Table 3: Evidence summary - cost and SPH.

First author and year Summary of study Evidence
Brophy et al. 2001 [15] Assessment of a 5-step ergonomics programme in a 525-bed nursing home. Yearly cost associated with back MSDs decreased from $201,100 pre-intervention to $91,800 post- intervention. During the 5 years following implementation, it was calculated that $546,500 was saved, more than three times the expenditure for lifting and other equipment (a total of $163,910).
Li et al. 2004 [41] Effectiveness of mechanical patient lifts in a population of 36 workers at a community hospital via pre- and post-intervention survey. Adjusted lost day injury rates and annual workers’ compensation costs were decreased (from $484 to $151 per full-time equivalent post-intervention).
Chhokar et al. 2005 [45] Assessment of overhead lifts in an extended care facility, with analysis of injury trends over 3 years pre-intervention, and 3 years post-intervention. An estimated total saving of $1,257,605 was made over a 3-year post-intervention period (based on the presumption that claims costs would have continued to rise throughout this period). Even assuming that costs plateaued, the authors still calculate a saving of $412,754.
Nelson et al. 2006 [12] Implementation of an ergonomics programme in 23 high-risk units (N=875 nursing staff). Costs/savings were compared over a nine-month pre-intervention, and a nine-month post-intervention period. The initial cost investment for the equipment was calculated as being recovered in approximately 3.75 years. The cost of worker medical treatment decreased from $95,091 to $49,244, the cost of compensation decreased from $134,763 to an estimated $35,200, and the cost of lost personal day productivity decreased from $55,743 to $49,352. Total savings on overall injury costs were calculated to be $245,727.
Miller et al. 2005 [44] A pre- and post-intervention comparative study assessing the effectiveness of ceiling lift introduction on patient handling injuries. From the first two pre-intervention years to the end of the one-year intervention period, a 70% decrease in claims cost (a decrease of 18 days lost) was reported, compared with an increase of 241% in claims cost at the comparison facility (an increase of 499 days lost).
Charney et al. 2006 [51] Data was compared on patient handling injuries before and after implementation of a ‘zero-lift’ programme in 31 US hospitals (replacement of manual patient lifting, transferring and repositioning with mechanical lifting/other devices). Average total incurred losses per claim decreased from $6,510 to $4,991, following the implementation of a ‘zero-lift’ programme in 31 hospitals in the US.
Garg & Kapellusch 2012 [18] Long-term effects of ergonomic programme implementation with patient handling device installation in six long-term care facilities and one chronic care hospital, plus a control group. Injury data was collected for an average of 38.9 months pre-intervention and 51.2 months post-intervention. A mean saving of $71,822 per year in worker compensation costs related to patient-handling activities was reported, with a decrease in workers’ compensation costs of 90.6% (p<0.001).
Lipscomb et al. 2012 [57] An analysis of direct costs associated with compensation claims for MSD injury over a 13-year period. Policy change and cost of lifting equipment resulted in an immediate decline in mean costs per injury claim, and costs per full-time equivalent, with the proportion of claims resulting in paid lost time decreased from 12.5% pre-intervention, to 7.4% post-intervention.