A recent study involving 887 nursing homes over a 10-year period found that the rate of back injury was reduced 21 percent when an ergonomic intervention was made through an Ohio Bureau of Workers’ Compensation (BWC) program (a $500 equipment purchase per nursing home worker that reduced physical stress in handling residents). The savings in claims costs nearly equaled the cost of the equipment. However, when the resident-to-staff ratio was greater than 2.0, a savings of $1,062 was seen due to reduced claims costs.
BWC ergonomic consulting services produced a marginal impact on injury rate although the authors noted that confounding, misclassification and bias made this finding questionable. BWC ergonomic training courses led to modest claims reductions but demonstrated significant cost savings relative to instruction cost.
The Bottom Line – How This Applies To Ergonomists
Ergonomic equipment that assists in the handling of patients can reduce the incidence of back injury within nursing homes. When a resident to staff ratio greater than 2.0 exists, a significant cost savings can occur. However, the net direct cost savings appears to be neutral as this ratio lowers.
This study did not consider indirect costs or the social benefits of injury avoidance.
Other Key Points
From 1995-2004, 23,724 work-related back injuries occurred within the study’s 887 observed nursing homes generating $232 million in direct costs (average cost per claim was $9,790; average annual claim cost relative to all nursing home workers was $365). Nursing homes with 21-100 employees sustained higher rates of back injuries (3.9 per 100 workers) compared to nursing homes with a small number of employees (3.4 per 100 workers) and with a larger number of employees (3.2 per 100 workers).
The larger the nursing home workforce size, the more likely BWC interventions occurred during the 10 year study. Ergonomic consulting was sought by only 11 percent of small employers compared to 62 percent of the large employers. Equipment purchases, despite the existence of grants, were far more common among large employers (21 percent participated) as opposed to small employers (less than 1 percent participation).
The authors point out that a key study limitation was unknown management motivation relative to participation in BWC’s program. If management was strongly supportive of reducing back injuries, their workplace would most likely see lower incidence rates.
Workers’ compensation claim data (i.e., date of injury, age, gender, employer ID, ICD-9 codes, and costs) was collected from 1995-2004.
With employer cooperation, interventions were applied during 200-2001 and included:
• consulting (ergonomics, industrial hygiene, safety, or other)
• capital expenditures (grants for lifts, electric beds, other devices)
• course hours (ergonomics training, safety committees, investigations, etc.)
• number of ergonomic video training tapes loaned from BWC
The location, date, and type/amount of provided intervention was documented. A study case was defined as a BWC accepted claim with a back injury diagnosis code. Intervention impact on claim incidence and cost was analyzed.
This position paper can be acquired at: http://www3.interscience.wiley.com/journal/122539941/abstract
Article Title: Impact of Publicly Sponsored Interventions on Musculoskeletal Injury Claims in Nursing Homes
Publication: American Journal of Industrial Medicine, 52:683-697, 2009
Authors: R M Park, P T Bushnell, A J Bailer, J W Collins, and L T Stayner
This article originally appeared in The Ergonomics Report™ on 2009-08-26.