title: A cost-benefit analysis of peer coaching for overhead lift use in the long-term care sector in Canada.
abstract: OBJECTIVE
  To evaluate whether a peer-coaching programme for patient lift use in British Columbia, Canada, was effective and cost-beneficial.
  
  
  METHODS
  We used monthly panel data from 15 long-term care facilities from 2004 to 2011 to estimate the number of patient-handling injuries averted by the peer-coaching programme using a generalised estimating equation model. Facilities that had not yet introduced the programme served as concurrent controls. Accepted lost-time claim counts related to patient handling were the outcome of interest with a denominator of full-time equivalents of nursing staff. A cost-benefit approach was used to estimate the net monetary gains at the system level.
  
  
  RESULTS
  The coaching programme was found to be associated with a reduction in the injury rate of 34% during the programme and 56% after the programme concluded with an estimated 62 lost-time injury claims averted. 2 other factors were associated with changes in injury rates: larger facilities had a lower injury rate, and the more care hours per bed the lower the injury rate. We calculated monetary benefits to the system of $748 431 and costs of $894 000 (both in 2006 Canadian dollars) with a benefit-to-cost ratio of 0.84. The benefit-to-cost ratio was -0.05 in the worst case scenario and 2.31 in the best case scenario. The largest cost item was peer coaches' time. A simulation of the programme continuing for 5 years with the same coaching intensity would result in a benefit-to-cost ratio of 0.63.
  
  
  CONCLUSIONS
  A peer-coaching programme to increase effective use of overhead lifts prevented additional patient-handling injuries but added modest incremental cost to the system.
authors.affiliation: Institute for Work & Health, Toronto, Ontario, Canada Department of Economics, McMaster University, Hamilton, Ontario, Canada Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Emile
authors.initials: E
authors.lastname: Tompa
authors.affiliation: Workers Compensation Research Institute, Cambridge, Massachusetts, USA.
authors.forename: Roman
authors.initials: R
authors.lastname: Dolinschi
authors.affiliation: Division of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, San Antonio, Texas, USA.
authors.forename: Hasanat
authors.initials: H
authors.lastname: Alamgir
authors.affiliation: Institute for Work & Health, Toronto, Ontario, Canada.
authors.forename: Anna
authors.initials: A
authors.lastname: Sarnocinska-Hart
authors.affiliation: Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Jaime
authors.initials: J
authors.lastname: Guzman
mesh_terms: D001955:British Columbia; D003362:Cost-Benefit Analysis; D006801:Humans; D017770:Lifting / Q000009:adverse effects*; D008134:Long-Term Care; D055805:Moving and Lifting Patients; D009735:Nursing Homes; D009740:Nursing Staff / Q000193:education*; D016273:Occupational Exposure / Q000009:adverse effects; D060051:Occupational Injuries / Q000517:prevention & control*; D010379:Peer Group; D015397:Program Evaluation; D013663:Teaching / Q000379:methods