Two-page paper with two resources. Using the example below.Calculate the break even for the number of procedures.  Use an electronic spreadsheet to show how you computed the break even and embed the spreadsheet in your paper.  Discuss the impact of the various reimbursements (e.g., Medicare, Medicaid, private, or self-pay).  Think about your upcoming capital proposal and how you might use the break-even analysis in your Capital Investment Plan Proposal. 

Our robotic equipment and its maintenance represent a fixed cost of $23,320 per month. The cost-effectiveness of robotic-assisted surgery is related to patient volume: With only 10 cases, the fixed cost per case is $2,332, and with 40 cases, the fixed cost per case is $583.

We recently purchased an endoscopic ultrasound(EUS), which allows doctors to examine the 

Linings of the esophagus and stomach, as well as the walls of the gastrointestinal tract. It is a necessary, but expensive, piece of equipment, which cost us $20,000 ($11,000 to purchase, plus$9,000 for renovations).

 Our fixed costs are four fulltime equivalent employees at $336,000 .

Medicare payments are $885 per procedure, and each procedure requires $175 in average variable costs. It has been estimated that we will complete 500 procedures in the first year and 850procedures in years 2 to 5.

We have calculated that 3% of Medicaid patients

account for more than half of our total costs.

Because of this, we are proposing the removal of

the highest risk patients from the primary care

physician´s office and instead providing all

services within a high-risk clinic. Residents will

have a team assigned to them, helping them learn

to manage their chronic conditions. The CFO sees

this plan as a major challenge, because it will

reduce fee-for-service revenue by $25 million,

and add $2 million in costs for items like the

office, staffing, claims analytics, predictive

modeling and risk stratification tools, and case

management information technology platform.

However, we currently lose money on these

residents, so we should lose less money.

Bibliography

Aslam, I., Davis, S. A., Feldman, S. R., & Martin, W. E. (2015). A Review of Patient Lifting Interventions to Reduce Health Care Worker Injuries. Workplace Health & Safety, 63(6), 267–275. https://doi.org/10.1177/2165079915580038

Carayon, P., Xie, A., &Kianfar, S. (2013). Human factors and ergonomics as a patient safety practice. BMJ Quality & Safety,23(3), 196-205. doi:10.1136/bmjqs-2013-001812

Chanchai, W., Songkham, W., Ketsomporn, P., Sappakitchanchai, P., Siriwong, W., & Robson, M. (2016). The Impact of an Ergonomics Intervention on Psychosocial Factors and Musculoskeletal Symptoms among Thai Hospital Orderlies. International Journal of Environmental Research and Public Health,13(5), 464. doi:10.3390/ijerph13050464

Dennerlein, J. T., Hopcia, K., Sembajwe, G., Kenwood, C., Stoddard, A. M., Tveito, T. H., Hashimoto, D. M., … Sorensen, G. (2011). Ergonomic practices within patient care units are associated with musculoskeletal pain and limitations. American journal of industrial medicine, 55(2), 107-16. doi:10.1002/ajim.21036.

Hignett, S. (2003). Intervention strategies to reduce musculoskeletal injuries associated with handling patients: A systematic review. Occupational and Environmental Medicine, 60(9). doi:10.1136/oem.60.9.e6

Kris Siddharthan, Audrey Nelson, Hope Tiesman, FangFei Chen “Cost Effectiveness ofMultifaceted  Program for Safe Patient Handling.” Publication Nos. 050021 (1-4). Pp- February 2005. Agency for Healthcare Research and Quality, Rockville, MD.

.

Li, J. (2004). Use of mechanical patient lifts decreased musculoskeletal symptoms and injuries among health care workers. Injury Prevention, 10(4), 212-216. doi:10.1136/ip.2003.00497.

