Everyone is keeping score and tracking it in some way. When we exercise, we track number of repetitions, weights used, and miles ran. Our doctors log health indicators like body weight, cholesterol, glucose, and blood pressure to name a few. More recently COVID19 infection and vaccination rates are under the microscope. Tracking the numbers in our lives is how we identify when things are going well, but more importantly, expose gaps where improvements can be made.

Keeping track of a Safe Patient Handling and Mobility (SPHM) program is no different. There is often a significant financial investment for the patient lift equipment that is needed to make the program successful. Having the ability to track and score the SPHM program’s effectiveness through indicators like improved patient outcomes, employee retention rates, and lower workers’ compensation costs is a great way to show return on investment (ROI).

Most healthcare facilities have a lift of some kind, and often, two or three per floor or unit depending on patient needs. Just having a lift does not mean there is a fully integrated SPHM program. Check out this comparison from the Association of Safe Patient Handling Professionals (ASPHP) on the differences between a lift program and a fully integrated SPHM program.

The Integrated SPHM program is hallmarked by:

• A commitment to no more than 35 pounds of manual lifting.
• New employee training and education with annual competencies.
• Ongoing evaluation of patient handling best practices.
• Patient mobility assessments on admission, readmission, and status change.
• An interdisciplinary SPHM committee / subcommittee tasked with evaluating and providing feedback related to difficult transfer tasks, new pieces of patient handling equipment, and patient handling incidents / injuries.
• Periodic transfer task observations.
• Routine lift equipment inspections for condition, repairs, and maintenance.
• Routine sling condition inspections to identify those needing to be replaced.
• A process to assure accessibility of slings at the point of use (either by laundry or supply staff).
• Utilization of patient lifts to assist in accomplishing rehabilitation goals.

Periodic evaluation is needed to maintain accessibility and viability of the SPHM Program. Compliance rate and program results are two types of evaluations that are typically gathered. Compliance rate can include equipment usage frequency, completion of annual lift competencies, and observations of equipment use. Program results will identify outcomes such as decreases in pressure ulcer formation, resident falls, and employee injury rates. All of these metrics can be utilized to validate the ROI of a SPHM program.

SPHM program monitoring tools have been developed by MEMIC consultants and are available through the MEMIC Safety Director.

SPHM Evaluation tools:

SPHM Scorecard: Evaluates the facilities’ program components in comparison to best practices.  This tool can be utilized to establish a baseline and then used periodically to document progress. 

Patient Handling Lift Monthly Audit:  Developed for facilities that may not have an audit in place, manuals may be missing, or manuals do not include a detailed maintenance checklist.  Integrate staff into this process by implementing a precheck of the equipment and sling prior to patient use.  Monthly review of lift equipment becomes more integral the older the equipment gets.

Sling Assessment:  Sling review and documentation is best accomplished during the laundering process after the slings have hung to dry and prior to being redistributed to the patient units.  Best practice includes removal of slings that are in disrepair, missing labels, and/or have fraying or holes. Refer to this helpful  Sling overview from Interior Health BC.

SPHM Committee timeline:  The timeline is used as a roadmap for addressing patient handling tasks, incidents, and processes tied into the overall program. Other resources can be found at the UMass Lowell Healthy Work Participatory Program website, and in several documents and links provided by the Minnesota Department of Labor and Industry.

SPHM Caregiver Challenges Survey:  Direct caregivers complete a myriad of transfers throughout the day, and their input is needed for the full picture of moving and repositioning patients. The caregiver challenges survey is to be used anonymously so that the staff are more open to giving feedback.

Completed documents should be provided to the QAPI, Safety, or SPHM Committee so initiatives can be reviewed, approved, tracked, and followed up on in a timely manner.

If you have any questions, please contact your MEMIC Safety Management Consultant or review our additional resources within the MEMIC Safety Director.

Authored by Clayton Cartwright and Esther Murray