Published on: September 18, 2024

Often, small changes can have a big impact. This is especially true when workers and employers come together to identify effective control measures in reducing the risk of musculoskeletal injuries (MSIs).

By Marnie Douglas

This is what happened at St. Jude’s Anglican Home, a long-term health care facility in Vancouver. A series of simple, practical changes to how staff do their work has reduced the risk of injury, improved their well-being, and bolstered the health and safety culture in their workplace.

It started with kitchen staff and their director working together to identify MSI risk factors and make changes to how the work is done. Heidi Horne is the director of Support Services and co-chair of the facility’s joint health and safety committee. Heidi consulted with the cooks to help her understand how the equipment was being used and the specific challenges for staff.

“When staff brought these issues forward, I wanted to get them addressed right away,” she explains.

Heidi then reached out to WorkSafeBC’s Laura Gibbins, occupational safety officer, for some ideas. Laura, in turn, engaged ergonomist Heather Kahle in Prevention Risk Management Services, and Heather visited the facility to conduct an ergonomic evaluation of the kitchen.

Collaboration is key

“It was a real collaborative effort between WorkSafeBC, the employer, and its staff. In this situation, it was also encouraging that the employer reached out to us, which doesn’t happen often,” says Laura.

With the help of WorkSafeBC’s ergonomics team, Heidi and the kitchen staff identified and assessed risk factors of the equipment that were causing discomfort and required immediate attention.

• The blender on the counter was too high, resulting in staff having awkward postures from pouring soup into the blender with their elbows at or above shoulder height. With multiple servings of soup being blended at lunch time each day, staff were exposed to repetitive movements that required static postures. This placed additional force on the shoulder and arm muscles.
• The hot cart required workers to grasp the lip of the water inserts with their fingertips and lift using a pinch grip, causing static awkward postures and forceful movements.
• The mincer station required workers to reach above shoulder height to access the meat mincer and hold an insert in place to capture the food being minced. Because the mincer was too high, staff were exposed to awkward and repetitive working postures.
• The spice shelf was too high, meaning staff had to reach above shoulder height.

Heidi says that once they identified the issues, she invited the facility’s maintenance worker to explore what changes to the workplace design and layout could improve the MSI concerns raised by kitchen staff. As an example, workers asked that the spice shelf be lowered.

“That was an easy and immediate fix,” adds Heidi.

In collaboration with the employer, Heather offered valuable ideas as part of the ergonomic assessment in the kitchen and the following solutions were implemented:

• Lowered shelves to an appropriate working height for improved working postures
• Prioritized and provided space for items used more frequently, and moved those used infrequently
• Purchased a tool to help lift the water inserts to eliminate static postures

There was further discussion about whether the following changes could take place:

• Lowering storage shelving units to allow workers easier access to supplies
• Purchasing a new, modern mincer with lower attachments to improve posture
• Relocating the fridge to provide more space so staff could improve postures when using the mincer machine
• Supplying a stand or means to support food being minced

Unfortunately, due to existing equipment placement and limited kitchen space, not all ideas could be implemented. They were able to lower the shelves, but neither the fridge nor mincer stand could be altered or moved.

The employer identified a big win through this process, replacing the mincer with more modern equipment that does the work of both a blender and mincer. “We visited a test kitchen in Langley, got a one-on-one with a manufacturer to show us this new piece of equipment that could do the work of both the blender and mincer, and we were sold on it,” Heidi adds.

“Once we had the ergonomic assessment, everything fell easily into place.”

Caring for those who provide care

At the same time the kitchen was getting an ergonomic evaluation, similar work was going on in a different area of the care facility. Ruth Legacy, St. Jude’s director of care, oversees care aides and nurses at the facility. She began to look at ergonomic changes after hearing concerns from workers.

“The nurses were getting sore shoulders because the computer carts were too tall,” she explained. “They do a lot of reaching to access touch screens, and they use them all day long. I noticed one nurse brought in her own mouse to avoid having to reach the screen, so we purchased a mouse for each computer.”

As well, Ruth changed the setup of the nursing station to improve working postures. It was rearranged ergonomically with adjustable chairs, custom-built stands to elevate the screens, and shelves for under the computers.

Another notable change involved the soaker pads on beds and the incontinent briefs worn at night by residents.

Ruth explained that they were using older-style soaker pads that needed to be laundered, then hung and moved to a dryer. Workers were experiencing MSIs due to the awkward postures and weight of the soaker pads and laundry bags. She found a disposable soaker pad that could be discarded after use. This reduced the weight of the laundry bags and tasks that laundry workers performed.

“This switch made a significant difference for staff in terms of MSIs from lifting heavy bags of laundry and hanging the wet pads to dry. It also reduced staff exposure to biohazards,” she said.

Ruth also sought feedback from her workers. She then introduced eight-hour absorbent, disposable underwear. The new underwear reduced the frequency of workers having to change a resident several times a night. This task required them to physically roll and move a resident, placing them at risk of MSI.

“Most of the changes and adjustments were relatively inexpensive and have been very positive for staff,” explains Ruth. “The collaboration between everyone involved to make these changes has been amazing.”

A formula for success

Heather adds that staff feel secure in bringing forward any safety concerns they have. “I think the staff are very safety conscious and will speak up if they see something unsafe, because they understand that safety is everyone’s responsibility.”

Heather says that St. Jude’s demonstrated a commitment to workplace safety by consulting with staff across various departments and external experts to understand and address their concerns. The collaborative environment it fostered was key in developing effective solutions to improve the workplace layout and design.

The directors, who oversee both direct and indirect care areas, worked with each other and their staff to understand the routine aspects of jobs in relation to specific concerns they heard. They were proactive in providing time and resources to address MSI concerns, and the employer was transparent and responsive throughout the process.

Directors and workers were all actively involved in a learning process that promoted a positive health and safety culture and demonstrated ownership for continuous safety improvement.

Next steps

Collaboration between the leaders and workers, and a firm commitment to continuously improving health and safety performance are the foundations of a strong health and safety culture at St. Jude’s. Next steps will include continuous monitoring of the measures put in place and updating as required.

“It’s an ongoing process, continually identifying risks and engaging the staff. They know the job the best and should be involved at every step in any changes that involve their work,” Heather adds. “The collaboration between WorkSafeBC, the employer, and staff was key to effectively bringing about positive health and safety changes in the way they do their work.”

For more information

Visit our Ergonomics page.

This information originally appeared in the Fall 2024 issue of WorkSafe Magazine. To read more or to subscribe, visit WorkSafe Magazine.