Mao, X., Jia, P., Zhang, L., Zhao, P., Chen, Y., & Zhang, M. (2015). An Evaluation of the Effects of Human Factors and Ergonomics on Health Care and Patient Safety Practices: A Systematic Review. Plos One,10(6).DOI:10.1371/journal.pone.012994

Rogers, B., Buckheit, K., & Ostendorf, J. (2013). Ergonomics and Nursing in Hospital Environments. Workplace Health & Safety,61(10), 429-439. doi:10.1177/216507991306101003

Smedley, J., Trevelyan, F., Inskip, H., Buckle, P., Cooper, C., & Coggon, D. (2003). Impact of ergonomic intervention on back pain among nurses. Scandinavian Journal of Work, Environment & Health, 29(2), 117-123. doi:10.5271/sjweh.713

Zwerdling, Daniel. “At VA Hospitals, Training And Technology Reduce Nurses’ Injuries.” NPR, NPR, 25 Feb. 2015, www.npr.org/2015/02/25/387298633/at-va-hospitals-training-and-technology-reduce-nurses-injuries.

Palmer, J. (2018, September 11). LIFTING PATIENTS PUTS NURSES AT RISK: HAVE YOU TRIED THESE ALTERNATIVES? (P., Ed.). Retrieved February 14, 2019, from https://www.healthleadersmedia.com/nursing/lifting-patients-puts-nurses-risk-have-you-tried-these-alternatives

Question: What are the most effective interventions for dealing with ergonomic risks involving patient handling and awkward postures in hospital settings, and how can the public health officials help encourage the availability these interventions?

 CDC – Safe Patient Handling and Mobility (SPHM) – NIOSH Workplace Safety and Health Topic. (2013, August 2). Retrieved February 15, 2019, from https://www.cdc.gov/niosh/topics/safepatient/default.html

  Conn, E. J. (2013, September 16). OSHA Launches Ergonomics Campaign in Healthcare Industries. Retrieved February 14, 2019, from https://www.oshalawupdate.com/2013/08/12/osha-launchesergonomics-campaign-in-healthcare-industries/

Healthcare hazards. (2002, July 31). Retrieved February 14, 2019, from https://www.ishn.com/articles/82284-healthcare-hazards

Intervention to Ergonomic Risks

Abstract

This paper has on dealing with ergonomics risks that involve patients handling and the intervention that can be order in place ofthe workerto ensure there is a safe working environment. Many health complications such as back pain occur due to unsafe working conditions. The method used in collecting information was through an onlinedatabase collection of literature that is related to ergonomic risks. Information was carefully sampled to meet certain conditions.

From the articles,three intervention to ergonomic risks were discovered. The first intervention was the use of devices to reduce ergonomic risks. These devices can be mechanical and enhance improved service delivery apart from reducing the risks. Secondly, an educational intervention was aimed at making the employees aware of the safe methods they can use to avoid ergonomic risks. Lastly, change in policies is also another intervention here the managers should change their policies to those that ensure their employees are safe. To ensure that employees are not vulnerable to ergonomic risks medical officials should provide devices to staff, they should educate their staff,andlastly, they should change policies. Therefore, it is important for the management of hospitals to ensure safe ergonomics to protect employees from ergonomic risks.

Introduction

Ergonomics is the process of scheming or putting things or systems in order in a workplace so that they can be of good use to the people who these products. Ergonomics does not only involve sitting,but it involves a scheme of anything that may be of use to people. For example, places of work, various sports and leisure activities that people involve themselves, and the health and safety of various individuals. The main goal of ergonomics is to identify various human abilities and their limitations and use this knowledge to try and improve the way various people interact with products, the systems in their vicinity and environment that they interact in regularly. It works to improve the different places of work and their environment to reduce the risks or any other harm that people may incur in their places of work. Ergonomics has importance throughout our interaction with our environment.

Many illness and injuries tend to occur in our places of work. The current problem ergonomic hazards are that hospital employees are dealing with ergonomic risks and physical pain with patient handling and awkward postures.

Back pain is the most suffered due to activities in the workplace. They are also other risks that one may incur to due to poor working environments such as blindness. These problems affect people working in different environments like offices, agricultural institutions,and building sites. But with ergonomics, these risks are reduced because it creates a safe, comfortable and productive workplaces. The area of focus in this paper are hospital workers, interventions for patient handling, and awkward postures.Also, in the general public ergonomics helps to plan for the ever-increasing needs of the aged or people with disabilities by ensuring that the public transport, building facilities, and living spaces offer the perfect and comfortable way for staying without straining.

