Category Archives: Health Care Workers

Implementation of a resident handling programme and low back pain in elder care workers

Source: Andreas Holtermann, Occupational & Environmental Medicine, Volume 74, Issue 6, 2016
(subscription required)

From the introduction:
Low back pain (LBP) is the most important contributor to number of years lived with a disability and a major risk factor for sickness absence and work disability. Occupational groups with physically demanding work, like healthcare workers, have particularly high prevalence of LBP, and a considerable fraction of the LBP is considered to be caused by work-related factors. Moreover, LBP is a particular barrier for sustainable employment among workers with physically demanding work. Therefore, implementation of equipment (mechanical lifts or other assistive devices) for reducing the mechanical loading of healthcare workers during manual handling of residents should theoretically be efficient for preventing LBP and sickness absence among those with LBP. However, interventions implementing equipment for reducing the mechanical loading on healthcare workers during manual handling of residents show conflicting results on LBP. This might be due to the relatively short follow-up period of previous intervention studies introducing equipment for manual handling, which may need longer time before being fully implemented in an organisation. Moreover, it can be caused by lacking repetitive measures of both the implementation of the intervention as well as the often fluctuating level of LBP. Thus, there is a research gap in the documentation of the effects on LBP

Cost-Benefit Analysis of a Support Program for Nursing Staff

Source: Dane Moran; Albert W Wu; Cheryl Connors; Meera R Chappidi; Sushama K Sreedhara; Jessica H Selter; William V Padula, Journal of Patient Safety, Published Ahead-of-Print, April 27, 2017
(subscription required)

From the abstract:
A peer-support program called Resilience In Stressful Events (RISE) was designed to help hospital staff cope with stressful patient-related events. The aim of this study was to evaluate the impact of the RISE program by conducting an economic evaluation of its cost benefit.

A Markov model with a 1-year time horizon was developed to compare the cost benefit with and without the RISE program from a provider (hospital) perspective. Nursing staff who used the RISE program between 2015 and 2016 at a 1000-bed, private hospital in the United States were included in the analysis. The cost of running the RISE program, nurse turnover, and nurse time off were modeled. Data on costs were obtained from literature review and hospital data. Probabilities of quitting or taking time off with or without the RISE program were estimated using survey data. Net monetary benefit (NMB) and budget impact of having the RISE program were computed to determine cost benefit to the hospital.

Expected model results of the RISE program found a net monetary benefit savings of US $22,576.05 per nurse who initiated a RISE call. These savings were determined to be 99.9% consistent on the basis of a probabilistic sensitivity analysis. The budget impact analysis revealed that a hospital could save US $1.81 million each year because of the RISE program.

The RISE program resulted in substantial cost savings to the hospital. Hospitals should be encouraged by these findings to implement institution-wide support programs for medical staff, based on a high demand for this type of service and the potential for cost savings.

Philadelphia Union Wins Equal Pay for Immigrant Nurses

Source: Samantha Winslow, Labor Notes, May 5, 2017

It started when a few nurses at Temple University Hospital told stewards that they weren’t being paid for their experience.

One of the first to speak up was Jessy Palathinkal, who had become a nurse in India in 1990. She got her U.S. nursing license when she moved here in 1995. But when she started working at Temple, her placement on the pay scale was as though those five years of nursing never happened.

She asked why. Human Resources told her the hospital didn’t count years of experience in foreign countries.

“I was feeling a little bit upset. I had all the certification,” Palathinkal said. “I thought, ‘Well, that’s not right, but what can I do?’”

What Palathinkal did was tell her shop steward. The steward told officers of their union, the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP). And the officers started asking around to see whether anyone else was affected.

They put out a call in their monthly newsletter—did anyone else think that their pay was incorrect for their level of experience? Three more nurses had the same complaint.

Four nurses joined a class-action grievance. Management denied it. That’s when union officers decided this was a hospital-wide issue…..

Hospitals turn to job cuts amid budgetary woes

Source: Paige Minemyer, Fierce Healthcare, May 1, 2017

Squeezed budgets and regulatory uncertainty are pushing a number of hospitals across the country to cut back on staff.

