This article is a part of the ‘Technology, transformation and health care” series created in partnership with AMS Healthcare. These solutions-focused articles will focus on emerging technologies and their potential for transformational change in our health-care system.
More than 60,000 health-care workers miss time from work annually due to musculoskeletal disorders (MSD) resulting from routine tasks such as lifting and transferring patients.
Dwayne Van Eerd, a researcher at the Institute for Work and Health, says these disorders account for 30 to 40 per cent of health-care workers’ compensation claims. MSD can vary from person to person, impacting a worker’s back, neck, shoulders, elbows, hips and knees, making it difficult to estimate how long someone could be off the job.
“Some people could be off for weeks, if not months. Others may be able to return to work more quickly, but often in the return to work they would require an accommodation,” says Van Eerd. “And therefore, what ends up happening is they don’t go back to doing patient lifts, as that’s one of the big risk factors, and that means other colleagues in the workplace are doing more.”
In workforces with severe staffing shortages, like those impacting nurses and care aides, this puts additional pressure on staff.
Often, workplaces with high risk of musculoskeletal injuries have “minimal lift programs” that promote the use of assistive equipment like lifts, transfer belts, slide boards and walkers. However, though some health-care facilities have these measures in place, many are under-used because of the labour shortages and demanding workloads, says Van Eerd. If a nurse cannot find a colleague to help with a two-person lift, or to help operate a lift device, the nurse may opt to do it alone to save time and help a patient in pain.
A survey of care aides by British Columbia’s Hospital Employees Union (HEU) found that more than 50 per cent of respondents reported being injured on the job, and nearly the same percentage were required to perform two-person care or lifts by themselves.
Alexandre Girard, a roboticist and professor of mechanical engineering at the Université de Sherbrooke in Quebec, is working on improving lifts and transfer devices in health-care settings. Last year, Girard published the results of a research project on reducing the physical effort a caregiver has to exert when moving a patient who is being carried in a lift. Pushing and turning large portable lift devices, common in older facilities where permanent ceiling-mounted lifts cannot be installed, can wreak havoc on caregivers’ bodies.
“What we did is develop this fifth wheel that helped assist the motion of the floor lifts,” explained Girard. “It produces some force to help you move, but the fifth wheel is also good because it helps to make turning easier, and turning is one of the tasks that is hard on the back.”
To test the device, Girard and his colleagues monitored the force that a caregiver would have to apply on the lift’s handle to move and turn it. The research team recorded and timed subjects as they navigated a hospital room, a corridor and a bathroom while monitoring the force required to move the lift.
When the lift had a fifth motorized wheel, not only did the subjects need to use less force, but they also were able to navigate the hospital environment more quickly. Girard says implementing this type of lift in health-care settings can be done relatively quickly.
Implementing this type of lift in health-care settings can be done relatively quickly.
Now, Girard and his team want to use artificial intelligence (AI) to make patients more comfortable during movement and make the process more efficient.
Existing lifts typically employ a fixed amount of force when lifting a patient. Girard says he hopes that by integrating AI into lift and transfer devices, the lift could assess what the caregiver is trying to do ahead of time and calibrate an appropriate amount of force and velocity based on the patient’s needs.
“With the next generation of machines, we want to shift the paradigm to machines that will help assess [the patient] with a given force and not impose a motion,” said Girard. “So, that’s kind of a new way to move people.”
Given the high rate of MSD in health-care workers, Girard considers himself lucky to work on solutions that could have an impact on workplace safety.
“It’s a rewarding topic for a researcher,” says Girard. “If you do a good job, there’s a good chance it’s going to be in a product that’s really going to be helping people.”
But the attention and funding paid to preventing these injuries has dwindled over the past decade.
Van Eerd says organizations focused on occupational health and safety are increasingly focused on mental-health issues. Given that the COVID-19 pandemic exacerbated overwork and burnout in the health-care sector, Van Eerd says the shift is understandable.
“From my perspective, as a researcher having been in workplaces, what it seems to be is that the attention on MSDs, despite the fact that they still represent around 40 per cent of [health-care] claims, is being traded off for the attention on psychological health and safety,” he says.
Aside from improving lift technology, Van Eerd recommends education and awareness regarding MSD that goes beyond health-care workers’ initial training and workplace on-boarding. In a participatory research study that brought long-term care workers into the process of making new workplace safety protocols, Van Eerd says the workers recommended integrating information about MSD into existing health-and-safety processes.
“In a busy hospital or in acute-care settings when things are very busy, if you provide the sort of traditional education approaches and services or flyers, they might get looked at but time is a factor,” says Van Eerd. “If it’s built into the health-and-safety processes that already exist, and individual workers are aware of what they can do, there’s more likelihood, in my opinion, that they will actually reduce the risks of those injuries.”
Van Eerd says many care workers are driven to provide the best care possible for the individual that’s in front of them, sometimes to the detriment of their own health. It’s important for workers to remind each other that better care doesn’t have to come at the cost of their well-being.
“Most of the care workers themselves indicated they felt that reducing the risks, and therefore reducing the injury rates, actually had an impact on improving care,” says Van Eerd.