To make a place to be comfortable, the following factors are considered by ergonomist: anthropometries like body sizes, biomechanics which includes muscles and strength, environmental physics like vision, noise,and light, and social psychology which involves communication and behaviors(Wiker, 2012). Medical workers also suffer these ergonomic risks.    Key wordsin this paper are, ergonomic hazard, posture, intervention, patient handling, and hospitals.Therefore, this paper focuses on dealing with ergonomics risks that involve patients handling and the intervention that can be used to solve these risks.

Background

The way that workers have been handling patients has changed over time. In the past, workers had to physically transfer patients, by picking them up or letting the patient lean on them. The way that the workers had to hold the patients cause the workers to bad postures. This was not only occurring in hospitals, but as well as homes and clinics. Caregivers also deal with the same situations. Healthcare programs have been creating different types of interventions in hospitals and home that are cost effective and reduce workers pain.

More and more inventions are being created and being placed, in homes, hospitals, and clinics. They are reducing the ergonomic hazards for workers and patients. According to the Occupational Safety and Health Administration(OSHA) in the US, theinterventions to control ergonomic hazards that were made were, modifying equipment, making changes to the work practices, and buying different types of tools or devices to assist in the making the interventions.” Making these changes has reduced physical demands, eliminated unnecessary movements, lowered injury rates and their associated workers’ compensation costs, and reduced employee turnover“(OSHA).  There has been a significantdifference between not having an intervention and working with an intervention.

Method

The main aim of this research is to identify ways of dealing with ergonomic risks. I had to identify several kinds of literature regarding the various interventions that can be used to deal with ergonomic risks that occur due to the handling of patients.Literaturesources were searched by using the various online libraries like Google scholar, Sage journals. PubMed,and BMJ Journals. Out of the twenty-five abstracts that were read, the research was based on finding the following: studies that show implementation and intervention which have a purpose of reducing the ergonomic risks that health workers go through in their places of work. Secondly, they were to use the literature available and determine how effective will each intervention be in dealing with the ergonomic risks in the health care sector. Additionally, through the studies,I was able to determine how the health care backgrounds affect these background risks.  Furthermore, the literature that will be usedrequireshaving to talk about hospital workers or caregivers, written after 2000, full text available and for free.

For purposes of easier reviewing the articles were categorizedaccording to device intervention, education intervention and the change of policy intervention. By this it meant that the interventions were based on three categories: using new devices that can reduce ergonomic risk, educating the health workers on these ergonomic risks and policy change that occur due to the outcomes that occur due to these ergonomic risks(Tullar et al., 2010).

Results

From the articles, we were able to analyze the various interventions that can be used to reduce ergonomic risks. The articles emphasized three main way that can be used to minimize these ergonomic risks. They include; ensuring that devices are well equipped and have controls to make them desirable when they are needed. Furthermore, the administration should educate their employees on the best practices that they can use to reduce ergonomic risks. Lastly, change in policy depending on the outcomes that come from ergonomic risk individual should protect themselves from these risks.

Use of Devices to Reduce Ergonomic Risks

Health workers find it difficult for lifting patients who are more than 35 pounds. If they lift patients with this weight or more, they are vulnerable to ergonomic risks such as back pains. Therefore, for effective service delivery, they require devices that may aid them to lift objects that are heavier than 35 pounds. Hospitals have a role in equipping their hospitals with these devices so that their employees are not vulnerable to ergonomic risks. Some hospitals have bought this equipment for their hospitals like the overhead lift which comprises of a motorized hoist that can lift patients above towards the ceiling. The lifts also have an overhead rail that makes it easier to move patients from one position to another either in the same room or different rooms. The devices are expensive,but when used effectively they can serve the whole hospital. But depending on the benefits, they bring to the hospital they are cost effective. They have different designs some have two motor lifting more than 1000 pounds. Others are permanent while others are mobile thereby moving from one place to another(Aslam, Davis, Feldman, & Martin, 2015).

Apart from these overhead lifts, there is also other adjustable equipment such as height- adjustable equipment also play a key role in minimizing ergonomic risks. This adjustable equipmenthelps the health workers to move the patients to the required without straining. Less help is needed when mounting this equipment thereby the process of getting the patient to these chairs is made simpler. Patients can be able to get to the examination table by use of this equipment with very little effort. With the examination table, the patients can be examined well and therefore, leading to proper diagnosis. Examination chairs help physicians to improve the care they give to people with disabilities or those who can perform limited activities(Carayon et al., 2014).

