Authors (including presenting author) :
Wong KCM(1), So MFT(1) , Ho CH(2), Tsang BPY(2), Cheung YP(3), Ho VKC(4), Yeung YS(4), Fok JPC(1), Leung MKW(1)
Affiliation :
(1) Occupational Medicine Care Service (OMCS), New Territories East Cluster (2) Department of Anesthesia, Pain and Perioperative Medicine, Prince of Wales Hospital (3) Department of Orthopedics & Traumatology, Prince of Wales Hospital (4) Department of Occupational Safety & Health, Prince of Wales Hospital
Introduction :
Orthopedics & Traumatology Assistants (O&TA) are essential in preoperative preparation and intra-operative support. Their work is labour intensive involving lots of Manual Handling Operation (MHO) tasks. OSI surgical table is designed for orthopedic trauma patient positioning in surgical procedures. O&TA is required to lift and carry a 55 pounds OSI table platform from manufacturer storage rack, tilt it from vertical to horizontal position and hold it up with barehand during OSI surgical table preparation. Frequency of the concerned MHO tasks is 16 per month. Based on an ergonomic assessment tool: Rapid Entire Body Assessment (REBA), ergonomic risk is classified as “very high”.
Objectives :
1. To improve occupational health of O&TA 2. To streamline workflow, minimize MHO and enhance efficiency
Methodology :
A focus group among stakeholders from OMCS, OSH, Operation Theatre and O&T was formed to investigate risk associated with concerned procedure and identify potential improvement measures. Staff engagement is utmost important in the process, consensus on improvement measures include 1) invention of a tailor-made trolley to keep OSI table platform horizontally to eliminate lifting the 55 pounds platform, it also supports the platform during the maneuver, staff need not to hold it up barehandedly, 2) Streamline the process by putting all the surgical table accessories under tailor-made trolley and transfer it to operation theatre simultaneously, 3) tailor-made training on OSI table preparation.
Result & Outcome :
Staff feedback towards improvement measures is very positive, 86% O&TA satisfied with the changes. In a symptom survey with response rate 100% (n=14), marked improvement in pain and perceived hardship associated with OSI table preparation were noted. Before the improvement measures: 71% staff reported pain (average pain score 4.6/10) and perceived hardship was 7.3/10. After the improvement measures: only 14% staff reported pain (average pain score 1.5/10) and perceived hardship was dropped to 3/10. Adopting streamlined workflow in OSI table preparation, average preparation time dropped from 16 to 8.5 minutes. Significant improvement in REBA ergonomic assessment revealed that ergonomic risk in OSI table preparation after our conjoint effort is “low”. In short, this work improvement project is successful which doesn’t only enhance work safety but also improve work efficiency. We would like to share this smart OSI surgical table preparation with other HA hospitals to care our carers. Key of success in this project include: staff engagement, teamwork, innovation and management support.
