The Economics of Ergonomics: Why We Cant Afford Poor Workspaces

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If the goal of ergonomics is to boost productivity and increase comfort while reducing workplace injuries and errors, never before has ergonomic furniture been a more necessary fixture—and economical necessity—than in today’s radiology environment.

In a profession that demands long hours, most often sitting at a workstation or computer desktop, being uncomfortable or in pain is a distraction and detracts from the efficiency of a radiologist’s workflow. Ultimately, this impacts a facility or practice’s bottom line. Radiology en masse has embraced ergonomic and functional furniture—adding more comfort and convenience in reading rooms across the United States, spurred by an increase in exam volume despite a plateau in workforce levels.

However, in light of the U.S. recessionary economic climate and the pressure to pinch pennies, how can a practice looking to minimize expenses rationalize the purchase of ergonomic furniture or workstations? Perhaps, as suggested in a 2003 study in Occupational Health & Safety, the question should not be how to pay for an improved office environment, but instead can institutions afford to continue paying for a poor work environment.

Making the business case in troubling times

The case for ergonomic furniture is compelling, due to the broad spectrum of workplace injuries related to video display terminals and computer desktop usage, such as computer vision syndrome and a host of musculoskeletal complaints, according to Nogah Haramati, MD, chief of radiology, professor of clinical radiology & surgery at Albert Einstein College of Medicine, a division of Montefiore Medical Center.

Haramati collaborates on workstation prototypes with AFC Industries, which Montefiore uses throughout its 14 reading rooms. (All intellectual property developed from the collaboration is AFC’s, with no financial ties between Montefiore, Haramati and AFC.)

“In the days that the economy was economically robust, there was sufficient cash within businesses and industries to support a $1,000 investment to improve your worker and get $3,000 benefit in a year, along with decreased absenteeism and decreased workers’ comp,” says Haramati. “If you did a hard analysis within specific subgroups of the working population, ergnomics made sense but it wouldn’t be across the board for every worker.”

What’s changed in today’s economically constrained times? The skill level of the work force. For more highly trained workers, such as radiologists and ultrasound technologists, ergonomics becomes a serious issue, especially as many institutions operate in “raw survival mode.” With little to no money to invest in capital expenses that are long-term views, making the argument for ergonomic furniture is now a harder one to sell.

“This really means that the bar for the next few years—or as long as this depression/recession lasts—needs to slide up a little. The economic crunch simply tightens and narrows the subgroup to the more experienced workers, the ones in which you have invested a lot of training and the ones who will be expensive to replace,” he adds.

This subgroup of experienced workers for which the bar needs to be raised includes upper-tier physicians such as radiologists, non-invasive cardiologists, as well as imaging technologists, particularly for ultrasound or echo work. That same logic applies to other medical professionals such as cytologists, who are at risk for workplace injuries due to the tedious nature of their work. For these subgroups, the work environment, by its very nature, is a dangerous and most often, non-ergonomic one.

“The musculoskeletal stress is high in those groups and even in an economic crisis, it is still worthwhile to keep those workers productive,” Haramati says. “If anyone of them benefits by doing one extra case a week due to an ergonomic environment, then the institution is ahead financially.”

Realizing an ergonomic ROI

At St. Joseph’s Hospital in Atlanta, radiologists are clearly seeing the benefits of an ergonomic redesign implemented four years ago within the hospital’s radiology reading room. At that time, the tertiary care community hospital switched to PACS (Philips iSite) and also restructured its reading room from a mass of cubicles to a state-of-the-art reading environment with height-adjustable Carl’s Table workstations from Anthro.

In an environment where 14 radiologists share offices, dealing with individual furniture preferences, neck injuries or even slipped discs, administrators were looking for a way to provide maximum flexibility with adjustability, according to Medical Director of Radiology Henry Krebs.

“For me, as a radiologist, anything that lessens repetitive stress injuries and puts you in a more ergonomically friendly position, is critical,” Krebs says. “You really do need the equipment to adapt to you and what your individual needs are rather than having a user have to adapt to the workstation.”

Originally, Krebs says they considered simply installing height-adjustable built-in shelving, but nixed that idea when they realized the cost for the shelves alone would be approximately $3,000 to $4,000 per installation. Instead, the department installed 12 Carl’s Tables (and got a volume discount).

“It’s completely adjustable to individual radiologist’s wants and desires, allowing them to be comfortable and productive, no matter what their preferences are,” Krebs says, adding that since the installation, productivity has gone up about 20 to 25 percent.

The biggest advantage of using the Carl’s Table, aside from the productivity gains, Kreb says, is the lack of complaints about the uncomfortable nature of their working environment. “I call it the refrigerator, it just runs. I don’t have to think about it, worry about it, you just sit down and go to work—it’s basically invisible,” Kreb says.




Should I buy now?

For radiology departments and facilities considering whether a broad ergonomic deployment is a sound investment, or simply questioning where to get started, Haramati suggests performing a critical assessment of the current situation in your reading environment and Krebs concurs. “You have to look at the economics of who is paying for new furniture,” Krebs notes. “Ultimately, if I am getting more hours out of each radiologist, that is fewer rads that I will have to hire. But for a hospital that makes purchasing decisions for its radiology group, the only thing you can use as leverage is that the more comfortable they are, the more productive they can be.”

With a non-biased review of how workers are functioning in the current state of environment, you can gain insight into the spectrum of worker needs. Examine subgroups who have specific issues such as repetitive stress injuries, back problems or vision problems that ergonomic furniture could help ease or alleviate. Once that population is identified, it is up to the institution to consider the impact of having this group continue working under those conditions, as well as the economic impact on the workplace environment.

For practices and departments looking to minimize expenditures, one approach is to consider which people are high-risk and more symptomatic today and make an entry-level investment in ergonomic furniture, and leave the rest as is.

“In the short-term, it costs less than you believe when you do a careful analysis and for the long-term, if you have one very experienced worker who drops out because of workplace injury, especially in organizations that don’t have huge numbers of people in that specialty, doing a financial analysis in retrospect, usually turns out that the organization would have been better off economically if they had accommodated its workers’ ergonomic needs instead of ignoring them,” Haramati concludes.