HWPP Case Study: Preventing Back Injuries in a Community Hospital (pdf)
Population: Healthcare Workers
Problem: Injuries from Patient Handling


The Center for the Promotion of Health in the New England Workplace’s (CPH-NEW) Healthy Workplace Participatory Program (HWPP) is a toolkit to help employers implement a participatory Total Worker Health® program. The HWPP tools facilitate meaningful involvement of front-line workers in identifying and designing solutions to address root causes of workplace health, safety, and well-being concerns. This case study describes how HWPP tools were used by healthcare workers to strengthen injury prevention efforts throughout a community hospital and reduce injury claims.


Frisbie Memorial Hospital is an 84 bed community hospital in rural Rochester, NH. The care given at Frisbie focuses on three fundamental principles: people, technology, and trust. When employee injuries related to patient handling doubled from 2012-2013, it became a priority for Frisbie to make patient handling safer for its employees.

Making the Case

Drawn to its structured and participatory approach, a hospital employee health nurse manager decided to “pitch” the CPH-NEW Healthy Workplace Participatory Program (HWPP) to hospital management as a way to address patient handling injuries. During the pitch, she focused on patient handling injuries and workers’ comp claims to demonstrate the need for the HWPP. She was given the green light to conduct a pilot test of the program within the medical and surgical unit – the unit with the greatest increase in patient handling injuries.

Engaging Employees

In order to get the HWPP off the ground, a pre-existing hospital ergonomics committee served as the Design Team (DT). The DT created a survey and collected information directly from floor nurses and aides to find out why patient handling injuries were occurring. From the survey, key issues included:

  • Difficulty finding and using patient lift equipment
  • Inconsistent breaks
  • Poor sleep quality
  • Stress

Multi-faceted Intervention

The DT designed and proposed an intervention that addressed each of the key issues. The intervention included:

  • Adding two patient lifts
  • Improving sling storage
  • Enhancing training on the use of patient lifts
  • Training lift “super users” to serve as lift experts on each hospital unit
  • Establishing and protecting nurse break schedules
  • Providing stress management training

Initial Outcomes

Hospital leaders recommended that the DT begin with improving lift equipment and training. Although the pilot HWPP was intended to reduce employee injuries in the medical and surgical unit, the new storage systems and super user training extended hospital wide. When news of the improvements made within the pilot test spread, other units improved their sling storage and management. As a result, there were fewer injuries reported and decreased cost for injury claims.

HWPP Continues…

Based on the success of the HWPP pilot test, Frisbie hospital management has asked the DT to tackle other issues, such as stress and fatigue, staff assaults, and slips, trips, and falls.

True to its philosophy, Frisbie was able to engage people to identify needed improvements in hospital technology to create a better sense of trust among employees.

This program breathed new life into the Safety Committee and the Ergonomics Team.” -Janice Parker, MSN, APRN, FNP-BC, COHN-S, CEAS II, Employee Health Nurse Manager

Total Worker Health® is a registered trademark of the U.S. Department of Health and Human Services (HHS). Participation by the Center for the Promotion of Health in the New England Workplace (CPH-NEW) does not imply endorsement by HHS, the Centers for Disease Control and Prevention, or the National Institute for Occupational Safety and Health (NIOSH). CPH-NEW was supported by Grant Number 1 U19 OH008857 from the NIOSH.