PowerPoint Presentation - Option 3 - University of Waterloo

Manual Materials Handling and Prevention of Musculoskeletal Disorders:

Making it Work! – CRE-MSD Conference

Linen and Waste Removal in a

Hospital SettingIvy Nanayakkara, Manager, OHS

October 2, 2017

Title of Presentation

Place – Date Page 2

Agenda

• About Halton Healthcare

• Manual Materials Handling: Our

context

• Discovery

• Dilemmas

• Decisions



About Halton Healthcare

• 3 community hospitals

• 4000+ employees

• 300+ physicians

• $3.36B in

redevelopment

projects



• Cancer Clinic, Radiation Clinic

• Ambulatory Procedures Unit, Child & Adolescent Day Program

• Grow to 457 with future 602 Bed Capacity

315 Beds

• 1.6 million sq. ft.475,000 sq. ft.

• 80% single patient rooms20% single

patient rooms

• Decentralized Food/Nursing/Registration

Centralized Food/NursingStations/Registration

New Services

Change Snapshot of our largest hospital



Manual Materials Handling – the hospital context

• Manual materials handling (MMH) means moving or handling things by

lifting, lowering, pushing, pulling, carrying, holding, or restraining.

(www.ccohs.ca)

• MMH is the most common cause of occupational fatigue, low back pain and

lower back injuries (www.ccohs.ca)

• MMH is everywhere is a hospital

• Almost a universal hazard in a healthcare setting

• Safe patient handling is a considerable risk

• MMH significantly impacts our support services such as:

– food services

– environmental services

– facilities

– waste and linen services

http://www.ccohs.ca/

http://www.ccohs.ca/



Worker reports

muscles are sore

after moving

several totes

• What are our employees

telling us?

• Have we had any injuries?

• Have workers been

trained?

• Do we know and

understand the hazards?

• How do we find out?

Worker reports that

contents of

biowaste spilled

when transporting

Employee reports

low back strain

while handling

waste from OR

Internal ‘clients’

have increasing

demands

Discovering Hazards

Vendors are not

always compliant

with internal

process



Discovery tools and process

• We examined the linen and waste role in our new environment and discovered several MMH hazardsPhysical Demands

Analysis

• Reviewed injury data and IRS reports

• Talked with staff

• Observed daily practices and historical training

Injury and IRS data

• Reviewed work flows

• Physical plant

• Tested routines and practices

• Reviewed equipment

Risk Assessments

• 96 gal totes a big challenge

• Distance travelled for transport

• Change in work flow

• New equipment

Hazard Discovery and Action Plan



Challenges identified

• Our OTMH plant is 1.6

million square feet

• Nearly 1 kilometre to

travel from highest

producers of waste to

docks each trip

• Challenges with lifting,

pushing, pulling, walking,

carrying, time, workflow,

efficiency



Solutions

• Implemented the use of

‘tuggers’ for transporting

waste to docks

• Significant reduction in

risk to worker

• Increased efficiency in

time




• Compactor is not in an ideal

location

• Transfer waste from bins to

compactor

• Hazards regarding lifting, twisting

• Reviewed weights and locations of

waste

• Highest area was from our ED and

OR and bags were 9lbs at

heaviest

• On average the bags are 3.5lbs to

6.1lbs



Solutions

• Training on body mechanics and safe lifting and

MMH practices

• Reviewed solutions for modifying the compactor

or installation of a mechanical lift




• Food/organic waste bins very

heavy

• Often wet and moveable contents

• High volume and requirements for

frequent pick up

• Demands from kitchen etc. high

• Several hazards identified:

push/pull hazard, walking and spill

hazards, time and workflow

impacts



Solutions

• Implemented use of smaller green

waste containers

• Significant decrease to lifting

hazard for worker

• Ability to load with ease on tugger

• Transport is less risky

• Staff are not happy with change

• Perceived workload increased due

to frequency of pick ups and

process of double handling at the

docks




• Biowaste totes are 96

gallons

• High producing departments

are located within a short

distance

• Bins travel the 1km distance

manually 6-8x per day

• Hazard for push and pull,

lifting, spill exposure



Solutions

• Training need identified

• Work flow must allow for distance travelled

• Explored options of smaller bins with vendor = not an

option

• Increase frequency of pick up from high volume areas to

decrease weight

• Industry practices are consistent and there aren’t any ‘off

the shelf’ solutions for automation (i.e. tuggers)




• Linen carts are an ongoing

risky challenge

• Overfilling on units

• Double handling of bags

• Vendor shortage of empty

carts

• Hazards are lifting, twisting,

turning, bending



Solutions

• Ongoing reminders to units not to overflow

• Training to staff about the hazards of

double handling

• Signs



Decisions

• Implement changes

• Review and monitor implementation and impacts

• Evaluate outcomes

• Solicit feedback

• Complete PDA

• Document progress and ideas



Lessons Learned

Safety First

Proactive Fact

Finding

Listen to Workers

Partnership with SMEs

Be flexible

and creative



Questions and Discussion

Documents

PowerPoint Presentation - Option 3 - University of Waterloo