Bush Administration Ergonomics Plan Fails to Protect Workers From Crippling Injuries

[Excerpt] On March 20, 2001, President Bush--in his first major legislative action--signed legislation repealing OSHA’s ergonomics standard. This important worker safeguard, issued in November 2000, was ten years in the making and would have prevented hundreds of thousands of workplace injuries a year. But, bowing to Big Business groups who opposed any ergonomics regulation, after the 2000 election, the Republican controlled Congress and the Bush Administration joined together to kill this worker protection measure. Last March, as Congress contemplated the repeal of OSHA’s ergonomics standard, Secretary of Labor Elaine Chao stated, “Repetitive stress injuries in the workplace are an important problem.” She promised that if the standard was repealed, the Department would “pursue a comprehensive approach to ergonomics, which may include new rulemaking…This approach will provide employers with achievable measures that protect employees before injuries occur.

User involvement in healthcare technology development and assessment: Structured literature review

Purpose – Medical device users are one of the principal stakeholders of medical device technologies. User involvement in medical device technology development and assessment is central to meet their needs. Design/methodology/approach – A structured review of literature, published from 1980 to 2005 in peer-reviewed journals, was carried out from social science perspective to investigate the practice of user involvement in the development and assessment of medical device technologies. This was followed by qualitative thematic analysis. Findings – It is found that users of medical devices include clinicians, patients, carers and others. Different kinds of medical devices are developed and assessed by user involvement. The user involvement occurs at different stages of the medical device technology lifecycle and the degree of user involvement is in the order of design stage > testing and trials stage > deployment stage > concept stage. Methods most commonly used for capturing users’ perspectives are usability tests, interviews and questionnaire surveys. Research limitations/implications – We did not review the relevant literature published in engineering, medical and nursing fields, which might have been useful. Practical implications – Consideration of the users’ characteristics and the context of medical device use is critical for developing and assessing medical device technologies from users’ perspectives. Originality/value – This study shows that users of medical device technologies are not homogeneous but heterogeneous, in several aspects, and their needs, skills and working environments vary. This is important consideration for incorporating users’ perspectives in medical device technologies. Paper type: Literature review

A systems ergonomics analysis of the Maidstone and Tunbridge Wells infection outbreaks

This paper describes a systems ergonomics analysis of the recent outbreaks of Clostridium difficile which occurred over the period 2005-07 within the UK Maidstone and Tunbridge Wells NHS Trust. The analysis used documents related to the outbreak, alongside the construction of a system model in order to probe deeper into the nature of contributory factors within the Trust. The findings from the analysis demonstrate the value of looking further at cross-level and whole-system aspects of infection outbreaks. In particular there is a need for further study of the causal relationships that exist between hospital management and clinical management levels within the system. Finally, the paper discusses ways forward and strategies that could adopted in order to limit the outbreak of hospital-related infections and shape future research

Infection outbreaks in acute hospitals: a systems approach

This paper puts forward the case for applying a systems approach to the analysis of hospital-based infection outbreaks. A major advantage of the systems approach is that it affords insights into how actions or occurrences at one system level (e.g. individual error) collectively interact with team (e.g. leadership style) and organisational (e.g. safety culture) levels of analysis. Most of the research concerned with behavioural aspects of infection control has focused on a single level of analysis (e.g. interventions to improve hand washing). The infection outbreaks at the Maidstone and Tunbridge Wells NHS Trust are used as a case study in order to demonstrate the usefulness of the systems approach. The paper further outlines the human and organisational issues raised by the analysis and provides a means through which these aspects of infection can be highlighted as part of a future research agenda

Save our surgeons: an ergonomics evaluation of laparoscopic hysterectomy

This paper presents an investigation of ergonomic issues and coping strategies during gynaecological laparoscopic surgery. Data were collected with questionnaires, postural analysis and interviews. The results suggest that work-related musculoskeletal disorders were present in almost 90% of survey respondents. The workplace factors included equipment dimensions, preference of port positioning and patient size with limited adjustability for all surgeons to perform comfortably and effectively. These findings have implications for service provision (availability of surgeons) and patient safety (human interface design)

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Temporal series analysis on avoidable mortality for the assessment of an intervention program in a hospital.