One of the largest reductions in staff is taking place at Brigham and Women’s Hospital in Boston, which last week announced plans to offer buyouts to 1,600 employees. The reason for the trouble: flat reimbursement and rising operating costs.

And it’s a problem felt across the country, STAT reports. Financial woes have already led Catholic Health Initiatives to slash 900 positions through layoffs and buyouts, STAT reports, and The University of Texas MD Anderson Cancer Care Center to cut 1,000 jobs.

In recent weeks layoffs have been announced at organizations in New York City, California, Minnesota and Rhode Island:
• Organizational restructuring” at NYC Health + Hospitals could lead to the loss of more than 600 jobs across the system’s 11 acute care facilities, according to a report from the New York Post.
• Hennepin County Medical Center in Minneapolis will cut 130 positions, or 2% of its full time staff, according to the STAT article.
• Riverside Community Hospital in California will layoff 42 employees amid a $400 million expansion, the Press-Enterprise reports. In addition to the job cuts, Riverside will close its cardiac rehab center and its ambulatory services unit.
• Care New England Health System, the second largest health system in Rhode Island, which recently announced a merger with Partners HealthCare, revealed that it will begin a “wide array” of layoffs at its flagship hospital, Women and Infants Hospital, reports the the Providence Journal. Though leaders at the facility would not confirm how many layoffs were planned, they said that both clinical and non-clinical positions would be affected…..

The Wage and Job Impacts of Hospitals on Local Labor Markets

Source: Anne M. Mandich, Jeffrey H. Dorfman, Economic Development Quarterly, Vol 31, Issue 2, 2017
(subscription required)

From the abstract:
This study examines the impact of hospitals on local labor markets in rural and urban counties. We measure the ability of hospitals, particularly in rural communities, to attract nonhealth-related employment and provide higher wage jobs to residents based on their education level. Results find hospital employees with an associate’s degree can expect a 21.4% wage premium, when compared with alternative opportunities, and those with a bachelor’s degree can earn 12.2% more working in a hospital. Hospitals are shown to be positively related to overall employment as well as exhibit positive employment spillover. For rural counties, a short-term general hospital is associated with 559 jobs in the county, 60 of which are hospital based and 499 are non–health care related. With the positive benefits on wages and non–health care job growth, hospitals have measurable positive labor market outcomes above their primary objective of providing health care access, particularly in rural counties.

Health Care Workers Bring Sanctuary Movement into the Union

Source: Porfirio Quintano, Labor Notes, April 13, 2017

I had no money and spoke no English when I illegally crossed the border into California 23 years ago, but I worked hard and fought for the right to stay here.

Had I made that harrowing journey this year, I’m sure I’d be deported right back into the crosshairs of the Honduran government’s death squads that had targeted me and many other community organizers.

Instead I quickly won a grant of political asylum—and later received full American citizenship.

I know I’m one of the lucky ones. At the San Francisco hospital where I work, nine out of 10 members of my union are foreign-born. We never ask anyone about their immigration status, but I know several green card holders who are getting ready to apply for citizenship now that their place in America seems less secure.

People might think the Bay Area is one big protective cocoon for immigrants, but that’s not the case. The suburb where I live is not a sanctuary city. And my elected county sheriff contracts with the Department of Homeland Security to house people awaiting deportation hearings.

Who can my co-workers count on if Immigration and Customs Enforcement (ICE) agents come looking for them or their family members? Our union, thankfully…..

NHS research finds ‘direct link’ between staffing levels and death risk

Source: Shaun Lintern, HSJ, April 13, 2017
(subscription required)

….The project looked at staffing levels across 32 general medical and surgical wards at one NHS hospital between April 2012 and March 2015. More than 107,000 patients and almost 700,000 staff shifts were analysed using data from rostering systems and electronic observations, with the number of care hours per patient per day calculated and compared to mortality risks.

