Loss aversion is the concept that losses are more psychologically impactful than gains. This is the most important idea in behavioral decision-making (1,2,3) and plays a huge role in healthcare.
Loss aversion can prevent organizations from making risk associated decisions to address complex challenges. Though avoiding risk is important, it might prevent the implementation of innovative solutions that could be perceived as riskier when additional investment is required (4). Consequently, the fear of further losses and additional spending can prevent decision makers from taking even well-calculated risks which carry a potential for worthwhile returns.
Healthcare organizations today deal with the crippling financial effects of clinical adversity in the form of hospital-acquired conditions (HACs). HACs are avoidable complications which contribute to over $2 billion in excess hospital costs annually, add an average of 8 days more length of stay (LOS) and increase patient mortality risk by 72% (5,6). Examples of HACs include such issues as patient falls, skin pressure injuries, and deleterious effects of patient immobility.
Leading with mobility as an intervention and creating more patient movement episodes is the remedy to significantly decrease, if not eliminate some of the impact of the more financially costly HACs (7,8,9). Achieving more movement, itself, comes with risks, as caregivers with a goal of preventing falls, struggle with weak and balance-compromised patients and thereby limit patients’ fall risks by undertaking fewer episodes of patient movement. Add to this the very real challenge of hospital staffing shortages that create overextended patient caregiver resources which make it difficult to accomplish all the intended goals for ideal care (13).
SPHM is Evidence Based Practice (EBP)
Evidence-based practices associated with safe patient handling and mobility combat the negative patient effects of HACs mentioned earlier, namely immobility, PIs, and falls.
Furthermore, SPHM programs have demonstrated success when they have been specifically designed to be part of an early mobility program (7,12).
Patient positioning devices and policies and procedures around use of mechanical lifting devices can reduce the risk of health-facility acquired pressure injury by up to 17% (11).
Achievable Goals
It is possible to realize 36% lower cost per claim for hospitals using the SPHM Interprofessional National Standards (14) and the indicated technology (10).
Furthermore, hospitals can expect to see up to 95% less injury incidence using the Interprofessional SPHM standards and the indicated technology (10).
It is an accepted standard of strategic risk control to implement use of patient lift and handling technology and the respective care task slings (15). Guldmann’s award winning GH3+ overhead lift system is integrated into thousands of hospital rooms throughout the world. Having the lift system at the point of care and ready for use, eases the caregivers’ burden to not have to retrieve the lift motor. When the lift is paired with bed care specific slings, such as the Tencel Repositioning sling (which is skin synergic) or Twin Turner sling, caregivers can easily and more efficiently with fewer persons reposition patients, perform turns for pressure relief, turn for hygiene or dressings, change linens and more (16).
To address the high injury costs from preventing falls, the same GH3+ lift system can be used to expunge caregiver injury when attempting to prevent a fall. The GH3+’s Trainer Module mode, when used for effective patient mobilization has a fall arrest feature which will stop a fall in progress without the caregiver bearing the entire physical burden of arresting the fall (17).
It is clear there are widespread missed opportunities to leverage mobility friendly SPHM technology solutions to avoid the financial losses associated with HACs and known negative outcomes as well as missed opportunities to more frequently and effectively provide mobility support for patients (8).
Proof Positive
The healthcare fiscal struggle is real, and it is clear that one important way to combat these fiscal woes is to defeat the epidemic of patient immobility. Strained resources and fears associated with patient falls and staff injuries fuel the epidemic. Are we using the technology we invest in to battle immobility? Are we ‘stuck’ thinking equipment has fixed uses and labels such as dependent and active? We need to unhook our biases from established ways and adopt new mindsets along with technology innovation which can tackle strained resources, falls, and staff injuries. When utilized, Guldmann solutions offer great results to lead a progressive mobility mission.
Guldmann’s ethos is ‘Time to Care’, which signifies that its solutions are conceived and designed to have meaningful life impact for patients and caregivers and ease the burdens associated with immobility for everyone (18).
Leading with a Progressive Mobility mission will avoid substantial healthcare annual losses, have a positive effect on the healthcare workforce, and achieve improved patient outcomes.
References
1. Kahneman, D. & Tversky, A. (1992). "Advances in prospect theory: Cumulative representation of uncertainty". Journal of Risk and Uncertainty. 5 (4): 297–323.
2. Kahneman, D. & Tversky, A. (1979). "Prospect Theory: An Analysis of Decision under Risk". Econometrica. 47 (4): 263–291.
3. Kőszegi, Botond; Rabin, Matthew (September 2007). "Reference-Dependent Risk Attitudes". American Economic Review. 97 (4): 1047–1073.
4. Loss Aversion, Explained, The Decision Lab, https://thedecisionlab.com/biases/loss-aversion, retrieved June 10, 2022
5. Hospital-Acquired Conditions lead to avoidable cost and excess death, IBM Watson Health, Hospital-Acquired Conditions Research Brief (ibm.com) 2018
6. Critical Care Statistics | SCCM https://www.sccm.org/Communications/Critical-Care-Statistics
7. Wyatt, S., et al Integrating Safe Patient Handling and Early Mobility: Combining Quality Initiatives, J Nurs Care Qual. Apr/Jun 2020;35(2):130-134
8. Kayser, S.A., Wiggermann, N.E. and Kumpar, D. Factors associated with safe patient handling practice in acute care and its relationship with patient mobilization: A cross-sectional study, International Journal of Nursing Studies 104 (2020) 1-8
9. Bouldin, E.D. et al, Falls Among Adult Patients Hospitalizes in the United States: Prevalence and Trends, J Patient Saf. 2013 March ; 9(1): 13–17.
10. 2018 Aon Health Care Workers Compensation Barometer https://asphp.org/health-care-workers-compensation-barometer-report/
11. Gibson, K., et al. Linking worker health and safety with patient outcomes. WorkSafe Victoria (WSV). The Institute of Safety, Compensation and Recovery Research (ISCRR) http://www.iscrr.com.au/__data/assets/pdf_file/0006/1321719/EvidenceReview_Linking-worker-health-and-safety-with-patient-outcomes.pdf 2017
12. Dennerlein et al, Lifting and exertion injuries decrease after implementation of an integrated hospital-wide safe patient handling and mobilisation programme
Occup. Environ. Med., 74 (5) (2017), pp. 336-343
13. AHA Letter Re: Challenges Facing America’s Health Care Workforce as the U.S. Enters Third Year of COVID-19 Pandemic, https://www.aha.org/lettercomment/2022-03-01-aha-provides-information-congress-re-challenges-facing-americas-health, March 2022, retrieved June 15, 2022
14. Safe Patient Handling and Mobility- Interprofessional National Standards Across the Care Continuum, 2nd Edition, 2021, American Nurses Association
15. The Facility Guidelines Institute, Patient Handling and Mobility Assessments, 2nd Edition, 2019, www.fgiguidelines.org
16. Guldmann Tencel Repositioning Sling https://www.guldmann.com/us/products/slings/turning-handling/repositioning-sling-tencel ; Guldmann Twin Turner Sling https://vimeo.com/user127483995
17. Guldmann GH3+ Trainer Module, https://www.guldmann.com/us/products/ceiling-lift-systems/lifting-motors/trainer-module-for-gh3plus
18. Guldmann Time to Care, https://www.guldmann.com/us/about/profile