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Development and Evaluation of a Model for a Home Care Ceiling Lift Program in B.C.
RS2006-OG12
Final Report Date: April 2008
| Principal Investigator: | Annalee Yassi (UBC) |
| Co-Investigators: Co-Author: |
Nancy Paris, James Watzke (BCIT) Ryan Kanigan (Peak Research Inc.) |
For more information about this project, please contact Dr. Annalee Yassi.
Issue
Community health workers (CHWs) have a high risk of experiencing musculoskeletal injuries (MSIs) due to repositioning and transferring clients on a regular basis, typically without the aid of mechanical lifting devices.
While ceiling lifts have been shown to reduce MSIs in other healthcare settings, they have not been widely implemented in home care environments, and the barriers and facilitators to doing so are not well understood. To address this challenge, the researchers developed a model home care ceiling lift program for B.C., with input from home and community care stakeholders.
Key findings
- The research identified several program goals, elements and measures of success that could be used for a home care ceiling lift program in B.C.
- The model program includes two broad components: a central resource centre and regional program champions in each health authority.
- Based on input from home care stakeholders, the four most important issues for a program to address are: education, standardization, communication and funding. Several options for addressing these issues were identified.
- The researchers recommend piloting and evaluating the program in B.C.
Objectives
- To identify and analyze the key issues related to implementing ceiling lifts in the home environment.
- To develop and evaluate a model for the successful implementation of a ceiling lifts in home and community care in BC.
Method
The research team examined academic, scientific, clinical and grey literature to identify key issues in home care ceiling lift programs. They analyzed which issues are important for how a program works (program drivers) and which issues are important program outcomes. Program goals were also developed to take into account the interests of stakeholders, including the Ministry of Health - Home and Community Care, community health workers, unions, home support agencies, clients, family members of clients, occupational therapists and case managers, as well as suppliers, installers and technical support personnel.
Based on this work, the research team developed a home care ceiling lift program model that included program goals, program drivers and success measures.
In order to evaluate the model, interviews were conducted with 32 home care stakeholders with a wide variety of roles including agency managers, clients, community health workers, technicians and case managers. Participants were asked to evaluate the importance of the program elements by indicating their level of importance. The researchers used this input to identify the most important elements for implementation.
Results
The literature review and analysis identified several positive changes or outcomes that could result from a home care ceiling lift program. These outcomes, (which could be used as measures of success once a program has been implemented in B.C.) include:
- Stakeholders perceiving the use of ceiling lifts in home care more positively.
- Stakeholders being more aware of the options available for ceiling lift equipment in homes and the resources and options available to acquire equipment.
- Increased reporting by CHWs regarding concerns they experience when transferring clients, so that their agencies can ensure they have the necessary equipment.
- Greater use of equipment loan programs to enable the purchase of lifts.
- Increased use of tools and resources to effectively implement a no-lift policy in home care.
- The application of standard criteria when recommending equipment to use to increase the safety of CHWs.
The model developed by the researchers has two main components – a central resource centre for information and coordination related to ceiling lifts in home care, and regional program champions in each Health Authority to be a resource person for home care ceiling lifts.
Several potential program features and ways to implement them were identified through the literature review and analysis, and then prioritized according to stakeholder input. The top four items were education, standardization, communication and funding. The following list shows the program elements ranked according to the proportion of participants who ranked the item as “very important”:
- Provide agencies and health authorities with the information, tools and resources to efficiently implement an effective no-lift policy and ceiling lift program.
- Develop and implement standard criteria, guidelines, and policies for client transfer / reposition assessment.
- Improve methods to communicate risk between clients, CHWs, clinicians, agency and HA staff.
- Adequately resource assessments (i.e. address limits in funding and human resources to complete assessments (and install equipment) before clients are transferred home).
- Develop and implement standard practice guidelines that ensure clients receive assessments prior to receiving home support service.
- Identify and publicize available funding sources to assist clients with purchasing and installation.
- Educate clients, CHWs, agency and HA staff that CHW health and safety is as important as client care.
- Provide task specific training to clinicians (e.g. assessing weight bearing status, assessing safety of transfers), and CHWs (e.g. using ceiling lift equipment).
- Adequately resource agencies (& CHWs) to use ceiling lifts.
- Increase awareness of Occupational Health & Safety responsibilities for CHWs under the Workers Compensation Act.
- Identify and publicize current information on: equipment options, with purchase and installation costs, and the benefits of ceiling lifts in homes
- Address geographic delivery challenges.
- Establish Regional Champions coordinate the program in various geographic regions.
- Establish a web-based provincial information resource.
Conclusions
The researchers conclude that the key elements identified through this research and stakeholder input can be combined into a pilot home care ceiling lift program that could be implemented and evaluated in B.C. They note that the top four — education, standardized knowledge transfer, and communication and funding — are the most essential elements to include.
Future directions
The researchers recommend implementing and evaluating a pilot home care ceiling lift program based on the priority elements identified through this project.
Publications and Presentations
Paris N, Kanigan R, Hackett G, Flegal C, Strom L, Back C, Goelman A, Watzke J, Yassi A: Development and Evaluation of a Model for a Home Care Ceiling Lift Program in British Columbia. British Columbia Healthcare Workplace Health, Safety & Wellness Conference, Kelowna, Canada, September 2007.