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Frances Pisano, CEO and founder of Pisano & Associations LLC (the parent company of The ERGOLAB at Ergonomic Edge) was published in the most recent version of the Design-Build Institute of America‘s (DBIA) monthly publication, Design Build DATELINE.  Design-Build is a membership organization bringing together thousands of organizations and individuals representing architects, engineers, public and private owners, general and specialty contractors, manufacturer and suppliers, students, college and university faculty, legal and finance professionals and many more. 

Frances was asked to share her point-of-view on Hospital Ergonomics, the article is titled “Hospital Design; Ergonomics Should Be The Next Big Trend” – check it out!

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Do you know where your employees are?

Ask any business owner or executive about the impacts of Healthcare costs on their business and you will get an EARFUL.  Healthcare accounts for 15.4% of payroll costs…and that percentage is increasing.  Today’s business enterprise spends significant time and resource energy on the aggressive management of that number.  Very little if any savings will come from that number (unless REAL healthcare reform happens; don’t hold your breath for it)…today the exercise is about holding the line.   Just keep treading water.

An unexplored SAVINGS opportunity does exist; it’s not as sexy or polarizing as healthcare costs BUT it can drive very real cost savings.  

Did you know that the total cost of unplanned employee work absences – not vacation or personal time – represents 9.2% of the average company’s payroll expense? (Source – Marsh Mercer 2008 online survey http://www.kronos.com/AbsenceAnonymous/)

Why?

Absences impact your business in three ways:

  • Direct costs for the benefits or wages paid to employees while absent,
  • Indirect costs for lost productivity or the replacement worker expenses to “cover”
    absences and minimize loss of productivity, and
  • Administrative expenses, whether due to internal staffing and overhead, or to vendor
    services.

The impact on Productivity is even more alarming:

Absenteeism or “Incidental unplanned absences” result in the highest net loss of productivity per day (i.e., missed or postponed work not being covered by others): 21%versus 15% for planned absences and 17% for extended absences.

Absenteeism is a MANAGEABLE cost driver and a sound Ergonomics strategy can help.

How?

Trapped in that 9.2% number are unreported employee pain and discomfort issues.    In many cases, ERGONOMIC workplace issues are the cause of this pain and discomfort.  A recent study from Spain estimates that > 6.4 million people take an unplanned absence each week citing muscular-skeletal problems as the reason.  Out of these, 40.9 per cent of the work force experiencing lower back pain, 40 per cent with neck pain, and 22.9 per cent with upper back pain.

Poor environmental and task design within the work environment drives this pain and discomfort.   ERGONOMICS can help. 

Do you have an in-house program that documents absenteeism drivers?   Probably not.   Our ERGOLAB team works with business leadership to build a proactive approach to absenteeism through;

  • Employee pain and discomfort surveying,
  • Task assessment and redesign consulting and
  • Ergonomics education and training

Interested ?  We’d love to hear from you – fpisano@ergonomicedge.com or 401 529 8398

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There is an old carpenter’s axiom, ‘measure twice, cut once’.  The lesson? Careful, informed planning is essential to ensure a positive outcome.  Hurry to complete a project, and you do so at your peril. A lot of wasted wood cut just a skosh too short.  

Ideally, Ergonomics should play a central role in the design and build out of any building where people will work.  Understanding the needs and limitations of the human body at rest and in movement should inform the work of architects, designers and builders.   Have you ever worked in a business environment where the building structure, layout, space allocation for job tasks, movement & pass-through, while up to all current day building codes, seems to interfere or impede productivity?   The workspace allocated per employee in office environments is often driven by cost issues (cost per sq foot), rather than building an understanding of the tasks employees would be asked to perform….THEN DESIGN TO MEET THOSE NEEDS.   Or, perhaps the business, like most, have gone through significant expansion in their use of technology. New tools are forced into existing environments; this reality introduces risk factors into the workplace.  Or, the employer needs to support as many workstations in an area as possible, with little or no regard for human factors and ergonomic realities.  (think CALL CENTER – have you ever walked through a large call center – YIKES – an MSD factory). 

