Adventist Health Sonora Case Study - Arjo MOVE® Program

In 2014, Adventist Health Sonora was working toward enhancing its culture of safety. It recognized an opportunity to make improvements for its patients and employees by reducing injuries and injury-related costs. After researching many options, Adventist Health Sonora selected Arjo MOVE for its proven results and broad range of support solutions.

The goal was to decrease staff injuries, facilitate early mobility, and improve patient outcomes. With the proper tools, training and sustainment strategies, the staff would be able to safely transfer & assist patients without manual lifting. Thanks to a comprehensive, integrated solution, the partnership reduced injuries and costs, and strengthened a culture of safety.

Care bio

Adventist Health Sonora serves three counties in central California. The facility offers 72 acute beds, 12 transitional care beds, and 68 LTC beds. Sonora has more than 1,600 employees on two campuses in 32 clinics. This community hospital sees more than 33,000 patients in the emergency department alone.

“I never imagined it would work as well as it did, but I knew that it could decrease staff’s potential for injury and reduce our injury rate, which ultimately saves us money.”

Kathy Murray
Director, Risk Management, Occupational Health
Adventist Health Sonora

The challenge

At the time, California had passed new legislation that required general acute care hospitals to establish an effective injury prevention program which included training on the use of patient handling equipment to protect both patients and health care workers. Workers’ compensation and lost time on the job were costing the hospital several hundred thousand dollars per year. In 2013, Sonora experienced 22 patient-handling injuries. Acknowledging the need for outside resources, Adventist Health Sonora began the search for a solution.

The process

Over the course of several months, the Administrative Council, comprised of Adventist Health Sonora’s President and Vice Presidents, along with the Employee Health Nurse, reviewed potential options to reduce injuries during patient handling activities. The final decision was easy. Arjo provided the most comprehensive solution along with a guaranteed 60% reduction in injuries during the three-year contract. The Chief Nursing Officer and her team were engaged and supportive throughout the process.

The solution

In April 2014, Adventist Health Sonora partnered with Arjo’s MOVE Clinical Consultants to implement the Arjo MOVE mobility program. MOVE Clinical Consultants offered more than just products; Adventist Health Sonora liked that the program included training, three years of support and the expertise of a clinical consultant. The MOVE Clinical Consultant provided hands-on, interactive training for on-site training advocates (called Transfer Mobility Coaches™), which included a number of scenarios and challenges they might face and how to deal with them.

“Having trainers on our staff was a very good strategy, as peer leaders can help reinforce the change in process with encouragement and continual education,” said Kelly Johnson, Employee Health Nurse at Adventist Health Sonora.

Adventist Health Sonora originally signed a three-year support contract and then extended it for one more year because of the success of the program. They have continued to order more equipment, as even those who weren’t convinced in the beginning soon started borrowing devices and then requested equipment for their own departments. According to one of the staff nurses, the program is sustainable and has been widely embraced.

“Our clinical consultant was encouraging and supportive. Her strong rapport and continual assessments allowed her to troubleshoot and promote compliance.”

Kelly Johnson
Employee Health Nurse
Adventist Health Sonora

The Arjo MOVE package was tailored to Adventist Health Sonora’s specific needs. The package included:

• Initial data collection, facility mobility assessment, and identification of equipment and consulting support needs
• Process mapping, executive and nursing leadership briefs, coach and staff training, administrative and “go-live” support
• Specialty rehab training and clinical services over a 36-month period
• Quarterly performance assessments to identify additional training or consulting needs

The outcome

During the initial training period with Arjo’s MOVE Clinical Consultants, 48 coaches, 236 general staff, nine rehab staff and six clinical managers were trained. Every other month, regular site visits included supporting process review, problem solving, equipment monitoring, injury review, unit rounding/coaching, recommendations, and focused training.

“We transferred $800,000 in 2015 & $1,000,000 in 2016 from the Workers’ Compensation Trust back to the operating budget, in large part due to this program.”

Kathy Murray
Director, Risk Management, Occupational Health
Adventist Health Sonora

Thanks to thorough training and strong leadership, the program is a big success. In the first year they had four injuries, which was an 82% reduction from the previous year. After two years, they experienced only one injury — a 97% reduction. Severity and cost of injuries decreased, helping to recapture funds from the Workers’ Compensation Trust.

The administration is thrilled with the results. The program was presented during the Joint Commission Survey as a best practice in improving patient care and employee safety.

Benefits

As a result of the program, the Adventist Health Sonora staff has seen benefits beyond the reduced injuries and monetary savings. They have also seen an increase in employee satisfaction and a decrease in turnover.

Advantages are also carried to the patients by decreasing the risk of falls and increasing mobility. ”Patients have a device to provide secure assistance, providing them a safer means to progress through their care. The equipment also allows more privacy and independence, which contributes to their motivation and healing,” Kelly said.

Cultural transformation

The program was met with some resistance in the beginning. Most believed the initiative would not work, would be time-consuming, and ultimately unsustainable. However, training and full implementation moved forward with the full support and leadership from the CNO. The dramatic decline in injuries proved the effectiveness of the program over time. The clinical staff fully embraces the program, helping to reinforce the safety-focused culture. Today, the program is thriving under its new name, S.T.A.R. Program: Safe Transfer, Activity and Repositioning. There is a continuous flow of updates and information as a reminder to a large clinical staff that works around the clock. S.T.A.R. is more than a program — it is a symbol of Adventist Health Sonora’s commitment to provide a safe, caring experience to both patients and employees.

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