Is there a way to use ergonomics to change employee perceptions of work?

Continuing on with my blog series on the four common reasons why employees don’t do what they’ve been trained, I’m going to take a closer look at perception.  The scenario I’m going to use as the basis for this is one which is occurring in many hospitals and long term care facilities around the country:  caregivers not using safe patient handling (SPH) equipment to move patients.  This has become a source of frustration for many SPH program leaders.  As you will see, the lack of SPH equipment use could easily involve all 4 reasons but for this blog we’ll focus only on perception.

Here’s a brief background on SPH for those not too familiar with it.  Caregivers have had one of the highest rates of musculoskeletal disorders compared to other occupations for several years.  The main reason has been due to the physical moving and handling of patients.  As a result some states have passed laws requiring SPH training and equipment while other healthcare facilities have implemented SPH programs in hopes of reducing the injuries and the costs associated with them.  Aside from the cost of training, the total dollars spent on SPH equipment for a facility can easily end up in the thousands, if not hundreds of the thousands.

When I worked at one of the largest health systems in MN, one of the primary reasons I heard from caregivers for not using SPH equipment to lift or boost patients is the perception of increased time.  Nurses and nursing assistants were already so busy they didn’t have time to go get the equipment.  This perception was very true when we had only floor-based lifts that were stored at the ends of the hallway or in the back of a storage closet. To address and solve this issue we installed ceiling lifts so the caregivers would have the lift within the room, i.e. at the point of use.  We purposely placed the slings and other accessory items in the storage rooms where they got their other common supplies.  With this we continued to hear complaints about the time it took to use the lifts.  Their perception of increased time changed from having to get the lift equipment that was down the hall to the actual time it took to move or lift the patient with the lift.  They stated it took too long.  Needless to say, hearing those remarks were quite frustrating to me.  However, it didn’t matter how I felt it mattered how the end users, the caregivers, felt.  They weren’t going to use the equipment unless it was easy and took the same amount of time as manually moving a patient.

Now I had to determine why they still perceived it took too much time to use the lift.  I had to figure out the root cause for this perception.  After closely examining lifts and boost with and without equipment I understood.  When a nurse needs assistance to move or lift a patient she typically calls for assistance.  She waits for assistance to come, however, while waiting she was doing talking to the patient, performing other patient cares or charting until assistance arrived.  The wait could range from a couple minutes to several minutes.  Then the two (or more) of them would count to three and move the patient.  The move was over in just a few seconds.  However, the total amount of time (wait time and move time) was 3-15 minutes.

Now compare this to using SPH equipment.  The caregivers were trained and instructed that they could use the ceiling lift by themselves for the majority of moves.  They could use a second person if they wanted but it wasn’t required.  When I observed one caregiver doing the move by herself using the equipment the total time was between 5-10 minutes.  When I observed one caregiver calling for assistance and then using the ceiling lift it took a similar amount of time as to doing it manually.

So, why did the caregivers perceive using the lift took them longer?  Because when they moved patients manually they mentally didn’t take into consideration the time spent waiting for assistance.  Their time perception was the actual lift time (one, two, three—lift).  When they used the equipment by themselves the increased time was due to the fact that they were doing the whole process by themselves.  So even though the total time was the same, their perception was that it took longer.

How was this perception changed?  Part of it was through time, i.e. as the caregivers became more confident and accustomed to how to use the equipment their perception of it taking more time decreased.  The other part was through presenting the actual timing facts (with some video to back it up) to the caregivers.  Showing them that the time it took to use the SPH equipment and the time it took to wait for someone else was virtually the same.

Did ergonomics and human factors have a roll in changing perceptions?  Absolutely.  Root cause analysis, knowledge of human behavior and psychology and having the correct equipment for the task at the point of use all was vital to overcome this perception.

What are your experiences with perceptions?  How have you addressed them?