1 Roles and Resources Peer Leaders:. 2 Peer Leaders: Roles and Resources Mary Willa Matz, MSPH VHA...

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Roles and ResourcesRoles and Resources

Peer Leaders:Peer Leaders:

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Peer Leaders: Roles and ResourcesPeer Leaders: Roles and Resources

Mary Willa Matz, MSPHMary Willa Matz, MSPHVHA Patient Care Ergonomics Program Manager/Consultant VHA Patient Care Ergonomics Program Manager/Consultant

Occupational Health Science Researcher Occupational Health Science Researcher Industrial Hygienist Industrial Hygienist

VISN 8 Patient Safety Center of InquiryVISN 8 Patient Safety Center of InquiryJames A. Haley VA HospitalJames A. Haley VA Hospital

Tampa, FloridaTampa, Florida(813) 558-3928 (813) 558-3990 fax(813) 558-3928 (813) 558-3990 fax

[email protected]@va.gov

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Peer LeadersPeer Leaders

Peer Leaders are the Key to Program Peer Leaders are the Key to Program Success…Success…

ImplementImplement Program ProgramMaintainMaintain Program Program

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PL Roles/ResponsibilitiesPL Roles/Responsibilities

Peer Leaders as Peer Leaders as

Agents of ChangeAgents of Change

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“If you want to make enemies, try to change

something.”

Woodrow Wilson

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The Realities of being a SPHMPL Change Agent

The Realities of being a SPHMPL Change Agent

Ultimate Goals/Purposes are broad…Ultimate Goals/Purposes are broad… Responsibility is to assist in implementation Responsibility is to assist in implementation

of a SPHM Program that..of a SPHM Program that.. Promotes significant Promotes significant ThoughtThought Changes Changes Promotes significant Promotes significant BehaviorBehavior Changes Changes

Creates an effective ‘Culture of Safety’Creates an effective ‘Culture of Safety’

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The Realities of being a SPHMUPL/Change Agent


A ‘SPHM UPL/Change Agent’ facilitates… A ‘SPHM UPL/Change Agent’ facilitates… staff buy-instaff buy-in staff input during SPH Program staff input during SPH Program

development and implementation development and implementation maintenance of the SPH Program over maintenance of the SPH Program over

time time (SPHM Follow-up study)(SPHM Follow-up study)

attainment of goals of the SPH Programattainment of goals of the SPH Program

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To be an effective change agent, a PL needs….To be an effective change agent, a PL needs…. Knowledge of…Knowledge of…

Why you’re doing it (Rationale/background)Why you’re doing it (Rationale/background) What it includes (Program elements)What it includes (Program elements) What you’re going to do it with (Program materials/tools)What you’re going to do it with (Program materials/tools) How you’re going to do it (Action Plan)How you’re going to do it (Action Plan)

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To be an effective change agent, a PL needs….To be an effective change agent, a PL needs…. Communication Skills…Communication Skills…

How to listen effectivelyHow to listen effectively How to share & transfer knowledge effectively How to share & transfer knowledge effectively How to coach peers How to coach peers

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Back Injury Resource Nurses Back Injury Resource Nurses (BIRNS) – VA(BIRNS) – VA

ErgoCoaches – NetherlandsErgoCoaches – Netherlands Ergo Rangers – BJC HealthcareErgo Rangers – BJC Healthcare Back Injury Resource Staff Back Injury Resource Staff

(BIRS) – Select Medical (BIRS) – Select Medical

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PL BenefitsPL Benefits

ErgoCoachesErgoCoaches

Take responsibility as Take responsibility as Problem-ownersProblem-owners Solution-ownersSolution-owners

1 – 2 per unit1 – 2 per unit Knowledge Transfer mechanismsKnowledge Transfer mechanisms

Annual conferenceAnnual conference NewsletterNewsletter Help deskHelp desk Website Website

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ErgoCoachesErgoCoaches

Facilities w/ ErgoCoaches had Facilities w/ ErgoCoaches had significantly lower sick leave due to significantly lower sick leave due to Musculoskeletal disordersMusculoskeletal disorders

Synergy betweenSynergy between Work of thousands of ErgoCoachesWork of thousands of ErgoCoaches National Support GroupNational Support Group Governmental working conditions covenantsGovernmental working conditions covenants(Knibbe, & Knibbe, n.d.) (Knibbe, & Knibbe, n.d.)

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Co-Worker BenefitsCo-Worker Benefits

Employee involvementEmployee involvement Enhances worker motivationEnhances worker motivation Increases job satisfaction Increases job satisfaction Leads to greater acceptance of change in Leads to greater acceptance of change in

workplaceworkplace(OSHA Ergonomic Guidelines for Nursing Homes, (OSHA Ergonomic Guidelines for Nursing Homes,

2003)2003)

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Co-Worker BenefitsCo-Worker Benefits

Staff are empoweredStaff are empowered Channel to voice ideas/suggestionsChannel to voice ideas/suggestions Opportunity to have input in making Opportunity to have input in making work environment saferwork environment safer

Increased competence in performing jobIncreased competence in performing job Increased sharing of knowledge/best Increased sharing of knowledge/best

practicespractices FostersFosters Culture of Safety Culture of Safety

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Example of PL BenefitExample of PL Benefit Lifts not being used on night shifts. Lifts not being used on night shifts.

