Super Coach Program - Injury Reduction Strategy

Introduction/Background

• The Summit Long-term care site is located at 955 Hillside Avenue in Victoria BC, owned and managed by Island Health Authority
• It is a 309 bed long-term care with just under 500 staff.
• It also contains a senior’s day program and 4 bed community dialysis clinic

Island Health Authority is a regional Health Authority that encompasses Vancouver Island, surrounding islands and part of the British Columbia mainland with approx. 28,000 employees.

As with many health care providers, staff injuries play a role in the day-to-day operations and create gaps in staffing models due to elevated employee sick-time and subsequent significant cost expenditures.
In an effort to address these issues, OH&S team developed a Musculoskeletal Injury Prevention (MSIP) Coach role, which are peer educators focusing on MSI risk factors at sites, units. MSIP Coaches participate in a 5-day training workshop where injury reduction strategies and communication skills are taught.

In addition, the OH&S team trains peer educators to provide ongoing education in regards to Violence Prevention (VP) strategies, and the Infection Prevention and Control (IPC) team trains peer educators on hand hygiene practices. Although these programs provide great information, Managers found it onerous to train and maintain volunteers to take on each of these roles.

In an effort to create efficiency of staff training, the leadership at Summit choose to create a Super Coach Program whereby chosen staff members would complete all the above mentioned tasks in a supernumerary position and cover all shifts in a 24 hour period.
To date we have trained 8 Super Coaches to provide in the moment support, audits, and training related to MSIP, VP & IPC.

Goal

Improve staff safety and morale by following interventions:

• Reduce staff MSI and violence related injuries with training, come along coaching, spot check audits with goal of reducing staff injures
• To complete hand hygiene audits with goal of reducing transmissible infections
• To complete unit workplace inspection to fulfill provincial WSBC requirements for JOHS committee and thru management/union collaboration and review of inspection and audits develop metrics for staff safety improvements.

What was Done and How?

Step 1

• Management selected Super Coaches based on criteria

   

Step 2 

• OH&S led 5 days of MSIP training workshop 
• OH&S led 3 days of Violence Prevention training
• IP&C led online training to perform hand hygiene audits on units 
• Regularly scheduled supernumerary shifts providing 24 hour coverage

Step 3

• Analysis on injury metrics to determine focused training (unit specific).

Step 4

• Administrative staff booked Super Coaches for shifts, coaches perform tasks based on goals set in monthly Super Coach meeting with the site manager and OH&S staff member.
• Analysis of audits and staff injury trends to determine effectiveness and future direction of focus of staff training.

Ongoing support

• SharePoint sites have been established specific for the coaches. This allows for effective communication and sharing between the mentors and trainers. SharePoint is a location for specific tools and resources for the Super Coach role
• Leadership support is essential for approval of the time spent in the coach role.
• OH&S can communicate and support the coaches both independently, and under the guidance of local leadership
• Routine Virtual check-ins with the coach groups are efficient and effective.

Education that is focused on prevention mitigates risks & injuries as staff awareness is increased. Coaching for these safety topics needs to be supported in practice through mentoring, debriefs, and a non-blaming culture.

Achieving staff buy-in was identified as a priority goal to strengthen the effectiveness of the Super Coach Program.

Selection criteria for Peer Coach/Super Coach training includes:

• Respected by peers
• Receives feedback willingly
• Relevant knowledge of the clinical area of work and site-specific practices
• Proven group facilitation skills

Coach training largely focuses on interpersonal skills, such as giving/receiving feedback and identifying the best moments for Peer Coach support.

Result of the Changes

Reduction in staff injuries:

Image

Image

Successes

• Reduced injury incidents
• Improved general staff morale-staff see improvements and programs based on their input

Challenges

• Coaches periodically pulled from coaching shifts due to short staffing
• Initial coach training is substantial

• The Super Coach model appears to be an appropriate model for health care teams in busy Acute and LTC where there are 24hr shifts and multi discipline teams working together.
• Smaller, specialized teams typically have Clinical Educator roles or similar which cover the staff safety training and support.
• Although MSIP Coaches, Violence Prevention facilitators and Hygiene Auditors exist in many Island Health Authority sites, it depends largely on management support and size of facility to support a Super Coach program.
• OH&S department will continue to monitor success of Summit Super Coach program before entertaining largescale implementation.

Lisa Diamond: Lisa.Diamond@islandhealth.ca

Peter Donohoe: Peter.Donohoe@islandhealth.ca 

Definitions:

• MSI - Musculoskeletal Injury
• MSIP - Musculoskeletal Injury Prevention
• HEU - Hospital Employees Union
• IH - Island Health Shared Services BC
• JOHS - Joint Occupational Health & Safety committee
• OH&S - Occupational Health & Safety dept
• IP&C - Infection Prevention Control
• VP - Violence Prevention
• Super Coaches - direct care employees selected by leadership using established selection criteria that undergo training by OH&S and Infection Prevention and Control staff to be peer mentors/coaches for safety in the areas of MSIP, Violence Prevention and Infection Prevention.