An Interview with Clemens Braun

By Jackie Gay

Clemens Brauns works for Vancouver Coastal Health as MSIP (Muscular-Skeletal Prevention) Advisor. I started by asking Clemens about the main focus of his job was and also how he came to be working in the field of Safe Patient Handling (SPH).

‘My job is to assist employees of the Health Authority access the help that they need to prevent injuries at work. It has been true for many years that the most common injuries in health care are to the back and shoulders.

‘I have a background in physiotherapy, so have hands-on experience of the day-to-day realities of moving and lifting patients. In fact it was when I was working at St Paul’s hospital in Vancouver that I first became involved with Muscular-Skeletal prevention, working as a part-time co-ordinator. But way back, before my professional training, I worked as a residential care aide in Sweden. There was very little equipment then, and it was very straining.

‘Even though I was young, I knew I would some day pay the price. It’s the accumulation of strain over the years, you see, that causes the damage.

‘That’s the biggest change I’ve seen over the years. When I first witnessed patient handling, staff were using manual techniques for all cases, from minimal to maximum assist. There were very few lifts available and of course patients have to be moved! Today, there is lots of equipment and almost all the organizations involved in patient care are pushing for minimal manual handling.

‘Initially my role involved developing policies and instigating education and training. Now that that work is basically completed, I help units get equipped properly – installing ceiling lifts for example, and promoting the concept of “non-manual” lifts.

I asked Clemens to outline the affect of these changes on the health care workers’ daily routine.

‘Say 15 years ago,’ he said. ‘Many staff would be manual lifting all day long – helping patients in and out of bed, in and out of wheelchairs, turning patients over in their beds. By the end of an 8-12 hour shift their shoulders and back would be achy and tired and they would be exhausted – if not injured.

‘Now the ideal is that unless a patient requires just a hand – for balance, maybe – then staff will use equipment to move them – on to a commode, for example; into a wheelchair and to and from the bath. They don’t have to wrestle with patients on their beds, they can lift them with one finger and the equipment.

‘Consequently they are less exhausted and with a much lower degree of fatigue. Staff have told me that the ceiling lifts are a “Godsend”. One lady said to me that she used to wonder how she’d be able to continue working until she was 65 – now that her workplace has safe handling equipment, she knows that she’ll be fine.

‘There was an interview on CBC recently with an employee in a care facility. She had suffered an injury and emphasized the different the installation of a ceiling lift made to her. “I’m confident I can continue in my work now,” she said.’

‘That’s the essence of my job. Preventing injuries and enabling people to both work and have a life after work – whether that be in the evening because they’re no longer so exhausted they just collapse; or when they retire after their service.

‘But there are other considerations as well. Health Authority staffing considerations can be severely affected by injury and sickness and there’s a huge financial element if staff have insurance or compensation claims.

‘I work on the “ethical” side of the coin but of course safe patient handling needs to make sense for everyone. Keeping people healthy and in their posts is the sustainable way forward.

My last question was about Best Practice in BC. Why is the province so far ahead of other parts of Canada and the World in Safe Patient Handling?

‘I think it was a fortunate “lucky constellation,”’ said Clemens. ‘Like other countries and provinces, Canada had a high rate of musculoskeletal injuries among healthcare workers and Worksafe BC (then called WCB) started pushing the Health Authorities to take action and implement effective injury prevention programs.

‘At the same time there was an increasing level of research indicating that there was no safe method to manually lift patients. Furthermore the evidence was that moving people in their beds – washing or toileting etc. – as well as transferring/lifting them in and out of the bed, caused the injuries. There had been ongoing training on how to lift people safely but this was having minimal results. The Unions and WorkSafe BC started to push for “no manual” lifting policies and the research showed that people needed tools for this. Training may prevent some injuries but the accumulation of stress is a big factor.

