I wrote this proposal in 2008, in an attempt to get my department motivated to reduce back injuries among my co-workers. The department will be getting powered stretchers and loaders this year, better late than never. The arguments used in this document to substantiate the need for powered cots are all still relevant and can serve as a starting point for putting together your own proposal or grant request.
Reducing Firefighter Injuries Related to Patient
Lifting and Moving
PURPOSE
This proposal
advocates the purchase of improved patient lifting and moving equipment for the
Fire Department .
This equipment will prevent or reduce work related injury, disability, monetary
and human cost associated with injuries in the Fire Department.
SUMMARY
This proposal
shall demonstrate the need for improved equipment through analysis of internal
and external injury patterns for firefighters and EMS
personnel. Carefully identify a means for preventing or reducing the incidence
of injuries related to lifting and moving patients. Thoughtfully suggest
specific equipment which will accomplish the task, and examine potential
funding sources to facilitate procurement of improved equipment.
INTRODUCTION
Last year in
the State of Virginia
over five hundred firefighters, emergency medical technicians, and paramedics
were injured on the job at a cost to the state and employers of over
$3,216,608.00[1]. Lifting
related injuries accounted for over 10% of all injuries and involved the back,
hips, knees, and ankles. In our department we currently have five employees out
on long term workers compensation injuries, and five on restricted or light
duty due to injuries[2].
Over the last five years this department had 20 reportable workers’
compensation claims directly related to lifting and moving patients at a cost
of $53,056[3].
The human and
monetary cost of work related injuries among fire and EMS
personnel is great. According to the Journal of Emergency Medical Services “at
any given time, almost 10% of emergency medical technicians and paramedics miss
work because of injury and illness they suffered on the job”, and “far exceeds
the national average of 1.3%”[4]. A
large number of these injuries are related to lifting and moving patients.
According to OSHA 25% of all compensation claims involve back injuries[5].
OSHA recommends engineering controls including reduction of weight lifted and
use of mechanical aids such as lifts, and acknowledges that frequency and
fatigue play a role². Our department is
currently relying on equipment and technology for lifting and moving patients
that is over forty years old and provides no mechanical assistance. Medical
responses have increased and the total number of lifting and moving operations
per shift has increased by nearly 20% over the last 5 years[6].
There is an obvious cost to the department in lost productivity, injury claims
and permanent disability.
Not only are
employees being injured, patients also become injured as a result of falls when
stretcher or moving operations go bad. The use of outdated equipment and poor
body mechanics makes the process of controlling patient movement down stairs,
across fields, through cramped quarters difficult and dangerous for both
patient and provider.
New products
have become available that can significantly reduce the number of injuries by
reducing fatigue, poor body mechanics, and repetitive heavy lifting. Powered
stretchers on the market virtually eliminate having to dead-lift patients from
a squatting position. Considering the average weight of a patient and the rated
capacity of some stretchers of 700lbs. that can result in several thousand
pounds of weight the crew will not have to lift in a single shift.
The
stair-chair utilized on most transport units is simply inadequate for most
patients even in ideal circumstances. It forces the crew to carry a patient
down a flight of stairs in a hunched over position, with one crew member
carrying nearly the entire weight of the patient at times. New equipment is
available that has a tracked belt allowing almost all of the weight to smoothly
be transferred to the staircase resulting in a much more comfortable and safe
move for both the patient and crew.
A common
sense solution to reduce accidents, injuries, and disabilities among both
employees and patients is available. The amount of data supporting its use is
compelling. The benefit to the employee, the city and the customer are obvious.
PROPOSAL
Purchase
twelve new Stryker Power-PRO XT stretchers with three stage IV poles, backrest
storage, wheel locks, battery charger, and rear oxygen tank mounts.
Our city has
used Stryker products for many years and has been satisfied with both the
quality and durability of the products they offer. Our existing cot restraining
devices will work with these stretchers requiring no additional modification to
our units. The Stryker product has been extensively tested and evaluated with
positive results from many other departments with demonstrated reduction in
injuries from over 50% to 100% and reduction in patient drop rates of up to 90%[8].
Purchase
9 new Stryker Stair-PRO stair chairs
Our city has
three of these units in service and everyone who has used them has been
impressed with the ease and safety of patient movement with this device.
Studies have found that it can reduce both compressive and shear forces on the
spine significantly. Actual use by other agencies has shown reductions of up to
100% in injuries sustained while moving patients down stairs[9].
BUDGET
The cost
break down for these equipment upgrades including cost for additional options we typically use, the extended amounts
and total expenditure required. It does not take into account any volume or
municipal discounts we may have available to us. There are
several options for funding this project; a Rescue Squad Assistance fund 50/50
grant is the most likely source at this time. The state should fund half of the
cost, and if the city council approves, the city will pay half. Please take
into account the savings to the city in reduced injury claims, missed time from
work due to injuries, and decreased general liability associated with moving
patients. The projected cost to the city in the first year is minimal, and
savings throughout the life of the equipment is enormous.
The figures
used below to illustrate potential direct costs savings to the city and make
the following assumptions;
- Even though 80% of calls involve some
type of patient or patient movement we will only be able to realize a 50%
reduction in injuries related to lifting
- worker compensation cost directly
related to lifting and moving patients will only be reduced by 50%
- Injury costs will not increase over
time
- No discounts will be given on
equipment purchases
CONCLUSION
The City of Chesapeake has the
opportunity to reduce injuries to both its employees and its citizens while
also cutting cost associated with treating these injuries. The potential exists
to prevent life-altering injuries by making a small investment in improved
equipment. The potential monetary savings are significant, and the savings in
human suffering, lost wages and disability are not measurable. Even in poor
economic times this proposal makes sense. It will save money, reduce related
cost associated with filling empty positions, reduce liability exposure. It
will enhance the city’s professional appearance and let the employees know that
they are valuable.
Appendix
Injury
statistics
Emily Caldwell,
The Ohio State University, Journal of Emergency Medicine article Emergency Responders at High Risk for
Work-Related Injuries, Illness. http://www.jems.com/news_and_articles/news/High_Risk_for_Injuries_and_Illness.html
Manufacturers web links:
Stryker Power-PRO PDF
http://www.ems.stryker.com/pp-mini-site/powerpro.html
Stryker saving statement PDF
http://www.ems.stryker.com/powertosave/
Stryker risk reduction studies
PDF
[1] Virginia
Workers Compensation Commission annual report for 2007
[2] Per
Telestaff 5/7/08
[4]Emily
Caldwell, The Ohio State University, Journal of Emergency Medical Services, 1/7/2008
Emergency responders at risk for
work-related injuries, illness.
[6] Chesapeake fire
department call statistics 2002 (15136) -2007(17992)
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