Case Studies

Functional Capacity Evaluation and Return to Work Assessments

In June 2014, we were approached by an NHS Trust which had a number of staff suffering from back problems or other muscular or skeletal conditions that affected staff fitness. The organisation had a backlog in their assessment of the Functional Capacity of these staff. These Functional Capacity Assessments were designed to assess the shortfall between the demands of the job and capabilities of the workers; facilitate the implementation of remedial measures and allow a seamless return to work after injury or illness.

 Our brief was to help the organisation to rapidly carry out these assessments and eliminate the backlog. The task was slightly complicated by the need to liaise effectively between several services in the organisation-clinical, occupational health, and moving and handling services.

We started by agreeing a system for the flow of information and a time table for the outstanding assessments. These allowed us to predict an estimated timeframe for the completion of the task.  The biggest challenge in the process was from frontline services either not being able to free up time for staff to be assessed or not being able to provide protected time for the assessment (meaning that a few assessments were rescheduled or interrupted by frontline operational demands).

Nonetheless, we were able to arrange and undertake all the assessments, make recommendations to the Trust, facilitate seamless return to workers after injury or illness and assist the organisation in eliminating its back log.

 

Ergonomics Moving & Handling Review and a Bespoke Course Design for Waste Management Services

In December 2013, we were approached by the Waste Management Service at a local authority to investigate the ergonomics risk from moving and handling to front line operatives. This invitation was triggered by a range of muscular and skeletal conditions reported by staff in the service. It was clear that staff were suspicious of management intentions and dubious about cooperating with any proposed remedial measures by management.

 

Our specific brief was to design and deliver a bespoke course to approximately 200 staff. We recommended to the client that it was better to begin by investigating the issue, collecting relevant information for the design of the training and to use the exercise to secure staff buy in, without which the proposed intervention would fail.

 

Our ergonomics adviser conducted a series of work through sessions shadowing staff in real operational situations(refuse collection lorries, waste management depot, waste collection runs) asking questions to clarify issues and investing in building a rapport with staff to diffuse any potential resistance to the future course.

 

We carried out an ergonomic review of moving and handling practices in the Service, documented a range of risks encountered by different waste management specialties from the perspective of the staff, designed and presented a bespoke course addressing the issues raised and delivered the course on site.

 

Our strategy was effective because the course addressed the real issues identified by staff, who with very few exceptions bought into the idea of the training courses as they felt a sense of ownership in the development process.

 

Following the presentation of the courses, we delivered a risk management plan to the Waste Management Service based on our review findings, and staff feedback both during the work through and training sessions.

 

Delivery of a New Equipment Tracking Strategy

 

In May 2010, we were approached by an NHS Trust which owned several hundred pieces of lifting equipment, hoists and accessories that were covered by statutory periodic maintenance and checks (Lifting Operations & Lifting Equipment Regulations 1998). There were concerns about the accuracy of the existing database, retention of hoist accessories (slings), and the cost of the current outsourced servicing contract in comparison to quality.

 

We met with the organisation and proposed a complete review of the current arrangement to inform further action. An action plan was agreed for the review. Our review found that the existing database was indeed inaccurate and the outsourced service could be replaced with a cheaper and better quality in house service. The review also recommended an updating of the equipment database and an integrated equipment tracking strategy.

 

The organisation subsequently commissioned us to write the integrated equipment tracking strategy, specify operational requirements for a new in house service, and update the database of clinical equipment.

 

We delivered a strategy for tracking of equipment in compliance with relevant equipment legislation on clinical equipment, on time and on budget; produced a plan for the replacement of the outsourced clinical equipment statutory compliance service with an in house service; specified operational requirements and protocols for the new in house service and updated the existing database of clinical equipment.

 

We therefore delivered a change management project which saved the organisation in excess £30,000 annually, led to a better quality service and improved the retention of hoists slings.

 

 Customised Training Design

In 2010 one of our clients required a novel custom designed back care course for dental staff. We carried out a training needs/training requirement analysis. This exercise provided information on the approximate numbers of staff in the group, previous training history, the current state of risk assessments, existing policies, and current problems.

Relevant data was obtained on work operations and processes, available equipment, and staff perception on current training needs. Training objectives, learning outcomes and a provisional course programme were drawn up. Several training events were implemented and evaluated by participants and trainer. The initial skills lab training venue was assessed as unsuitable and training was relocated to the dental surgery.

We made a site visit to the surgery to observe and interview staff under usual working conditions and to obtain data on relevant operations and processes, available equipment, and staff perception on the new course design. We also made modifications to the training programme. Staff rated the revised customised course very highly and this has raised the profile of back care training within the dental service.

Changing Staff Perception of Training

By 2007, we had provided annual statutory training and refresher courses to some of our clients for a number of consecutive years. Although, there were always changes in the field (some minor and others major) to report during refresher courses, it was becoming challenging to find new and engaging ways to present the material.

We responded by introducing new technology in the form of multimedia video cartoons and digital photography presentations and a series of interactive exercises including a circuit. These changes brought the subject alive in new ways.

The outcome was a renewed interest in our courses across a wide range of delegate disciplines, abilities and experience. To date, we still receive positive feedback on this entire range of innovative teaching methods.

Introduction of a more robust Risk Management System

In 2006 in response to our provision of a range of moving & handling courses to nurses, physiotherapists, occupational therapists, administrative and clerical staff and estates department staff, a certain Primary Care Trust (PCT) discovered that their risk management systems were inexistent. The organisation then worked with us to introduce a range of measures to further reduce Moving & Handling risk to staff. These measures included a review of the Trust Moving & Handling Policy, establishment of a Moving & Handling Steering Group, conduct of scheduled and systematic departmental Moving & Handling audits and the introduction of a monitoring system which links Moving & Handling training to staff supervision. The outcome was a more robust risk management system across the organisation. The organisation is now taking better care of staff, is more prepared for statutory inspections and less vulnerable to litigation.

Increasing Uptake on Statutory Courses

In 2003, we were approached by a Primary Care Trust who were experiencing poor uptake on statutory manual handling training courses. There was a concern that if the situation continued staff would not be getting the training needed to protect them from risk and the organisation might end up with a work injury law suit or struggle to fulfil its legal health and safety obligations.

We engaged the client and discovered that the then multidisciplinary approach to training, where all clinical staff attended the same training course was unpopular. Salveo worked with the client to research, design, deliver and evaluate a new series of custom designed discipline specific courses for nurses, physiotherapists/occupational therapists and speech and language therapists.

The new courses were well received by staff and course uptake went up permanently and significantly