‘So BC leaped ahead by deciding to invest in ceiling lifts and equipment that enabled staff to reduce manual handing. Essentially there was a realization that when you’re dealing with ergonomics there are two types of “risk control.” Administrative control such as procedures and training work around the risk; whereas Engineering solutions eradicate the risk. Even if people lift perfectly every time – which is never going to happen in the real world – there are still forces acting on the body and the effect of these are cumulative over time.’

Health Service staff working more safely for longer with energy left over for their families and interests – that’s what I call a “lucky constellation.”!’

Thank you, Clemens

By Jackie Gay

Beckley Farm Lodge is a residential care home in Victoria BC, on Simcoe Street. It is run by Beckley Farm Lodge Society. In November 2011 they were the first facility in Victoria to install an Angelica tilting tub, for the use of the community. Patients who are having difficulties bathing in their home environment are referred to Melissa by their case managers, or individuals find out about the service through other information networks such as ‘Seniors Living Magazine’.

The Angelica Tilting Tub is manufactured BEKA-Hospitec, a German manufacturing company. Angel Accessibility Solutions recently became a shareholder in BEKA, mainly because of the high quality functional Products that they make.

The Angelica Tiliting Tub presents a new way of bathing people who have mobility difficulties. Patients can walk straight into the tub and sit down, or than can be transferred by sling or assisted into the tub by a health care worker. Once they are sitting, they are fully supported by the sides of the tub before it is tilted backwards to provide a comfortable and safe full bath.

I started the interview by asking Melissa what kinds of patients she works with.

‘There’s a big variety,’ she said. ‘I have some who’ve had hip replacements, and have problems both getting in and out of a normal tub and also twisting and turning once they’re in there. Then there’s people with mobility difficulties such as amputees; and I have one patient who with ALS who is completely immobile and unable to support himself at all.’

‘The Angelica Tiliting Tub is great because once people are in they are fully supported – for example my guy with ALS has no core muscle support but once he’s in the tub he can sit and stay supported. The Angelica sort of “hugs” people.’

‘This tub is much better than other ones I’ve used because once tilted back patients are completely covered in water – before they would still be sitting up so didn’t get the benefit of total immersion.’

‘I also really like the drainage channel – which I call the “hygiene hole” – because it allows people to wash all over without twisting or turning themselves and I can wash people fully without having to manipulate their limbs or move them at all.’

‘And everyone really likes the jets!’

‘Part of the problem with bathing people who are frail or have mobility problems is that they are frightened – naturally – of slipping, falling or getting stuck. The Angelica Tiliting Tub takes all these anxieties away. I had one lady who was terrified of water and would avoid washing because of this. But we get her lovely and clean now.’

Community referrals pay $5 per bath and get a 45 minute slot. ‘I have one lady who is 102,’ says Melissa. ‘She is awesome – she walks straight into the tub. A normal tub would be too low for her, and too slippery. The mental fear is a big issue and I make sure I establish a routine and reassure people that I can steady them if necessary.’

‘The biggest benefit is that this tub is not scary. You sit in it just like you do in a chair, and then you lie back and are totally covered with water. This is the only tub I’ve used where you can do that. It has holistic benefits rather than just being purely functional. The ladies, particularly, like to lie back, relax and have a chat. I know people enjoy it, even if they can’t speak I see their faces – one patient I have can’t talk but he has a huge smile on his face while in the tub. He has so much going on in his life but for 20 minutes he’s in a warm, comfortable, relaxed environment. And getting clean!’

Other benefits are that the tub only take 2-3 minutes to fill and 90 litres of water (other comparable tubs take 200 litres). So there are considerable cost savings over time. Plus the tub is better ergonomically for the caregiver because the patient is flat and so everything is reachable without bending.

‘With other tubs,’ says Melissa, ‘bathing is a chore for both patients and caregiver. It’s about getting washed and people don’t want to go through it. With the Angelica Tilting Tub it’s more of an experience. Patients keep their dignity and relax properly. My schedule is chocked full.’