Background: Avoidable mortality (AM) is one of the most important health indicators (HI) and represents the quality of care in a hospital. Objective: This study measured the efficacy of a training program for a hospital healthcare staff to reduce AM. Methods: This epidemiological study on community intervention analyzed time-series data on HI by semesters from 2008 to 2015. The pre-intervention phase was examined from January 2008 to December 2014; the intervention phase was investigated in the first semester of 2015; and the post-intervention phase was examined in the second semester of 2015. Results: Resindicate a series with a rising tendency until the 14th semester and a pronounced descent in the 16th semester. The relative variation rate (RVR) was -20% to +20% with some exceptions. HI was 0.53% in the 16th semester rather than the expected 0.70% observed in the pre-intervention phase; therefore, 0.17% additional deaths were avoided because of the training seminar. Conclusion: The positive results suggest that this strategy is an important element in decreasing avoidable deaths in hospitals

The NOVO network: A Research and Development Platform with the Vision of a Nordic Model for Sustainable Systems in Health Care

Musculoskeletal and psychological/mental disorders are major causes of sick leave, threatening the welfare of individuals and the economics of companies and societies. The prevailing research and development (R&D) of ergonomic interventions show minimal long-term effects on health and wellbeing while interventions to improve production seem to have a dominant negative effect, particularly in the health-care sector. Scientific evidence suggests that improved partnership is needed between stakeholders with different and often opposing aims, i.e., organizational productivity vs. worker wellbeing. In 2006 a Nordic R&D network, the NOVO Network, was established highlighting the need for a new approach, integrating work environment and production needs in intervention R&D. Our hypothesis is that such an integration is more readily established in the Nordic countries, largely due to their leading positions in the world in terms of social capital. Through annual symposia and other activities, the NOVO Network brings together scholars and practitioners to share knowledge and experience and to suggest and develop new areas of collaboration towards increased organizational sustainability in health care. A multicenter study conducted within the framework of the NOVO network resulted in a new, practical tool. This tool aims to facilitate partnership instead of the prevalent domination orientation, thereby combining consideration of work environment and production needs. Based on our experiences so far, this article highlights some key future challenges. As a result, we hope to see development of a stronger Nordic R&D tradition towards increased organizational sustainability in health care

A research agenda on patient safety in primary care. Recommendations by the LINNEAUS collaboration on patient safety in primary care

This is the final version of the article. Available from Taylor & Francis via the DOI in this record.BACKGROUND: Healthcare can cause avoidable serious harm to patients. Primary care is not an exception, and the relative lack of research in this area lends urgency to a better understanding of patient safety, the future research agenda and the development of primary care oriented safety programmes. OBJECTIVE: To outline a research agenda for patient safety improvement in primary care in Europe and beyond. METHODS: The LINNEAUS collaboration partners analysed existing research on epidemiology and classification of errors, diagnostic and medication errors, safety culture, and learning for and improving patient safety. We discussed ideas for future research in several meetings, workshops and congresses with LINNEAUS collaboration partners, practising GPs, researchers in this field, and policy makers. RESULTS: This paper summarizes and integrates the outcomes of the LINNEAUS collaboration on patient safety in primary care. It proposes a research agenda on improvement strategies for patient safety in primary care. In addition, it provides background information to help to connect research in this field with practicing GPs and other healthcare workers in primary care. CONCLUSION: Future research studies should target specific primary care domains, using prospective methods and innovative methods such as patient involvement.The research leading to these results has received funding from the European Community’s Seventh Framework Programme FP7/2008–2012 under grant agreement no. 223424