Macro and Micro Ergonomic Outcomes in Healthcare: Unraveling the Relationship Between Patient Handling Performance and Safety Climate

Abstract

OCCUPATIONAL APPLICATIONS The management of risks surrounding patient handling activities continues to be an important factor in healthcare organizations. A great deal of research has been undertaken to investigate the best practices for physical transfers and equipment provision, yet there is less research adopting an organizational systems approach to this problem. In this article we compare two methods for assessing safety climate and patient handling safety performance and argue that a multi-level (mesoergonomic) interpretation of the relationship between the two affords insights into the safety of the system as a whole.

TECHNICAL ABSTRACT Background: Karsh et al. ((2014)) proposed a model for developing cross-level ergonomics investigations, which clarified the inclusion of micro, macro, and meso level factors to any organizational investigation. The growing body of research into the management of patient handling risks has not adopted these multi-level organizational systems approaches. Purpose: In this article we explore the use of this model to create a clearer understanding of the healthcare specific activities that surround the management of patient handling functions within a neurological rehabilitation setting. Methods: Six acute medical wards in a large UK teaching hospital were used to explore the relationship between patient handling, as part of a complex socio-technical healthcare system, and safety climate. Data were collected using the Tool for Risk Outstanding in Patient Handling Interventions and Safety Climate Survey and analyzed using descriptive statistics and Spearman's Rank Correlation. Results: A variety of results highlighted strengths and weaknesses in safety climate and patient handling risks. Significant correlations were found between Tool for Risk Outstanding in Patient Handling Interventions Tool for Risk Outstanding in Patient Handling Interventions Safety Climate scores and the Safety Climate Survey Overall Mean. Conclusion: These results suggest that the differences between scores across a variety of measures indicate that a wider range of data may be required to best represent a measure of safety climate in this occupational setting.

KEYWORDS:

• Healthcare
• mesoergonomics
• macroergonomics
• patient handling
• safety climate

ACKNOWLEDGMENT

The authors gratefully acknowledge the staff in the six locations who participated in this investigation.