No wonder! With Melissa’s professional competence, caring attitude and the unique features of the Angelica Tilting Tub, it can’t be long before the word spreads and bathing for seniors and people with mobility issues becomes about more than just getting clean.

Angel’s Management Team recently participated in a 2-day Strategic Planning Workshop hosted by Cathy McCullough from Gazelle Systems.

The purpose of this workshop was to help us shape the long-term future – not of mankind – but to guide our planning for the next 1-10 years.

It’s an interesting process once you get started.  You leave the every day details behind and delve into the heart and soul of the company: What makes us tick? What fuels us (and makes us combustible)? Why would people choose to deal with us?

Simple, on the surface, but we spent a considerable amount of time interrogating what might seem obvious, and it resulted in a clearer set of what are now our Guiding Principles.

I have never been comfortable with the term ‘Core Values’. They sound like something uttered in your final breath, or something so profound and otherworldly that casual discussion would somehow corrupt them.

So we decided that we would focus our plan around the much less ambiguous idea of Guiding Principles. These are principles that we adhere to as a Company and that we want all staff to understand and practice.

We weren’t starting from scratch – after all Angel has been in business for over 15 years now. We worked on identifying and clarifying what makes us the company we are and the qualities our staff should be prepared to sign up to.

The Guiding Principles are both principles we can hire too and an important way of expressing ourselves. They also act as checks and balances: if we cannot live up to these we had better find a way to improve or we face the same fate of any organization that is without fundamental precepts.

I am happy to communicate these Guiding Principles as evidence of our staff’s belief in what we do and commitment to doing it better.

We also want to share these values with our clients and the community to show the ways we would like to contribute and make a difference.

Guiding Principles

Angel….

Gives Exceptional….

• Value

• Service

• Support

Exceeds Expectations by Providing…

• Innovative Solutions

• Guaranteed Customer Satisfaction

Is Respectful of Everyone’s…

• Challenges

• Independence

• Dignity

Cheers,

George

All sports fans will know that the Olympic and Paralympic Games are to be held in London this year. All over the World and here in Canada our athletes are preparing for the biggest event of their careers – the ‘Big Dance’, as some have coined it.

Well, local sports fans and followers of this blog will be very pleased to hear that local sailors John McRoberts and Stacie Louttit have won their ticket to the dance!

John and Stacie, from Victoria BC, represented Canada in the 2008 Paralympics in China and came home with a Bronze medal in the Skud 18 sailing event.

Their qualifying event for London was the IFDS (International Federation for Disabled Sailing) World Championships held in Port Charlotte, Florida, this January.

In a week of tricky, highly competitive racing on the waters of Charlotte Harbor, John and Stacie beat their Canadian rivals in every race but one and were officially selected for the Games.

They then went on to sail in the Miami Olympic Class regatta for another week of glorious racing in beautiful Biscayne Bay, achieving fourth place against the top World teams of GBR, Australia and USA.

‘By the end of the month we were on top of our game,’ said John. ‘We were in the mix the whole time and led many races. So now we need to consolidate our tactics and decision making in preparation for September.’

The 2012 Paralympic Games take place from 29 August to 9^th September and the sailing competition will be in Weymouth, Dorset (not London!). The team has already raced twice at the venue and the Canadian Yachting Association has rented a house locally so that athletes can train and prepare effectively.

‘We feel at home there now,’ said John. ‘It’s great to be familiar with the venue and the conditions. We’re excited and very proud to be representing Canada again.’

If you would like to support John and Stacie’s efforts to bring home another medal then please visit their website www.teamucan2.ca

And there was another ‘family’ success down in Florida this January. Jackie McRoberts (John’s wife and the author of this blog) qualified for the Canadian Sailing Team in her single-handed 2.4mR keelboat ‘Ula’. She is more than excited to be able to continue her sailing career here in beautiful BC and proud to call Cadboro Bay her ‘office’!

Angel Accessibility Solutions is proud to be a sponsor for these terrific Canadian competitors.