Unit Based Safety Leader/Champion Programs

1. Unit Based Safety Leader/Champion Programs Presented by Lynda Enos, RN, BSN, MS, COHN-S, CPE Ergonomics Consultant, HumanFit, LLC. Tel: 503-655-3308 Email: HumanFit@aol.com Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

2. Components of Sustainable & Effective Safe Patient Handling Programs • Management Commitment (visible program champion) • Employee Involvement (inc. Labor) • A Business Plan (strategic & tactical) • Program Management (program facilitator) • Worksite Analysis • Hazard Prevention & Control (SPH equipment and safe work practices) • Education & Training • Disability Management (After Action Review) • Culture (Behavior change re equipment use and sensitivity) • Planning for Sustainability (NIOSH, 1997; OSHA 1991 & 2003; VAH 2010) Multifaceted programs are more effective than any single intervention. Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

3. Unit Based Safety Leader/Champion Programs • Unit based champion programs play a key role in sustaining patient and staff safety initiatives and programs A unit base champion is a staff person that: • Has advanced training and expertise about a specific safety issue e.g. using patient handling equipment and best work practices • Supports the facility and the unit leadership to meet program goals e.g. successful implementation and maintenance of the SPH program Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

4. Unit Based Safety Leader/Champion Programs A unit base champion assists to meet the SPH program goals by: • Assisting to integrate evidence based practice that achieves effective and safe care and thereby facilitating culture change on a unit • Acting as a leader, mentor, advocate to promote and raise the collective awareness of a program e.g. SPH to peers and other staff • Performing as a coach that will demonstrate and assist coworkers in using patient handling equipment and troubleshoot issues • Advocating new ideas or initiatives and working diligently to promote them. Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

5. Unit Based Safety Leader/Champion Programs • Evidence base supporting the use of unit based champion programs: • Skin champions • Patient safety champions • Safe patient handling • Other industries Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

6. Unit Based Safety Leader/Champion Programs Challenges With Implementing and Sustaining a Champion Program • Recruitment and retention • Time for education/training • Time to perform champion activities • Resources to manage/support a champion group • Keeping the program ‘fresh’ Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

7. Unit Based Safety Leader/Champions Champion Program Structure • Unit based • At least 1 champion per shift • Could be RNs and CNAs on patient care units • Technicians e.g. for Imaging depts. • Transporters • Facility Wide • May be beneficial for larger hospitals • Must have clearly defined program plan and management, champion roles and responsibilities Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

8. Unit Based Safety Leader/Champions Characteristics of Effective Champions • Creative, energetic, and enthusiastic about champion role • Strong communication and interpersonal skills • Ability to influence others to practice evidence-based care/serves as a role model (is respected by peers on unit) Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

9. Unit Based Safety Leader/Champions Characteristics of Effective Champions • Is willing to take the time to educate, elicit feedback from, and provide regular updates to unit staff members about the SPH program and progress on the unit • Recognized as credible by those with whom they work and senior management (Bergquist-Beringer et al 2009) • May have had a previous work related injury from patient handling Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

10. Unit Based Safety Leader/Champion Programs Recruiting Champions • Hand picked by SPH or Safety coordinator and/or unit managers or volunteers (preferred) • Recruit at staff training for SPH and/or unit staff meetings • Be careful if choosing staff who are already volunteered for many committees of other champion roles • Define role and ‘what is the benefit for them’ Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

11. Unit Based Safety Leader/Champion Programs Training • Competency based Example • Foundation and evidence base for SPH • Facility SPH program/policy information • How to teach and coach • Hands on equipment training • Return demonstration and teaching of other champions in class • Assist to teach a staff SPH class with trainer • Follow-up by SPH coordinator on unit to review skills, processes and answer questions Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

12. Unit Based Safety Leader/Champion Programs Activities PerformedExample from SPH programs • Review safe and appropriate use of SPH equipment and processes with new and existing unit staff • Coaching staff and review use of SPH processes e.g., • Patient assessment tools • Documentation and communications • Assist to design SPH marketing initiatives on unit to facilitate staff engagement in program Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

13. Unit Based Safety Leader/Champion Programs Activities Performed Example from SPH programs • Troubleshoot equipment & supply issues e.g. lift battery is dead, lift slings needed • Conduct ‘real time’ competency based audits of equipment use, processes and patient experience • Identify barriers to equipment use • Actively participate in Daily Safety Huddles Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

14. Unit Based Safety Leader/Champion Programs Activities PerformedExample from SPH programs • May be involved in after Action Review of patient handling related injuries on the unit • Assist staff and unit leaders to address specific SPH related issues e.g. safe care of a dependent bariatric patient • Educates patients, families and other non unit staff about the SPH program and use of equipment • Communicate ideas/program feedback to unit leader, SPH coordinator, committees etc. Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

15. Unit Based Safety Leader/Champions Ongoing Champion Support • Give the safety champion the power to come up with quick solutions to certain problems, such as getting equipment fixed or replaced. • Champion group meetings • Linkage to other champion groups • Regular communications • Email group • Newsletter • Rounding by SPH coordinator Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

16. Unit Based Safety Leader/Champions Ongoing Champion Support • Periodic Refresher training • Periodic review of champion effectiveness • Recognition & celebration of successes unit/facility wide Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

17. Questions & Discussion 17 17 Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

18. Selected References • Bergquist-Beringer et al (2009). Embracing the use of skin care champions. Nursing Management, 40(12): 19-24 • Champions Improve Staff Education and Compliance with Pressure Ulcer Prevention Strategies (2013). Onslow Memorial HospitalJacksonville, North Carolina, USA and • Appoint a Safety Champion for Every Unit (2014). Retrieved from the Institute for Health Care Improvement http://www.ihi.org • Nelson, A. Matz M, Chen F, Siddharthan K , Lloyd J, Fragala G (2006). Development and Evaluation of a Multifaceted Ergonomics Program to Prevent Injuries Associated with Patient Handling Tasks.International Journal of Nursing Studies, 43(6):717–733. Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14

19. Selected References • Patient Care Ergonomics Resource Guide: Safe patient handling and movement. Nelson, A.L. (Ed). (2001 rev 2005). Tampa, FL: Veterans Administration Patient Safety Center of Inquiry. • Safe Patient Handling and Movement: A Practical Guide For Health Care Professionals (2006). Audrey Nelson Editor. Springer Publishing http://www.springerpub.com/ • Veterans Health Administration (VHA) Directive 2010-032 June 28, 2010 - Safe Patient Handling Program and Facility Design Presented at Washington State Hospital Association LEAPT – Hospital and Worker Culture of Safety Meeting 7/18/14