outline

Outline

• What is ergonomics? – Benefits, concepts, factors, injuries, etc.

• Ergonomics for Healthcare environments– Challenges, opportunities, main characteristics.

• Example on Body Map– Exercise

04/20/23 Slide 1Ergonomics

Ergonomics

“The science of fitting the job to the worker”.• Multidisciplinary Nature of Ergonomics

– Anatomy and physiology– Engineering Psychology– Engineering– Medicine– Anthropology– Biomechanics

04/20/23 2

Source: http://www.usmra.com/repository/category/Ergonomics/Ergonomics_3.ppt.

Ergonomics

http://www.usmra.com/repository/category/Ergonomics/Ergonomics_3.ppt

Ergonomics04/20/23 3

Benefits of Ergonomics

• Decreased injury risk• Increased productivity• Decreased mistakes/rework• Increased efficiency• Decreased lost work days• Decreased turnover• Improved morale

04/20/23 5


Ergonomics


Ergonomic Concepts

• Tool Design• Workstation Design• Material Handling Limits• Visual and Auditory Task Design

04/20/23 Slide 6


Ergonomics


Factors

Environmental Factors Psychological Stress Physical

Noise Machine Pacing Posture

Vision Shift Work Force

Thermal Morale Repetition

Chemical Manual Materials Handling

04/20/23 Slide 7


Ergonomics


Psychosocial Factors

Significant Findings

• Fear of being replaced by computers

• Enlarged Jobs

• Uncertainty about job future

• Work pressure

• Lack of co-worker support

• Lack of productivity standard

• Lack of participation in decision-making

• Perception management not value ergo

Significant Findings

• Fear of being replaced by computers

• Enlarged Jobs

• Uncertainty about job future

• Work pressure

• Lack of co-worker support

• Lack of productivity standard

• Lack of participation in decision-making

• Perception management not value ergo




Target Regions

• Back• Lower Extremities• Upper Extremities

04/20/23 Slide 9Source: http://www.usmra.com/repository/category/Ergonomics/Ergonomics_3.ppt.

Ergonomics


Design and Disease

POSTURE DISCOMFORT

Standing Legs, Feet, Back

Sitting Neck, Back, Shoulders

Reaching Shoulders, Upper Arms

Head Bent Back Cervical Region

Trunk Bent Forward Lumbar Region

04/20/23 Slide 10


Ergonomics


Static Exertions

• Holding activities• Carrying• Standing• Pushing and pulling• Arms raised




Ergonomics Stress Areas

04/20/23 Slide 12

Knee

Hip

Source: Ergonomics for the 21st Century

Ergonomics

Workplace Indicators

• Performance deterioration…Engineering• Quality Control problems• Absenteeism and turn-over…Human Resources• Musculoskeletal disorders…OSHA Logs WC

reports• Complaints of fatigue and discomfort



Types of Injuries

• Muscle pain• Joint pain• Swelling• Numbness• Restricted motion• Repetitive stress injury

• Repetitive motion injury

• Cumulative trauma disorder

• Musculoskeletal disorder (MSD)



Control Technology

• Tool redesign• Workstation redesign• Job methods• Early detection• Job rotation• Machine pacing• Medical surveillance



Static Work Position

04/20/23 Course Name Slide 16

Source: BMA Ergonomic-Biomechanics in Office Seating

• static muscle strain• poor blood circulation• accumulation of waste

products• acidification• cramp• pain/discomfort• less movement

insufficient nutritionof cartilage and discs

Blood Blood

demand supply

Resting

Dynamic

work

Static

work

Sitting position (incorrect chair)

04/20/23 Slide 17

Fout

fig. 3.1.a

Fout

fig. 3.2.a

Facet joints opened

Support of ischia and coccyx

Wrong

Wrong15°


Ergonomics

Sitting position (correct chair)

04/20/23 Slide 18


Correct

fig. 3.1.b

Correct

fig. 3.2.b

Facet joints closed

Pelvis support

Coccyx free from seat

Support of ischia

5°

Right

Right

Ergonomics

Correct Workstation

04/20/23 Slide 19

reading/writing computer screen


Ergonomics

Correct Workstation

04/20/23 Slide 20

Incorrect

fig. 3.3.a

Correct

fig. 3.3.b


Ergonomics

Healthcare industry significant challenges

• Rising Costs– Healthcare costs continue to rise faster than inflation.

• Increased Demand– Demand for healthcare will grow, at least through

2030-2050.

• Building Boom – Experiencing a huge hospital building boom.

• War for Talent– Significant staffing shortages.

04/20/23 Slide 22

Source: Ergonomics for Healthcare Environments

Ergonomics

Changes in Healthcare Industry

• Changing Nature of Work– Regulations (HIPPA, Medicare Plus Choice)– technology – changing work styles (multidisciplinary teams) are

exerting profound effects on healthcare.

