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A cost-benefit analysis of peer coaching for overhead lift use in the long-term care sector in Canada
  1. Emile Tompa1,2,3,
  2. Roman Dolinschi4,
  3. Hasanat Alamgir5,
  4. Anna Sarnocinska-Hart1,
  5. Jaime Guzman6
  1. 1Institute for Work & Health, Toronto, Ontario, Canada
  2. 2Department of Economics, McMaster University, Hamilton, Ontario, Canada
  3. 3Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  4. 4Workers Compensation Research Institute, Cambridge, Massachusetts, USA
  5. 5Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, San Antonio, Texas, USA
  6. 6Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Emile Tompa, Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, Ontario, Canada M5G 2E9; etompa{at}iwh.on.ca

Abstract

Objectives To evaluate whether a peer-coaching programme for patient lift use in British Columbia, Canada, was effective and cost-beneficial.

Methods We used monthly panel data from 15 long-term care facilities from 2004 to 2011 to estimate the number of patient-handling injuries averted by the peer-coaching programme using a generalised estimating equation model. Facilities that had not yet introduced the programme served as concurrent controls. Accepted lost-time claim counts related to patient handling were the outcome of interest with a denominator of full-time equivalents of nursing staff. A cost-benefit approach was used to estimate the net monetary gains at the system level.

Results The coaching programme was found to be associated with a reduction in the injury rate of 34% during the programme and 56% after the programme concluded with an estimated 62 lost-time injury claims averted. 2 other factors were associated with changes in injury rates: larger facilities had a lower injury rate, and the more care hours per bed the lower the injury rate. We calculated monetary benefits to the system of $748 431 and costs of $894 000 (both in 2006 Canadian dollars) with a benefit-to-cost ratio of 0.84. The benefit-to-cost ratio was −0.05 in the worst case scenario and 2.31 in the best case scenario. The largest cost item was peer coaches’ time. A simulation of the programme continuing for 5 years with the same coaching intensity would result in a benefit-to-cost ratio of 0.63.

Conclusions A peer-coaching programme to increase effective use of overhead lifts prevented additional patient-handling injuries but added modest incremental cost to the system.

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