A growing part of our ERGOLAB practice is consulting within a hospital environment.  Nursing injuries are on the rise. OSHA accident and injury data has identified nursing as one of the most dangerous professions in the US.   Why?  THE PERFECT STORM OF FACTORS; 

  • HEAVY LIFTING – On average, a nurse  lifts 1.6 TONS of human body weight every shift.  Injuries from heavy lifting leave 50% or more working in chronic pain
    or at least 12% leaving the profession, many with permanent disabling injuries.  The rate of Musculoskeletal Disorders or MSDs in healthcare workers exceeds that of workers in construction, mining and manufacturing.
  • FATIGUE – Nurses walk 1/3 of every shift due to poorly designed floor layouts and inadequate storage at the point of care. A nurse walks more than 6  miles per shift.
  • TECHNOLOGY – New technologies have transformed healthcare; unfortunately, many of the nation’s hospitals were built before the invention of computers. Tools and technology is crammed into every nook and cranny on patient care floors.  Nurses spend HOURS at computer workstations that are poorly designed, forcing out of neutral body postures and increasing the risk of MSDs. 
  • EMPLOYEE SAFETY NOT A PRIORITY – Present day hospital culture is about PATIENT SAFETY concerns and conversations; employee safety is a distant second.   The typical hospital will have a Patient Safety Officer, with enterprise level responsibilities and resources. That same hospital will relegate Employee Safety responsibilities to any number of ‘owners’ at the middle management level. 
  • MORE WITH LESS – Financial challenges resulted in nursing layoffs – nurses are asked to do more…..much more….with less.  40 % of nurses today work in excess of 12 hours
    per shift. Longer hours, more shifts, less down time.  

Intelligent hospital design, leveraging human factor and ergonomics expertise would alleviate MANY of the factors listed above.  Lifting tools and technologies exist that could eliminate injuries due to heavy lifting.  Floor plan design must evolve to eliminate unnecessary walking that contributes to fatigue, then injury.  Technology can be better integrated at the point of care, with ergonomic solutions to minimize MSD risk.   Any design must have adaptable, changeable and flexible enough to meet accommodate changes in technology. 

The good news….a VERY real opportunity exists in the coming decade to address hospital design issues and create the care center of the future.  The healthcare industry is experiencing a construction boom: 

  • Hospital construction spending is forecasted at $36.8 billion by 2011 with expected annual increases year to year (source – Center for Medicare & Medicaid Service)
  • 58% of existing hospitals plan to add beds in the next few years to accommodate aging baby boomer populations (source – Nurse Executive Center – CNO Survey)

Ergonomics must be one of the guiding principles in future hospital design.   Let’s not ‘assume’ that Ergonomics is central to the design methodology….DEMAND IT.  Make sure the development teams have MEASURED TWICE…before they finalize design.  The costs of business as usual are too high.

Have something to say on this topic?  Please add your comments. 

If you’d like to discuss our consulting services in this area, please contact Frances Pisano at 401-529-8398 or fpisano@pisanoassociates.com

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Our ERGOLAB team spends a lot of time working in office environments; the day man met PC was a glorious one for workplace accountability – nothing like a digital trail to keep things on the up and up….not so great for the human body.  Why?  As work tasks became more and more automated, our work days became more sedentary. 

Our body was not designed to sit for 8 hours a day; we’re all familiar with the Ergonomics axiom, “the best body posture (position) is the NEXT body posture (position).  Our bodies were designed to hunting, gathering, foraging for food, and sometimes running away VERY quickly when WE became the potential ‘food’ (…and NO, battling the crowds at your local farmer’s market does not qualify as ‘foraging’).   We need movement, we need a variety of position and posture to maintain good body health and flexibility. 

