Evaluation of the Minnesota Safe Patient Handling Act: trends in workers’ compensation indemnity claims in nursing home workers before and after enactment of the law

Abstract

ObjectivesThe 2007 Minnesota Safe Patient Handling Act aims to protect healthcare workers from injuries caused by lifting and transferring patients. The effectiveness of the law in nursing homes is unknown. This policy evaluation measured changes in patient handling injuries before and after the law was enacted. Additionally, it assessed whether effects of the law were modified by facility levels of staffing and retention.MethodsWorkers’ compensation indemnity claims for years 2005–2016 were matched to annual direct care productive hours and facility characteristics (eg, profit status, hospital affiliation and region) for all Medicaid-certified nursing homes in Minnesota. Trends in patient handling claims were analysed using negative binomial regression with generalised estimating equations. The primary predictors were time period, staff hours per resident day and staff retention.ResultsThe patient handling indemnity claim rate declined by 25% in years 4–6 and 38% in years 7–9 following enactment of the law. Claims for all other injuries and illnesses declined by 20% in years 7–9 only. Associations between time period and patient handling claims did not vary by levels of staffing or retention. However, independent of time, facilities with annual retention ≥75% (vs <65%) had a 17% lower patient handling claim rate.ConclusionsResults suggest the law reduced patient handling claims in nursing homes. However, claim rates were elevated in facilities with low worker retention and those that were non-profit, not hospital-affiliated or in a non-metro area. Facilities with these characteristics may benefit from targeted state grants and consultation efforts.

Differential effectiveness of the Minnesota Safe Patient Handling Act by health care setting: An exploratory study

“…Consistent with national data on musculoskeletal injuries, 7 16 Claims for all other injuries and illnesses declined by 20% in 2014-2016 only. However, the study was limited to nursing homes and excluded medical-only claims, which comprise approximately 77% of total claims in Minnesota.…”

“…In a pre‐post California study, hospital RNs experienced declines in self‐reported musculoskeletal symptoms but no change in injury incidence in 4 years following enactment of the 2012 Hospital Patient and Health Care Worker Injury Protection Act 14,15 . In Minnesota nursing homes, we found a 38% reduction in lost time workers’ compensation claims for injuries related to patient handling (vs. a 20% reduction in claims for all other injuries and illnesses) following enactment of the 2007 MN SPH Act 16 …”

“…Workers' compensation studies often exclude medical-only claims because many states only collect data on lost time claims. 8,12,16 In our study, medical-only claims comprised 85% of total claims. The inclusion of medical-only claims provides a more complete picture of the injury experience in Minnesota health care facilities.…”

“…Many studies have used a subset of injuries (e.g., back injuries) or pre-coded fields for injury nature, source, and event, such as those provided by the OIICS, to define patient handling injuries. 8,12,16 Our review of individual injury circumstances likely resulted in more accurate identification of patient handling injuries. This summary of injury trends in hospitals, nursing homes, and outpatient facilities enrolled with a single Minnesota insurer may be used to generate hypotheses for larger-scale safe patient handling studies.…”

“…14,15 In Minnesota nursing homes, we found a 38% reduction in lost time workers' compensation claims for injuries related to patient handling (vs. a 20% reduction in claims for all other injuries and illnesses) following enactment of the 2007 MN SPH Act. 16 To our knowledge, no study has compared worker and patient handling injury characteristics or evaluated time trends in patient handling injuries by health care setting among facilities required to comply with a state SPH law. Additionally, the duration of existing evaluations may be inadequate to capture the full impacts of the laws because facilities are often given several years to establish their SPH programs and come into compliance.…”