appraisal, and compensation processes 3. Ergonomics in Practice case: Explain how Riverlea Rehab's administrators could use the four staffing processes discussed in this chapter to reduce staff injuries. enland 330 Integrative Case Studies CASE: ERGONOMICS IN PRACTICE Riverlea Rehabilitation Hospital's administrators had recently begun to notice high levels of absenteeism, workers' compensation claims, and time off from work associated with back and other injuries suffered by their workers. Staff were prone to injuries when patients lost their balance while being moved-especially when staff were required to use their own bodies to prevent patient falls. Patients, in turn, could be injured when staff were unable to secure the patients due to the overwhelming physical load or because of preexisting injuries or deficits in staff members' physical strength. Tim Montana, the administrative director, had heard that the new system of patient lifting devices planned for installation at Riverlca Hospital could effectively reduce both the number of workers' injuries and associated workers' compensation claims and absenteeism rates, but the new system was expensive. Montana believed the lift system's cost would be worth the benefits, but he wanted to make sure. The new lift system had been designed so that patients could be placed in a har ness and moved from a bed to a chair, the bathroom, or anywhere else in the room. It was meant to be used consistently, and consistent use was apparently associated with reduced risk of injury to both staff and patients. To prove that the new lift system helped address the problems associated with the musculoskeletal injuries reported by Riverlea nursing staff, Montana enlisted a team of researchers from the local school of public health. Montana wanted to be able to provide quantifiable evidence that the new system had made a positive impact at Riverlca. During Montana's meeting with the research team, Dr. Jason Terry, the lead envi- ronmental health services researcher, explained that the best approach to evaluating the impact of the lift system would be to undertake a longitudinal study of the health of Riv. erlea personnel. As Terry explained, the research team could first collect baseline informa- tion using existing injury data, then supplement these data by collecting new information about work practices, shifts, and musculoskeletal symptoms among the target workers. After installation of the new lift system hospital wide, the researchers could collect follow- up data to assess the system's efficacy. Montana convinced the rest of Riverlea's administrative team that a research study was justified, and approved the budget request to support the investigation. Baseline data were collected before the lift system was installed, and plans for the follow-up assessmen were made. However, Montana observed the implementation and initial use of the lift sy tem at Riverlea and was concerned about the process. He and his team had seen eviden that many staff members were using the devices incorrectly, were using them interm tently, or were not using them at all. Well aware that improper use of the system wou bias any research data collection process, Montana decided to ask the engineering depa ment to check whether the lift system was operating as planned. After a week of stu 331 Integrative Case Studies the engineering personnel reported to Montana that the lifts themselves were functioning system. After only a handful of conversations, Montana realized that there were plenty so that was not the problem. Montana next asked individual staff members for their opinions about the lift properly of opinions about the lift system, and most of these were negative. Staff appeared uncon- vinced about the value of the lift system, and instead were delighted to tell Montana stories about how they had managed to "work around" the system to lift their patients in the usual way." Montana still believed that the lift system could have a positive impact at Riverlea, but he knew that current use patterns were inconsistent and inappropriate. He knew he had to do something to intervene, but he didn't know where to start