Interview with Our Healthcare Ergonomists
We spoke with two of our healthcare ergonomists, Sacha Burn and Angela Spangler, to get their thoughts on the evolution of ergonomics in the medical setting, how workstation design impacts the health and well-being of a facility and the future of healthcare ergonomics. (Spoiler: Healthcare ergonomics will always be about the human body!) Read the following interview to learn more about this engaging topic.
Why is the healthcare setting considered to be the final frontier of ergonomics?
SB: If you think about the history of computer use, in all other work environments, such as manufacturing and office environments, people had to change the way they were working when computers were introduced. In the office, employees began to sit in static positions all day. A large body of research shows that static awkward postures have negative effects on the human body. As such, after computers were introduced there was a spike in musculoskeletal disorders and ergonomic-related challenges. In the 80s and 90s, ergonomists got involved and applied ergonomics to the complete design of workstations to make sure they fit the human body, were easy to use and reduced risk factors.
With the sharp influx of computers in healthcare environments today, we are starting to see the same challenges that were present in office environments. The caregiver population is used to working on paper-based documents and having more face-to-face interaction with patients. Now, they are being forced to use the computer for the majority of their shifts. The average age of the nurse is about 43 in the U.S. and these nurses who have been doing their jobs expertly on paper for years are now being forced to completely change their workflow and their body postures.
It’s our job as ergonomists to solve these issues in healthcare environments, as we’ve done in the office setting. Healthcare is the last environment where computers have been applied, which is why we call it “the final frontier.”
That’s a great response. The overall trajectory and evolution of the application of ergonomics in various environments is very fascinating. What are some of the issues caregivers face that can be mitigated through ergonomic design?
AS: A lot of this builds off how the caregiver interacts with technology, whether it’s at a charting station or nursing station or wherever the technology may be. Part of the issue is that no computer is a personal computer in the healthcare setting. They’re all shared devices. Caregivers are only approaching the workstations for moments at a time, hundreds of times per day. Nurses are using computers about six hours each day, but in four to five minute intervals. If the keyboard is not at an appropriate angle or the tools aren’t in a good configuration for their body, they don’t have time in those four to five minutes to figure out how to adjust the product, go through all the steps of adjusting it, input information and then leave it for the next person who walks up to it that will have to go through the same ordeal.
So, what are some suggestions that you would have in regard to designing a better workstation that would be more automatic and would instantly fit the majority of people who walk up to it?
AS: It’s important to realize the triggers in a workstation that could lead users to work in risky positions. Across both office and healthcare settings, our hands and eyes drive our posture. In designing a workstation where the hands are naturally going to fall to a correct negatively sloped angle, you’re eliminating a situation where users are typing on a keyboard that might be misadjusted. In focusing on what their eyes are doing, we find that having the adjustability in placement of the screen is essential. Basically, products that have “designed out” the ability to put anything in an incorrect position is something that can make them really easy to use and help ensure the safety of caregivers.
That brings me to my next topic. Tell me about the impact of workstation design on the well-being of the healthcare facility overall. It seems that the discomfort of the caregiver can potentially impact the health of an organization. Can you elaborate on this?
SB: Some of the challenges we deal with from an organizational perspective—when we’re making a business case for ergonomics—are that the organization sees an ergonomics program as a cost, rather than an investment. The facility doesn’t necessarily see the actually cost from having workstations that cause discomfort.
A workstation that is designed to force the caregiver to engage in awkward postures frequently can increase discomfort or work-related injuries. This is really prevalent at the moment. The American Nursing Association has reported that injured nurses contribute to about 1/3 of workers’ compensation costs in the U.S. When caregivers are uncomfortable at their workstations, it can lead to back pain and this has been shown as a risk factor for higher turnover. Thirty-three percent of nurses report leaving job because of the physical demands and 12% leave the nursing profession altogether from back pain.
If the caregiver has to turn his or her back on the patient to use the workstation, it’s much more likely that the patient will rate the satisfaction as low, as we know from research, which will affect HCAHPS scores and cause penalties for the healthcare facility. They could potentially receive fewer financial incentives because the patients are not having good experiences.
If we can design the workstations to accommodate as many caregivers as possible and ensure the caregivers are interacting with technology in a comfortable way, the organization is going to see a positive impact, not a negative one.
Here’s a pie in the sky question: What does the future of healthcare ergonomics look like to you? Looking at this landscape now, where can we go in the future to address potential issues and how do you see the evolution happening?
SB: Decades ago, we thought computers were going to solve all of our problems. But, now it’s 2014, and all we have is more problems from computers.
I think there is going to be a tipping point for us, from an ergonomics perspective. We’re trying to add more technology to the healthcare setting, but, at the end of the day, the most important part of healthcare is care: knowing that someone is empathizing with us and making eye contact. We can’t take the nurse or doctor totally out of the equation. Technology may be changing, but the human body is not. We need to design our technology to enhance the human capacity and improve both the work environment and patient outcomes. Essentially, we need to design for the human body.
AS: I agree with that. A lot of the future of healthcare ergonomics is really based on the future of technology and the environment. Maybe computers will change or we’ll transition to more personal devices and integrate more automation into care. Ergonomics is always going to be about making the work and the job more comfortable for the nurses and doctors, so, in the future of ergonomics, it is our job to make sure they’re comfortable in what they’re doing.
The future of healthcare ergonomics is always going to be about people.
Bios
SACHA BURN
Sacha Burn holds a master of science in ergonomics and biomechanics from New York University. Previously, she earned a bachelor of science in human factors and ergonomics from Cornell University. Sacha is based in New York City and is a member of the Human Factors and Ergonomics Society.
ANGELA SPANGLER
Angela Spangler holds a master of science in human factors and ergonomics from Cornell University and a bachelor of science in psychology from University of Idaho. Angela is a board-certified Associate Ergonomic Professional (AEP) based in New York City and a member of the Human Factors and Ergonomics Society.