In the past, corporate Health & Safety leadership often overlooked the needs and risks within their office environments; cubicle dwellers don’t use pneumatic equipment, drive a forktruck or work with hazardous materials. Accidents and injuries occurred in other places in the enterprise, except the occasional slip, trip or fall, the office harbored few (or so they thought) risks.  Now, with 20+ years of data  and learning behind us, we understand the very real and very expensive risks associated with unmanaged office ergonomics.  With the average cost of ONE musculoskeletal disorder averaging $25,000 in direct costs and 5 to 8 times that number in indirect costs…a passive approach to office ergonomics is NOT good business. 

Still…old myths and misconceptions in Office Ergonomics die hard. 

Misconception #1

The right chair will solve ALL your problems.  WRONG!   A personal pet peeve and a myth that must DIE (and remember, we SELL ergonomic chairs and tools at www.ergonomicedge.com ).  The office chair, while very important, is one element within an INTEGRATED Ergonomic solution.  Office system manufacturers spend millions to reinforce the belief that a chair (more importantly, their chair) is the answer.  There is no magic chair. Or for that matter keyboard tray, mouse, docking station or document holder.  Products are tools our ERGOLAB Ergonomists use, case by case, client by client, to build an Ergonomic solution, properly designed, personally adjusted, with adequate employee education and product training (you’d be amazed how many companies have NO IDEA how their existing chairs adjust…).  At ERGOLAB, we lead with Ergonomic guidance first…products are a very very distant second.  

Misconception #2

Repetitive Motion is the #1 cause of ergonomic injury.   WRONG!    Yes, repetitive ‘Out-of-Neutral’ motions can and do cause injuries. An example would be anyone who works on spreadsheets for long periods of their day; these folks do A LOT of cutting and pasting within the spreadsheets.  Over the long term, overuse can lead to pain, discomfort and injury.   What surprises most corporate Health & Safety Managers, is that STATIC  “Out-of-Neutral” body postures cause far more injuries….we are a generation of leaners and reachers.   Sitting in a chair for hours at a stretch invites poor postures; next time you are in a lengthy meeting, check out the body positions of everyone around you…..leaning, slouching, etc.  All positions that put extreme stress and pressure on our bodies.   

This underscores the value of careful, thoughtful office design; the cubicle footprint is often driven by ECONOMIC imperatives, rather than ERGONOMIC imperatives.  Think  adjustability of worksurfaces, up/down, in/out.  Make sure all employee tools fall within the REACH ENVELOPE…don’t ask an employee to reach and lean to talk on the phone or lean forward to view a monitor.    

Misconception #3

Office Ergonomics is a ‘hard sell’ in these tough economic times.   WRONG!   Now is precisely the time to integrate Office Ergonomics into your Health & Safety plans for your next fiscal year.  Let’s face it, everyone is working with reduced headcount. This means your current work staff needs to do more…..MUCH MORE….with less.  You need these employees to stay healthy and productive.  Beyond this, Worker’s Compensation costs are soaring…a proactive Ergonomics approach is about preempting injury. Fewer injuries, fewer claims, lower PREMIUMS.   In tough economic times, you can’t afford NOT to invest in Office Ergonomics. 

Misconception #4

Every employee needs the same Ergonomic tools.  WRONG!      Ergonomic solutions are personal; an employees height and body size, health conditions, work functions and personal habits all contribute to and inform an Ergonomic solution.   A good starting place for 90% of the employee population is an adjustable Ergonomic chair and quality adjustable keyboard – but REMEMBER – the workstation MUST be designed with the employee’s idiosyncratic needs in mind. As before, an Ergonomic solution. There is no one size fits all.

 Need some guidance in creating and implementing an Ergonomics program for your business?   Give us a call – 401-527-7047, or email me at cdavis@ergonomicedge.com.

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Well….the cat is out of the bag.  All this time, American business has been worried about a new attempt by OSHA to create an Ergonomic specific regulation.  Business organizations like the US Chamber of Commerce and others were lining up resources for another fight.  Well folks….it looks like the ‘war’ was won without a single shot.   Hidden in plain sight, is all the regulatory muscle OSHA needs; the general duty clause.