It is noted that when mechanical devices are used in the transfer of patients, there is lesser straining of the lower back thereby reducing the ergonomic strain that could have occurred if manual procedures could have been used. These mechanical devices are always preferred my medical workers because they expose them to less ergonomic risks. Hydraulic stretchers help to decrease injuries during emergencies. They help in carrying individuals from one point to another without straining. The emergency response team is aware of ergonomics in their place of work and the presence of hydraulic stretchers help to reduce the economic risk that they may face. When using these devices, it is important for health workers to adopt a neutral position so that they don’t strain during their operations.

With these devices, it comes with many benefits. There will be reduced injuries when using these devices as compared to the manual process. Also, they will be no time wastage;hence no compensation claims this eventually leads to increased productivity(Chanchai et al., 2016). Additionally, many employees will be retained because they are not exposed to risks. Lastly, there will be customer satisfaction leading to more customers.

Educational Intervention

Health workers who have undergone training in ergonomics in techniques of lifting activities and other related activities will have reduced ergonomic risks. They will exhibit a neutral posture while working so that they don’t strain. Furthermore, they will handle patients and equipment in a manner that will expose them to fewer risks such as back pains. Nurses with knowledge in ergonomics are less vulnerable to repeated musculoskeletal injuries. Through education of health workers, a culture of safety and handling patients safely is inculcated into their behavior thereby reducing the ergonomic risks that they may be exposed to like backaches. In a medical facility with properly trained health workers thereare reduced risks,and in most cases, the risks occur because of accidents(Dennerlein et al., 2012).

The management in the health sector should also train their workers on procedures that they can do to reduce ergonomic risks. Such procedures should be affected by the management to protect their employees,and they are as follows. Firstly, they should be educated on the number of people that are required to lift a heavy load. It reduces whereby people lift heavy loads exposing them to ergonomic risks. Secondly, they should also educate their employees on the importance of rotating shift. By rotational shift, employees can relax from strenuousexercises thereby not being exposed to ergonomic risks always. Furthermore, the management should also make their employees the importance of breaks. It is through these breaks that they can relax from normal work activities. Continuous work may make the employee to be exposed to ergonomic risks. Through the intervention of regular breaks, the employees reduce the chances of being exposed to ergonomic risks.

Policy Intervention

Change is a major aspect in our lives be it in industries, or various sectors such as transportation health or social policies. The policy change may lead to the desired results that will help an organization to move forward. In this scenario,a policy change may lead to reduced ergonomic risks. Various policies can be changedto reduce ergonomic risks. Firstly, a hospital that changed their policy from using manual ways of carrying patients to employing mechanical devices reduced ergonomic risks. With advancement in technology, hospitals should change their ways to new technologies that make work to be done in a fast way and also reduce that their workers may be exposed when handling patients. So it is important for the management to be changing their policies with advancement in technologies.

Moreover, the management should change their policies to ensure there is a rotational of duties. By doing this, it will make the employees not to be exposed to tasks that strain them for a long period. Instead, they will frequently be changing from easier tasks to more harder tasks. Therefore, this reduces the risk of them being exposed to ergonomic risks. It can only be effective if the management will adapt to changing the policies of the institution(Mao et al., 2015).

Lastly, the management should also change their policies so that they give their employees some time off duty. Through this intervention, the health workers get a chance to relax from their normal daily duties. By relaxing the employees reduce their chances of being exposed to ergonomic risks. Therefore, it is important for the administrators of any hospital to take note of the policies that are exposing their employees to risks and change them so that their employees are comfortable in their place of work.

Discussion

The safety of health workers is determined by the ergonomics of their place of work. It is therefore important for the environment in the health sector to be conducive so that the health worker can give their best. In the medical sector, there should be minimal errors that should occur. Due to ergonomic risks that happen in the health sector they can lead to medical errors. When these errors occur, they can lead to serious problems in the health sector like the death of clients. Therefore, it is important for public health official to analyze the situations in the medical sector and determine the best ways they can use to minimize these ergonomic risks.

