Form Health And Safety A Part Of Hospital Planning

Sheenu Jhawar

Customer service management in hospitals rests on two pillars among other possible ones- patients and staff. The staff forms a very important group of the employers’ customer base. Customer relations in this case may adopt many faces, one among them is the owner’s responsibility to the health of the staff at work.

When staff faces ill health owing to work place environment, it can lead to reduction in the staff’s working capacity, gradually progressing to loss in working days, financial loss in terms of these days, organisation of locums, and sometimes provision of free medical benefits to the staff as a goodwill gesture. Add to this the phenomenal possibility of legal redress. In other words, there is an obvious loss to the staff, but also a tremendous cumulative loss to the employer. Health and safety at work must form a part of the management agenda because it is not only humanitarian, but also beneficial and cost effective.

There are two aspects to this concept- the one is ‘manual handling’, and the other is maintaining ‘ergonomics’ at work.

Manual Handling

Most of the reported accidents arise from manual handling- which means the transporting or supporting of loads by hand or bodily force. In Indian scenario, where manual handling predominates, the actual figures are very high. Of course, there is some discrepancy between the reported and actual numbers, since, the reporting mechanism does not really exist in all Indian hospitals, and also the staff may not realise the injury when it onsets and attribute it to something else. The reason is that many such injuries build up over a period rather than being caused by a single handling incident. However, numbers are not necessary to realise the enormity of the situation, and preventive measures must be implemented so that the loss can be minimised. The way to go about it is – assessment and avoidance, leading to a reduction of such scenarios.

Poorly-designed tasks and incorrect lifting techniques and postures all increase risks to workers. A thorough assessment of the workplace and work entailed by the various categories of the staff must be looked into. This might shed some light on inappropriate procedures. Avoidance of such procedures by a short training to the staff is the next step.

Some examples of how this can be done are:

• Holding loads near the trunk.
• Avoiding twisting, or stooping to pick loads.
• Improving workplace layout to improve efficiency.
• Re-organising cables/ loose wires.
• Varying the work- allowing one set of muscles to rest while another is used.
• Removing obstructions to free movement.
• Avoiding steps and steep ramps when possible.
• Improving the lighting.
• Preventing extremes of hot and cold if possible, or providing protective handling.
• Most of all a good handling technique plays the most important role.

The most common injury caused by poor manual handling exercises relates to spinal injury. Besides handling inanimate objects, carriers who handle people (patients) as part of their daily tasks are the most at-risk group when it comes to back injury. The key principles of safe manual handling therefore mean explaining, and re-explaining to the staff about proper handling techniques.

Once the assessment and avoidance of potential problems is completed and the training is provided by the organisation, and it is understood that at the time of training the employees have followed the principles and techniques well, the responsibility for safe manual handling shifts from the employer to the employee.

However, this training should be a continuous process, covering all staff.

Ergonomics

A very common example seen in almost all offices is the placing of the office equipment. It is important to save space, but very important to consider safety too. An oft-seen sight is a desk with some working space, a computer monitor secure on the extreme left, the key board obviously centrally placed in a pull out drawer, some shelving to the right etc.

This typically ‘comfortable’ setting belies potential injuries. A monitor to the left and keyboard in the centre obviously means having to crane the neck and back each time you type and check on the monitor. ‘Shelving’ to the right means twisting to pick out your fare- typical worst case scenario causing eventual neck and back pain.

Ergonomics is about ensuring a good fit between people and the things they use. Designing tasks, equipment and workstations to suit the operator can reduce error, accidents and ill health.

To answer the question on whether intervention may be required, one could ask himself the following questions:

• Does the workstation/ equipment suit the body size?
• Does it also suit all users?
• Is it possible to see and hear readily?
• Does the equipment or system cause discomfort if used for a length of time?
• Is it convenient to use?
• Is it compatible with other systems in use?
• Could any of these aspects be improved?
• Do other users have similar reactions?

If the job, the equipment and the workplace are not designed to fit the people who work with them, mistakes are more likely and some of these could lead to accidents. More often than not, a minor alteration is all that is needed to make a task easier and safer to perform. Finally it pays to remember that the health of the employee is the health of the organisation.

The author is Director, Ace Vision Health P Ltd, Jaipur. Email:sheenujhawar@yahoo.com