WHAT?  Yes it’s true. During an April 7th web chat, Deputy Assistant Secretary Jordan Barab stressed that OSHA’s enforcement of ergonomic issues is a key strategic component, and will increase, noting that the general duty clause will be used to cite ergonomic violations.   THE GENERAL DUTY CLAUSE.  It’s not sexy or flashy….but this approach and regulation has teeth.  

The General Duty Clause of the United States Occupational Safety and Health Act (Federal OSHA) states:

29 U.S.C. § 654, 5(a)1: Each employer shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees.”

29 U.S.C. § 654, 5(a)2: Each employer shall comply with occupational safety and health standards promulgated under this act.

29 U.S.C. § 654, 5(b): Each employee shall comply with occupational safety and health standards and all rules, regulations, and orders issued pursuant to this Act which are applicable to his own actions and conduct.

Couple the above general duty clause with the new column in the OSHA 300 log capturing Musculoskeletal Disorders in the workplace, and you can begin to see why an Ergonomic specific regulation might not be necessary!

Assistant Secretary for OSHA Dr. David Michaels commented that,

OSHA’s field staff will be looking for ergonomic hazards in their inspections and we will be providing them with the support and back-up they need to enforce under the general duty clause. In addition, we will be examining employer logs to see if MSDs are accurately reported,” illustrating the increased emphasis on recordkeeping logs, during OSHA inspections. Michaels stated that OSHA plans to “take a hard look” at employer policies that discourage injury reporting.

You have to give OSHA leadership their ‘props’…the approach is an intelligent, common-sense approach.  No big expensive fight.  Apply the regs that are there….end of story.  

What are your thoughts on OSHA’s new tact????  Agree or disagree??

If you’d like to discuss, feel free to email me at cdavis@ergonomicedge.com or 401.527.7047.

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OSHA’s plan to expand workplace injury reporting has rattled quite a few cages.  The prospect of adding a column (yes, a column) to the existing OSHA 300 log has business up in arms.   The enhanced report would isolate  musculoskeletal disorders (or MSD) injuries.  

NOTE – The term MSD is used to describe a category of Ergonomic-related injuries that affect the musculoskeletal system; there is no single diagnosis for MSDs. It is believed that OSHA’s intent with this expansion in reporting is to determine whether there is a pattern of ergonomic-related injuries in certain jobs or work tasks.

Could reporting lead to regulation?   Maybe.  Regulation would be a stretch right now; Democratic leadership is playing rope-a-dope on so many fronts – healthcare reform to name one – we can’t imagine the Labor Department is anxious to ‘rile up’ business with the introduction of Ergonomic regulation.

Reporting….regulation…WHATEVER.   Our ERGOLAB team’s mission is to build a sound business case as to why Ergonomics MUST be a central element in every business’ Safety & Health strategy.  Ergonomics should not be a business ‘like to have’; Ergonomics should be a ‘must have’ because it makes good  business sense.   Shift the discussion from Reporting or Regulation to the RISK of doing nothing AND the Return-on-Investment or ROI of a proactive strategy.

At a client meeting yesterday, our ERGOLAB team was presenting findings from a facility-wide Pain & Discomfort survey.  This type of survey is a great starting point for any company looking to baseline their current ‘RISK’ related to Musculoskeletal Disorders or MSDs. Employees are asked to rate, from 1 to 5 (low to high) their level of pain &/or discomfort across 38 areas of the body. In addition, they are also asked to identify what work tasks or activities trigger or amplify their pain.  Our deliverables; a map of the quantity and severity of employee pain &/discomfort and insights into the tasks that may be the cause of or contributing to employee injury. This details the existing RISK of pain symptoms across the employee community; Ergonomic and Human Factors research (and common sense) tells us that if no change is made to the current work environment, employee pain will continue to escalate and injury is very possible. 

Following is a view of the RISK progression of ‘unaddressed’ employee pain and discomfort over time.   Get proactive with your company’s approach to Ergonomics; focus your energies on the ROI of Ergonomics.