Why? Batteries were being charged on night Why? Batteries were being charged on night shifts because no back-up batteries.shifts because no back-up batteries.

Solution: Buy extra battery packs so lifts can be Solution: Buy extra battery packs so lifts can be used 24 hours per day.used 24 hours per day.

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PL RepresentationPL Representation

• Representative from all areas where Representative from all areas where patient handling occurspatient handling occurs• NursingNursing• RadiologyRadiology• TherapyTherapy• Escort Escort • OthersOthers

• Suggestion: 1 PL per shift per Suggestion: 1 PL per shift per unit/areaunit/area

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PL Selection PL Selection

EligibilityEligibility Any direct patient care staff (i.e., RN, LPN, Any direct patient care staff (i.e., RN, LPN,

CNA, PT, OT, diagnostic tech, etc.) CNA, PT, OT, diagnostic tech, etc.) Has at least 6 months experience with handling Has at least 6 months experience with handling

patients patients Employed on unit for at least six months or a PL Employed on unit for at least six months or a PL

in another area previouslyin another area previously Anticipates working on unit at least one year or Anticipates working on unit at least one year or

moremore

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PL SelectionPL Selection

Respected by colleagues & Respected by colleagues & managementmanagement

Satisfactory performance Satisfactory performance evaluationevaluation

Responsible and reliableResponsible and reliable FlexibleFlexible Takes initiative/proactiveTakes initiative/proactive Good time management Good time management

skillsskills

OutgoingOutgoing ResourcefulResourceful Assertive Assertive

(appropriately)(appropriately) Interest in Interest in

SPHM/SafetySPHM/Safety Maintains good Maintains good

relationships w/ relationships w/ managementmanagement

QualitiesQualities

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PL SelectionPL Selection

Patient handling experiencePatient handling experience Effective oral/written Effective oral/written

communication skillscommunication skills Physically able to perform Physically able to perform

job dutiesjob duties Critical thinking skills Critical thinking skills

(appropriate for duties)(appropriate for duties)

Ability to teach peers Ability to teach peers using established training using established training programsprograms

Informal Leader – credible Informal Leader – credible with & respected by peerswith & respected by peers

Computer skillsComputer skills Ability to learn, apply, Ability to learn, apply,

and transfer new and transfer new knowledgeknowledge

SkillsSkills

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PL Roles/Responsibilities PL Roles/Responsibilities

• Act as Unit/AREA ‘Change Agent’

• Act as UNIT/AREA SPHM Champion

• Demonstrate Systems Thinking

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• Maintain current knowledge • Of… SPHM issues, technology, best practices

• Through… PL meetings, trainings, Outlook

• Equipment ‘Super User’

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• Facilitate SPHM “Knowledge Transfer”

• Safety Huddles

• Algorithms

• Policy

• Coaching

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• Facilitate SPHM “Knowledge Transfer”

• Training• In-services/Small Groups/One-on-one

• Peers, Managers, Patients/families

• Topics: Program Elements, Equipment Use, Safety Concerns, Best Practices, etc.

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• Follow unit injuries & close calls

• Act as Unit liaison w/ Infection Control, Facilities Management, Equipment Manufacturers, etc.

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• Follow Equipment Use/Management • Conduct Ergonomic ongoing

environmental/ergonomic evaluations

• Perform walk-throughs to assess equipment use and function (Equipment Use Checklist - Handout A-1)- Handout A-1)

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• Monitor Staff Competency(Staff Skills/Competency Check-off - Handout A-2)

• Monitor UNIT SPHM Program • PL Activity

• Program Status

• Program Compliance

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PL Activity/Status Log (Handout A-3) UPL’s Perception (weakness) Complete weekly Utility

Track PL activities/dose – Justifies need for PL program

Use as indicator for acceptance & effectiveness of SPH program

Champion Use evaluation tool determine problem areas

Suggest: Develop web-based data base with reporting capabilities

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PL Roles/ResponsibilitiesPL Roles/Responsibilities

Insert facility-specific and unit-Insert facility-specific and unit-specific roles/ responsibilities in specific roles/ responsibilities in Unit SPH BindersUnit SPH Binders

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Monitoring PL CompetencyMonitoring PL Competency

• PL Competency Assessment (Handout A-4)

• PL Activity/Status Log (Handout A-3)

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Suggested PL Training Suggested PL Training

Background/History/Patient Handling Injuries/Legislation Ergonomics and Biomechanics of Patient Handling Evidence/Research Findings SPHM Program elements:

Patient Care Ergonomic evaluation process Patient Handling equipment PL (job description/duties) After Action Review Algorithms SPHM Policy/Directive

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Risk analyses Patient Handling Equipment/Slings Program implementation/Maintenance

Strategies/Facilitators PL (UPL) Log Culture of safety Concept Change theory/strategies

Knowledge transfer concept/theory Social marketing Program Facilitators/Barriers

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Peer Education/Coaching Conducting competency assessments Adult education principles On-the-job (OJT) training principles Coaching

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Implementing a PL ProgramImplementing a PL Program

Determine PL roles for facility/unit/area. The PL Determine PL roles for facility/unit/area. The PL role may differ by clinical area.role may differ by clinical area.

