Honest exchange Informal and brief SPH Point Person may lead No finger-pointing: take a team approach Focus on adjusting the program to prevent future incidents
Section 9: After Action Reviews THE AAR PROCESS After Action Reviews Address: What happened? What was supposed to happen? What accounts for the difference? How to avoid a same future outcome? What s the follow-up plan?
Section 10: Organizational Needs Assessment GAP ANALYSIS GROUP ACTIVITY #7 Page 28 of Student Workbook Guide Where We Are Where We Want to Be How We Get There