1. law, govt and politics
2. government
3. state and local government

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
AGENDA:
 Safe Patient- Handling Policy
 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
Section 7: Multiple Intelligences
DIFFERENT WAYS YOUR
TEAM MEMBERS ARE SMART
Word 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