04/20/23 Slide 23


Ergonomics

New Trends in Healthcare Industry

1. Evidence-based practice– Evidence-based design. – Value of applying ergonomics to the design of

healthcare work environments.

2. Focus on the patient experience– Representing a shift from provider focus to patient

focus– Environmental quality for both patients and staff.

04/20/23 Slide 24


A golden opportunity to introduce ergonomic concepts and principles to the design and configuration of healthcare environments

Ergonomics

Unique Characteristics of the Healthcare Environment

• Unique Setting– Nonstop operation - 24/7/365 “shift work

and shared workplaces”.– Healthcare must serve entire population.– Regulations and information security.– A complete range of physical actions

performed from less than ideal positions.– Multi-tasking with physical activity and

highly skilled knowledge work. – Predominantly female workforce.

04/20/23 Slide 25


Ergonomics

Unique Characteristics of the Healthcare Environment

• History & Tradition – Improving working environment.– Focusing on the patient and staff-patient

interactions. (e.g. adjustable beds).

• Untapped Potential– Staff workplaces not involving direct patient

contact have not benefited from applying ergonomics.

04/20/23 Slide 26


Ergonomics

Areas of Potential

1. Market differentiation – In a war for talent, workplace makes a difference.– Culture image & strategic asset.

2. Performance– Performance improved 17.7% while the benefit -

to-cost ratio was 24:1– Staff Effectiveness, Errors, Staff Satisfaction,

patient safety, stress, outcomes, overall quality.

3. Health & Safety– MSD injuries are very expensive!

04/20/23 Slide 27


Ergonomics

Why is Ergonomics Important?

• Ergonomics focuses on people.• Good ergonomics yields improved performance

and productivity.• Good ergonomic programs include training and

change management.• Good ergonomics programs always yield more

benefits and save more money than they cost.

04/20/23 Slide 28


Ergonomics

Design Approaches

• Design for the extreme– e.g., doorways are designed so that the tallest

person can walk through them

• Design for the average– Where large population will use the same device or

environment, for example: reception counter.

• Design for the adjustable range– Maximize “goodness to fit”, for example: office

chairs.

04/20/23 Slide 29


Ergonomics

Ergonomic Strategies

• Adapt the workplace to the worker – not vice versa. People are very adaptive.

• Support work in the way it is done• Optimize support for the primary task• Provide appropriate user control• Emphasize ease of use• Provide for Personalization of Space• Train people in the proper useof equipment

04/20/23 Slide 30


Ergonomics

The Practice of Ergonomics Dedicated “solo”

WorkplacesShared Workplaces Collaboration Workplaces

• Used primarily by only one person• Designed or adapted to the needs of a specific user

• Used by multiple people during a shift and throughout a 24 hour period (often multitasking)

• Used concurrently by >= 2• Support team work and communication (formal and informal

Examples: Specialty, Diagnostic imaging, Physician’s offices, “Back office” support personnel

Examples: Nurses station, Patient rooms, Registration, Labs, Pharmacy

Examples: Meetingrooms, Training rooms, Offices, Hallways, Nurses stations, Cafeteria/braek rooms

Workplace Considerations

• Appropriately adaptable workplaces: Work surface heights, Task seating, Support the position in which primary task is performed, lighting, sufficient storage, and space, etc.

• Support both sitting and standing• Maximize adjustability, with ease of use • Support multi-tasking, Solo, and Collaboration• Support variety of work styles

• Comfort for Variety of users at different length of use (minutes to hours)• Duration• Information sharing• Display• Distraction: to others and to users

04/20/23 Slide 31

Source: Ergonomics for Healthcare EnvironmentsErgonomics

04/20/23 Slide 32

http://www.osha.gov/SLTC/etools/hospital/hazards/ergo/ergo.htmlErgonomics

04/20/23 Slide 33

http://www.osha.gov/SLTC/etools/hospital/index.htmlErgonomics

Hospital Examples of Ergonomic Design Issues and Opportunities

04/20/23 Slide 34

Source: Cornell University Ergonomics Web

•Task performed multiple times a day for every patient• REBA score = 9.• High Risk Level : Action needs to be taken SOON• Use height-adjustable IV stand that can be easily and quickly adjusted.

Ergonomics

Laboratory Problems: Poor Surface Heights

04/20/23 Slide 35


• Inadequate thigh/leg clearance• Arm compression, flexed arms• Lower back is not supported

Ergonomics

04/20/23 Slide 36


• Inadequate leg clearance because of low surface height • Sustained arm/elbow flexion• No arm rests• Feet aren’t flat on the ground or supported• Lower back is not supported• Consider alternative seating

Laboratory Problems: Poor Chair Fit

Ergonomics

Microscopy: Arm Support Pads

04/20/23 Slide 37


• Supports wrists and forearms in a neutral position.

