Braxton Health Care Center in Sutton, W.Va., didn't always have a low lost workday injury and illness (LWDII) rate. In 1997, the intermediate-care nursing facility's rate had spiked to 24, attributable mainly to back injuries from resident lifting and repositioning. The center's workers' compensation premiums were sky-high, and morale at the facility slumped as workers often found themselves doing double-duty as their injured coworkers recovered at home.

In response, the center's management purchased four resident-lifting devices. However, equipment alone wasn't the answer to Braxton's problem. During an inspection, OSHA compliance safety and health officers found no procedures or policies in place requiring employees to use the lifts—and as a result, some employees didn't. OSHA issued the center an ergonomic hazard alert letter, recommending the mandatory use of lifting devices.

Administrative Assistant June Bragg said Braxton quickly established a resident lifting and transfer policy that requires all workers to use the mechanical lift equipment and bans all manual lifting without explicit permission from a supervisor.

The facility also began an ambitious training program, teaching staff how to use the mechanical lifts properly and to work with a "lifting partner" to reposition a patient when appropriate. The instruction also extended to the residents, who learned how to help caregivers transfer them safely.

The result was an impressive turnaround at the facility—which experienced a steady decrease in injuries and has not had a single similar injury since late 2001. "The initial investment in lifting equipment is significant," said Bragg. "But the long-term payoff more than compensates for it in terms of insurance premiums, workers' compensation premiums, and employee morale."

While the facility's new patient lifting and transfer policy is cutting workplace ergonomic injuries significantly, a new program is helping reduce lost workdays due to work-related injuries.
Braxton's return-to-work program involves modifying the injured workers' job temporarily to eliminate specific tasks until the worker is fully recovered. Bragg explained that a doctor examines the injured worker, reviews the worker's job description, and determines which tasks the worker can or cannot do. For example, the doctor may determine that the worker should not have any direct patient contact, but may be able to set up food trays, clean hairbrushes, and do other, less physical tasks. The doctor conducts regular worker evaluations and specifies when the worker is able to resume full duties—typically six to eight weeks later.

Bragg said the program is a big morale boost because it enables workers to return to work faster, even if in a limited capacity. "None of our workers wants to be sitting at home recovering from an injury," she said. "They want to be on the job, contributing in any way they can. This program helps them do that."

Gary McKinney, a compliance safety and health officer in OSHA's Charleston Area Office, said Braxton's success demonstrates the value of addressing ergonomic issues—in nursing homes as well as other industries. "It's refreshing to go into a facility and see that they have identified the problems and successfully implemented solutions," he said. "Braxton provides a great example of OSHA's ‘add value' message—through lower injury and illness rates, lower workers' compensation costs, and workers who understand that their management cares about their safety and health." JSHQ