Determine number of UPLs needed for each Determine number of UPLs needed for each unit/area. The number of UPLs required may unit/area. The number of UPLs required may differ by clinical area.differ by clinical area.

Review PL Selection Criteria Review PL Selection Criteria Meet w/ nurse managers/supervisors to discuss PL Meet w/ nurse managers/supervisors to discuss PL

roles, selection, and number required for the roles, selection, and number required for the clinical unit/area. clinical unit/area.

Facilitate selection of UPLs.Facilitate selection of UPLs.

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Implementing a PL ProgramImplementing a PL Program

Conduct PL orientation/training. Several training Conduct PL orientation/training. Several training may need to be offered to capture all UPLs.may need to be offered to capture all UPLs.

Facilitate PL training by equipment Facilitate PL training by equipment manufacturers in order to attain ‘Super User’ manufacturers in order to attain ‘Super User’ status.status.

Hold regularly scheduled meetings. Initially, one Hold regularly scheduled meetings. Initially, one every two weeks is suggested, then monthly every two weeks is suggested, then monthly meetings are satisfactory.meetings are satisfactory.

Ensure all UPLs are on Outlook Ensure all UPLs are on Outlook Create facility Outlook PL Mail group.Create facility Outlook PL Mail group.

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PL ResourcesPL ResourcesPL ResourcesPL Resources

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PL Resources PL Resources

ResourcesResources Facility SPHM Champion/Coordinator Facility SPHM Champion/Coordinator SPH Presentations/Materials from this conferenceSPH Presentations/Materials from this conference Safe Patient Handling & Movement: A Practical Guide for Safe Patient Handling & Movement: A Practical Guide for

Health Care ProfessionalsHealth Care Professionals, Ch. 7 (A. Nelson, editor), Ch. 7 (A. Nelson, editor) AORN Ergonomic Guidelines for the PeriOperative AORN Ergonomic Guidelines for the PeriOperative

Environment (AORN website)Environment (AORN website) NAON Ergonomic Guidelines for NAON Ergonomic Guidelines for

Orthopedics/Rehabilitation Orthopedics/Rehabilitation Tool for Prioritizing High Risk Tasks Tool for Prioritizing High Risk Tasks (Handout A-5)(Handout A-5)

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PL Resources PL Resources

ResourcesResources SPH Unit Binder SPH Unit Binder (Handout A-6 - Table of Contents)(Handout A-6 - Table of Contents)

Easily accessible location on each unitEasily accessible location on each unit Install on VAMC Network Install on VAMC Network

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Program FacilitatorsProgram Facilitators

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Ways To Assure Success & Sustain ProgramWays To Assure Success & Sustain Program

Succession Planning (related to turn-over, change Succession Planning (related to turn-over, change of position, change of unit, etc.)of position, change of unit, etc.) Nurse Mgr/Safety Champion responsible for identifying Nurse Mgr/Safety Champion responsible for identifying

new PL after notification that current PL resigns, new PL after notification that current PL resigns, transfers etc.transfers etc.

Open PL course to others to gain Tempo/CEU creditsOpen PL course to others to gain Tempo/CEU credits

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RedundancyRedundancy Have PL Binder accessible on each unitHave PL Binder accessible on each unit Provide one PL per shift per unitProvide one PL per shift per unit

Peer Leader Back-up (if only 1 UPL/unit)Peer Leader Back-up (if only 1 UPL/unit) From UPL’s unit From UPL’s unit From other unit From other unit

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• Hold regular meetingsHold regular meetings Patient care responsibilities interferePatient care responsibilities interfere

• Stay connected through email helps but not Stay connected through email helps but not as good as face to faceas good as face to face

• Ensure management supports time for Ensure management supports time for meetingsmeetings

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Marketing Unit Peer Leaders Marketing Unit Peer Leaders (Handout A-7)(Handout A-7)

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Safe Patient Handling & Movement ProgramSafe Patient Handling & Movement Program

Peer Leaders are the Key to Program Peer Leaders are the Key to Program Success…Success…

ImplementImplement Program ProgramMaintainMaintain Program Program

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Never underestimate the Never underestimate the ability of a small group of ability of a small group of committed individuals to committed individuals to

change the world. Indeed, it is change the world. Indeed, it is the only thing that ever has.the only thing that ever has.

Margaret MeadMargaret Mead

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Peer Leaders: Roles and Resources

Peer Leaders: Roles and Resources

QUESTIONS/COMMENTS??QUESTIONS/COMMENTS??

1 Roles and Resources Peer Leaders:. 2 Peer Leaders: Roles and Resources Mary Willa Matz, MSPH VHA...

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