– Allowing for a more comfortable working position with less fatigue.

• Helps provide support in a more upright position

– Relieves fatigue and discomfort to neck and back.

• Eliminates resting elbows and forearms on hard work surfaces.

Ergonomics

Microscopy: Equipment

• Expanded-pupil technology to enhance the ergonomic performance of the microscope: – Freedom to wear glasses– Increased eye distance allows

for safety spectacles to be worn

• LCD Displays or Video Microscopes– Reduces eyestrain by

minimizing use of binocular lenses.

– Reduces awkward neck posture

04/20/23 Slide 38


Ergonomics

Histology Equipment

• Strain from swivel motion, turning crank, and lower back pain from leaning over machine

• Decreased range of motion• Employees received carpal tunnel

treatment, treatments of wrist and elbow tendonitis, and cervical neck pain

• RULA score of 6 requires a change in position SOON and further investigation.

• High-speed motorized unit for paraffin-embedded specimens. Motorized cutting mechanism and feed system.

04/20/23 Slide 39Source: Cornell University Ergonomics Web

Ergonomics

• User characteristics play a significant role in injury risks.

• User technique plays a significant role in injury risks.

• REBA score = 10• High Risk Level and

necessary action is needed SOON.

04/20/23 Slide 40


Radiology: Overhead X-ray

Ergonomics

Radiology – Filing System

• Filing Area – used 8 hours a day. • Constant reaching and bending.• Frequently Reported Filing Injuries:

– Pulling X-Ray file folders from file racks• Right shoulder strain • Employee hit in face by falling folders

– Lifting 6-8 file folders each time• Lower back strain (Lost Time -55

Days>$10,872)

– Foot stool available is trip hazard• Employee fell - contusion to knees

• REBA score = 9• High Risk Level : Action needs to be taken

SOON04/20/23 Slide 41


Ergonomics

Readings

1. Best Practices for Site-Wide Hospital Ergonomics.

2. Ergonomics for the Physician Practice.3. A physician's Guide to Ergonomics Standards.4. Guidelines for Nursing Homes.5. Ergonomics for Healthcare Environments.6. Ergonomics Assessment.7. Computer Workstations eTool - Evaluation

Checklist.


Musculoskeletal Disorders

• For example, musculoskeletal disorders (MSD’s) have become a prevalent form of injury in modern business:

• Fourteen fold increase in MSD’s from 1972-1994.

• In 1994, 32% of all injury and illness involving sick days was due to MSD’s.

• MSD’s costs in US very from $13-20 Billion annually.

04/20/23 Slide 43

http://www.ufv.ca/faculty/kpe/fletcherg/Ergonomics/introduction/intro1.ppt

Ergonomics

Eyes

04/20/23 Slide 44

Neck

Left Shoulder

Left Upper Arm

Left Elbow

Left Forearm

Left Wrist

Left Hand

Buttocks

Left Thigh

Left Knee

Left Lower Leg

Left Foot/Ankle

Upper Back

Right Shoulder

Right Upper Arm

Right Elbow

Right Forearm

Right Wrist

Right Hand

Mid/Low Back

Right Thigh

Right Knee

Right Lower Leg

Right Foot/Ankle

Source: Occupational Health Clinics for Ontario Workers

Ergonomics

0= Never1= Rarely

(Few Times /Month)

2= Frequently (Few Times/Week)

3= Constantly(Nearly Every Day)

04/20/23 Slide 45

• Frequency Discomfort 0 No Discomfort12 Fairly Comfortable345 Moderate Discomfort678 Very Uncomfortable910 Extreme Discomfort

Marley and Kumar (1996): Body Map

Ergonomics

04/20/23 Slide 46

freq

Discmfrt

B/1

= rarely

C/2

=frequently

D/3

=constantly

1 1 1 1

2 1 1 1

3 1 2 2

4 1 2 2

5 1 2 3

6 2 3 3

7 2 3 3

8 2 3 3

9 3 3 3

10 3 3 3

1 not likely to seek treatment

2 somewhat likely to seek treatment

3 very likely to seek treatment

legend


Ergonomics

Group X (n=6)

04/20/23Slide 47





Ergonomics

Group X Right Side / Left Side

04/20/23 Slide 48

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%




legend


Ergonomics

Group X Neck and Back

04/20/23 Ergonomics Slide 49

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Neck Buttocks Upperback Midlowback




legend


04/20/23 50

ThanksBy: Rada Hussein

[email protected]

Ergonomics

outline

Documents

stress areas

work position

auditory task design

backcervical regiontrunk

bma ergonomicbiomechanics

pullingarms raisedsource

main characteristics

body mapexercise