The use of mechanical devices to reduce ergonomic risk is one of the best strategies they can use. The devices save both on time as work is donein a faster way as compared to the manual way. It also offers the best way to work while not exposing you to risks. If medical officials can enhance this method, it can improve service delivery to the medical sector. Even though these methods are expensive, the benefits they bring to the medical sector are worth the cost.

It is also important to educate the medical worker on safe ways they can use to avoid being vulnerable to risks. The health sector may go at losses if the workers use them for the ergonomic risks, they expose their workers when they are working. Therefore, the management should educate their employee on how to avoid these ergonomic risks. Furthermore, if the patients are safe in these places of work they will be easily be retained. But if they are not safe, they may quit the work due to safety reasons.

The management should also be changing policies so that they can minimize the ergonomic risks to their employees. They should choose the best policies that make the place of work comfortable and safe for healthworkers.

Conclusion

In conclusion, this paper has focused on dealing with ergonomics risks that involve patients handling and the intervention that can be used to solve these risks. Ergonomics is the process of arranging things or procedures in order in place ofthe workerto ensure there is a safe working environment. Many health complications such as back pain occur due to unsafe working conditions. The method used in collecting information was through an online collection of literature that is related to ergonomic risks. Information was carefully sampled to meet certain conditions. From the articles,three intervention to ergonomic risks were discovered. The first intervention was the use of devices to reduce ergonomic risks. These devices can be mechanical and enhance improved service delivery apart from reducing the risks. Secondly, an educational intervention was aimed at making the employees aware of the safe methods they can use to avoid ergonomic risks. Lastly, change in policies is also another intervention here the managers should change their policies to those that ensure their employees are safe. Ergonomic risks and hazards are being associated with different disorders due to patient handling and awkward postures in hospitals. Not all hospitals are able to create or install the interventions.

Limitations of the research are not being able to record the difference between hospitals that use patient handling interventions and the hospitals that do not. More interventions are needed not only in hospitals but in other places such as homes,and clinics. Another limit is trying to find the most effective and efficient interventionfor non-hospital setting.  The occupational setting is what determines the best intervention that could be used. To ensure that employees are not vulnerable to ergonomic risks medical officials should provide devices to staff, they should educate their staff,andlastly, they should change policies. Therefore, it is important for the management of hospitals to ensure safe ergonomics to protect employees from ergonomic risks.

In public health an important aspect is trying to prevent people from being harmed or harming themselves. Ergonomicalhazards cause the patient and the care giver harm. Occupational settings should be able to determine the best type of intervention or hazard prevention to be placed in their setting. If each setting can find the best intervention, then egronomical hazards may be eliminated. Future technological inventions will play a large role in ergonomicalhazard interventions, which may be the best and most effective intervention for both the patient and worker.

References

Aslam, I., Davis, S. A., Feldman, S. R., & Martin, W. E. (2015). A review of patient lifting interventions to reduce health care worker injuries. Workplace Health and Safety. https://doi.org/10.1177/2165079915580038

Carayon, P., Wetterneck, T. B., Rivera-Rodriguez, A. J., Hundt, A. S., Hoonakker, P., Holden, R., & Gurses, A. P. (2014). Human factors systems approach to healthcare quality and patient safety. Applied Ergonomics. https://doi.org/10.1016/j.apergo.2013.04.023

Chanchai, W., Songkham, W., Ketsomporn, P., Sappakitchanchai, P., Siriwong, W., & Robson, M. G. (2016). The impact of an ergonomics intervention on psychosocial factors and musculoskeletal symptoms among Thai hospital orderlies. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph13050464

Dennerlein, J. T., Hopcia, K., Sembajwe, G., Kenwood, C., Stoddard, A. M., Tveito, T. H., … Sorensen, G. (2012). Ergonomic practices within patient care units are associated with musculoskeletal pain and limitations. American Journal of Industrial Medicine. https://doi.org/10.1002/ajim.21036

Mao, X., Jia, P., Zhang, L., Zhao, P., Chen, Y., & Zhang, M. (2015). An evaluation of the effects of human factors and ergonomics on health care and patient safety practices: A systematic review. PLoS ONE. https://doi.org/10.1371/journal.pone.0129948

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