ABSTRACT
An Environment of Care can be defined as the experience of a user with the healthcare delivery system. The Agency for Hcalthcare Research & Quality (AHRQ) states that quality in health care means doing the right thing at the right time in the right way for the right person and having the best results possible. To anchor ergonomics in this context we need to examine where the ergonomics program contributes to the performance of the healthcarc delivery system. The National Institute for Occupational Safety & Health (NIOSH) published guidelines for setting up a good ergonomics program focused on prevention of the work-related musculoskeletal disorders in the manufactming and service industries. This pilot study applied the NIOSH model in a hospital and attempted to examine its relevance to healthcarc settings. With few recordable musculoskeletal injuries in the organization, the program was set up in a pathology department where management was willing to collaborate
rather than where a need was urgent. The program was therefore set as a standalone and adapted to address ergonomic issues related to computer terminals in the lab and offices. A task force was set up and assessed the design of the computer workstations using a standard checklist, musculoskeletal symptoms were surveyed and a series of focus groups and training sessions in Healthy Computing were conducted for labor and management. Products were selected to address the ergonomic deficiencies noted in the design of the workstations. The action steps that could be implemented during the project were compared against the guidelines of the NIOSH model ergonomics program. The pilot study revealed that of 41 items listed in NIOSH model, 30 (73%) were applicable to the hospital environment. However, the ergonomic concerns in healthcare go beyond musculoskeletal injuries of the care providers and the NIOSH guidelines do not address ergonomic concerns related to patient safety. Other criteria may have to serve for selecting an intervention site and assessing the impact of the program. Three conclusions can be drawn about integrating ergonomics in an Environment of Care: 1) the impact ofthe ergonomic program may not be manifested in OSHA logs but in medical insurance data; 2) to make the ergonomic program more effective, link it to patient safety and risk management; 3) more research is needed to link the ergonomic concerns of both employees and patients in a healthcare setting. Out of 14 dimensions of healthcarc performance listed by the Organization for Economic Cooperation & Development (OECD), this pilot study showed that at least 4 may be impacted by an ergonomics program: environment & amenities, efficiency, responsiveness to the needs of the users, and safety.