Key findings from the research were:
– When patients were exposed to low nursing hours during the first five days of their hospital stay, their risk of death significantly increased.
– For each day of low registered nurse staffing, the risk of death was increased by 3 per cent.
– Patients whose stay included days of high patient turnover in terms of admissions per nurse were associated with a 5 per cent increase in the risk of death.
– High levels of temporary staffing on the ward was associated with increased risk of death.
– When 1.5 or more nurse hours per patient day were provided by temporary staff the risk of death increased by 12 per cent.
– Each additional nurse hour per patient day was associated with a 2 per cent decrease in the chance of vital sign observations being missed…..

Professor Griffiths said the study was due to be published later this year. It will add to a growing body of NHS based research showing links between registered nurse staffing and patient outcomes. In December, a study by Professor Alison Leary found a “calculable” link between nurse numbers and patient outcomes, including 40 separate correlations with staffing levels…..
Registered nurse, healthcare support worker, medical staffing levels and mortality in English hospital trusts: a cross-sectional study
Source: Peter Griffiths, Jane Ball, Trevor Murrells, Simon Jones, Anne Marie Rafferty, BMJ Open, Volume 6, Issue 2, June 2016

Lifting and exertion injuries decrease after implementation of an integrated hospital-wide safe patient handling and mobilisation programme

Source: Jack T Dennerlein, Elizabeth (Tucker) O’Day, Deborah F Mulloy, Jackie Somerville, Anne M Stoddard, Christopher Kenwood, Erin Teeple, Leslie I Boden, Glorian Sorensen, Dean Hashimoto, Occupational & Environmental Medicine, Volume 74 no. 5, May 2017

From the abstract:
Objective: With increasing emphasis on early and frequent mobilisation of patients in acute care, safe patient handling and mobilisation practices need to be integrated into these quality initiatives. We completed a programme evaluation of a safe patient handling and mobilisation programme within the context of a hospital-wide patient care improvement initiative that utilised a systems approach and integrated safe patient equipment and practices into patient care plans.

Methods: Baseline and 12-month follow-up surveys of 1832 direct patient care workers assessed work practices and self-reported pain while an integrated employee payroll and injury database provided recordable injury rates collected concurrently at 2 hospitals: the study hospital with the programme and a comparison hospital.

Results: Safe and unsafe patient handling practice scales at the study hospital improved significantly (p<0.0001 and p=0.0031, respectively), with no differences observed at the comparison hospital. We observed significant decreases in recordable neck and shoulder (Relative Risk (RR)=0.68, 95% CI 0.46 to 1.00), lifting and exertion (RR=0.73, 95% CI 0.60 to 0.89) and pain and inflammation (RR=0.78, 95% CI 0.62 to 1.00) injury rates at the study hospital. Changes in rates at the comparison hospital were not statistically significant. Conclusions: Within the context of a patient mobilisation initiative, a safe patient handling and mobilisation programme was associated with improved work practices and a reduction in recordable worker injuries. This study demonstrates the potential impact of utilising a systems approach based on recommended best practices, including integration of these practices into the patient's plan for care.

Quelling a storm of violence in healthcare settings

Source: Elizabeth Whitman, Modern Healthcare, Vol. 47 no. 11, March 13, 2017

Violence in healthcare settings has risen steadily in recent years. That has taken a growing financial and human toll on the nation’s 15 million healthcare workers and on its hospitals and long-term care centers, and has prompted executives, providers and policymakers to take action in myriad ways.

The Impact of the Affordable Care Act on Health Coverage for Direct Care Worker

Source: Stephen Campbell, PHI, Issue Brief, March 2017

From the summary:
Direct care workers—nursing assistants, home health aides, and personal care aides who support older Americans and people with disabilities—are among America’s lowest paid workers, often struggling to access health coverage. However, new coverage numbers show that this workforce benefited substantially from the Affordable Care Act (ACA). Between 2010 and 2014, half a million direct care workers gained coverage. At the same time, the uninsured rate across this workforce decreased by 26 percent. As the Trump administration and the new Congress consider the future of the Affordable Care Act (ACA) and Medicaid, it is important to consider the impact of these changes on this critical U.S. workforce.