As always, we are here to help!  Contact us at the ERGOLAB with any questions, or if you’d like to discuss scheduling a Pain and Discomfort survey at your facility. Email me at cdavis@ergonomicedge.com or call 401 – 527 – 7047.

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I was in a meeting with a new client last week.  “Linda” (not her real name), is the Director of Environmental Health & Safety for a growing biotech firm.   Our firm has been brought in to address a growing number of Repetitive Strain Injuries in the company’s lab facilities.  “Linda” shared her frustrations with the company’s past approach to Repetitive Motion injuries;

“We wait until something bad happens, until it’s too late to avoid injury and the costs associated with the injury. We practice Whack-a-Mole Ergonomics.  When an employee complains of pain…WHACK…only then can I get them support.   Another issue in a different part of the company, WHACK…again, band-aid the issue with a product or even bring in an Ergonomist to take a closer look at that employees issues.  We spend all our time WHACKING and reacting; we need to get ahead of the issues.” 

Linda’s Whack-a-Mole analogy describes the reality in most companies; expertise and instruction is brought in after pain &/or injury.  When the average direct cost of a Musculoskeletal injury is $25,000 (that excludes indirect costs that average 4 x that number based on OSHA data) – the cost of Whack-a-Mole Ergonomics can add up quickly.  A significant part of our Ergonomic practice is working with client’s to build a PROACTIVE Ergonomics program within their company.  Following is an Action Plan you can use today, to take control of Ergonomic issues in your company, and leave the Whack-a-Mole approach behind.  For a deeper discussion on how to implement this program you can email me at cdavis@ergonomicedge.com.

Proactive Approach to ERGONOMICS:

Action 1.0

Build a business case on the value of the PROACTIVE approach to Ergonomics.  Leverage the resources that are available from OSHA, NIOSH, National Bureau of Labor & Statistics and academia – Cornell, UCLA and others.  Using your company’s historical OSHA recordable data; build an air-tight case for why the proactive approach is better business. Focus on the bottom line impact.

Action 2.0

With your business case in hand – pitch Executive leadership and secure commitment to a long-term Ergonomic program.

Action 3.0

Ensure Ergonomics is integrated into your fiscal planning cycle; the program must be integrated into your Environmental Health & Safety strategy. The EHS community may also need to be sold on the approach; share your business case. 

Action 4.0

Identify Ergonomic consulting resource for support of activity (in most cases companies do not have resident expertise).  Potential partner should have deep experience in task assessment and redesign across all company environments (Manufacturing, Material Handling, Warehousing, Office, Laboratory, Field etc). In addition, review firm’s methodology, ensure actions measurable (as you will be asked to demonstrate program value at some point – be ready for this – put onus on consultant/partner). Talk with current and past clients. 

Action 5.0 – Getting Started

5.1 – Build a Communication Plan around the launch and ongoing merchandising of your Ergonomic program. Included in this plan – Introduction to Ergonomics training for all employees (baseline understanding and value of Ergonomics), Company Champions Program – identify internal Ergonomic program Champions by functional area.

5.2 – Launch program with company-wide Pain & Discomfort Survey. It’s purpose – isolate work environments, tasks and employee categories with injury markers. Outcome – map out high/medium/low risk tasks – permits company to prioritize and align investments

5.3 – Isolate high risk tasks for assessment & redesign – launch Ergonomics work…

Building support and positive momentum is central to getting in front of Ergonomic issues.  If you have any questions, we’re here to help!

Some valuable links to assist you in building your Ergonomics business case:

Puget Sound Human Factors & Ergonomics Society Chapter Cost Benefit Analysis Calculator  – http://bit.ly/PugetHFESCalc

Cornell Ergonomics ROI Calculator – http://bit.ly/CornellROI

OSHA eTools – Computer Workstations – http://bit.ly/OSHAeTools

NIOSH – http://bit.ly/NIOSHErgo

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