A growing problem in health care, particularly with physicians, is ergonomic injury—and it’s more than just a pain in the neck. These job-related injuries cost $15 billion to $20 billion a year. Preventing ergonomic injuries not only helps keep the physician comfortable, but it makes the workplace safer. During an education session, AMA member David Welsh, MD, shared some of the ways health care organizations can prevent ergonomic stress.
“Why worry about ergonomics? Because ergonomics modifies tools and tasks to meet the needs of the people rather than forcing people to accommodate to the task or tool,” said Dr. Welsh, a general surgeon in private practice in Batesville, Indiana. He is also a member of the Council on Science and Public Health and chair of the Organized Medical Staff Section (OMSS) governing council.
“The goal should be to integrate the physician into the working environment or, better yet, accommodating the environment to the position,” he said.
Some ergonomic injuries involving physicians include the neck, back, shoulder, wrist, hands and legs. Physicians can develop cataracts, leg edema, varicose veins and more.
To improve the health care work environment, Dr. Welsh (pictured above) shared how to correct ergonomic stress during an OMSS education session held during the 2019 AMA Annual Meeting in Chicago.
Identify and analyze the problem
“Ergonomics has to do with work related to musculoskeletal disorders or something they like to call cumulative-trauma disorders,” said Dr. Welsh, adding that microtrauma can lead to scar tissue, which results in decreased flexibility, strength and function.
For example, nurses at his local hospital had repeat injuries related to the growing obesity problem in southeast Indiana. These young nurses were getting back injuries by repeatedly lifting patients. This prompted the hospital to recognize the problem. A new system that was put in place that helps move patients up in bed, decreased the injuries.
Once a problem is identified, analyze the situation. What is causing this problem? What are the risk factors for physicians?
“We need to be thinking about stress, fatigue and pain,” said Dr. Welsh.
Assess the workplace and equipment
This is something that businesses in other industries have done for a long time, but health care does not do regularly.
“It’s basically just taking a picture of what you’re doing, how you’re doing it, what are the steps you’re taking. Is there a way to do things better, safer?” said Dr. Welsh, adding that leaders look at equipment, as well as the positions of tables, screens and tools.
This isn’t “just running into the administrator’s office and saying, ‘You’ve got to change this,’” said Dr. Welsh. “You’re going to promote leadership and put policies and procedures in place to help support the workplace culture, balance and well-being”.
Additionally, promote workplace communication and exercise support training, as well as programs to evaluate equipment for ergonomics.
Implement a solution
Organizations should look at short- and long-term goals. To begin, prioritize simple and lower-cost fixes first, while working with your budget. Gather stakeholders, surgeons, anesthesiologists, nursing and hospital support to plan for implementation.
“Staff leaders will want to get that critical mass so you can go to the administration and say, ‘We've come up with these ideas to help with this problem. We'd like your help to put it through,’” said Dr. Welsh.
Once a process is in place, evaluate whether the solution did what you thought it was going to do. This is also where organizations should say exactly what the extent of the problems were. For example, Olympic swimmers take videos of themselves to see how to improve their stroke.
Health care professionals can also take pictures or videos of themselves at work. A physical therapist can also observe and see what physicians are doing and provide suggestions.
“If we can do something to make sure the next person doesn't have to cut short their career doing what we all love to do, that would be a good thing,” said Dr. Welsh.