Podcast appearances and mentions of tom waters

It's been two months since the government first announced its plans to enact the largest welfare reforms for a generation, aiming 'to help sick and disabled people who can and have the potential to work into jobs'. Since then, there has been considerable debate about the consequences of these reforms. But why does the government want to implement reforms in the first place? How does the current system work? And what could the impact be for those receiving these benefits?In this episode, Helen is joined by Tom Waters, Associate Director at IFS, and David Finch, Assistant Director at the Health Foundation, to unpack the government's proposals and explore what they mean for the future of health-related benefits.Become a member: https://ifs.org.uk/individual-membershipFind out more: https://ifs.org.uk/podcasts-explainers-and-calculators/podcasts Hosted on Acast. See acast.com/privacy for more information.

This week, we look at the Spring Statement. What were the decisions and trade-offs made by Chancellor Reeves? To pick this apart, IFS Director Paul Johnson is joined by IFS Associate Directors Ben Zaranko and Tom Waters.Become a member: https://ifs.org.uk/individual-membershipFind out more: https://ifs.org.uk/podcasts-explainers-and-calculators/podcasts Hosted on Acast. See acast.com/privacy for more information.

RUGBY: Garbally College manager Tom Waters with Galway Bay FM's Kevin Egan after their 29-10 Connacht Schools Senior A defeat to Sligo Grammar

Sign up to our live event: https://ifs.org.uk/events/ifs-zooms-live-how-make-your-first-budget-successCurrently, around 4.3 million children - that's around 30% of all kids - are living in relative poverty. Since 2010 that figure has risen by over 700,000 and the new government has made tackling child poverty one of its key policy objectives, with a cross-government strategy due to be published in 2025. In today's episode, we'll explore the factors contributing to this increase in child poverty, including changes to the benefits system, housing challenges, and the broader economic context. We'll look at the long-run impacts that child poverty has and examine the potential policy options available to reduce child poverty.To do that, Carl is joined by Tom Waters and Christine Farquharson.Become a member: https://ifs.org.uk/individual-membershipFind out more: https://ifs.org.uk/podcasts-explainers-and-calculators/podcasts Hosted on Acast. See acast.com/privacy for more information.

In this episode of the Nine Finger Chronicles podcast, host Dan Johnson is joined by Tom Waters to discuss Tom's recent Kentucky Velvet Buck hunt. They start by reminiscing about the music they listened to growing up, including classic rock, country, and rap. Then, they dive into the details of Tom's hunt, including how he discovered the buck and his baiting strategy. Tom explains that he had been scouting the area for years but only saw the buck for the first time this summer. He also shares his feeder schedule and how he uses it to slow down the deer movement. The conversation concludes with a discussion about the buck's movement patterns and Tom's setup distance from the feeder. Tom Waters shares his experience of harvesting a velvet buck on his property. He explains that he was hunting from a blind near a feeder when the buck showed up. Tom discusses how the deer behavior changes when they shed their velvet and become more aware. He also talks about the deer population in his area, the influence of agriculture on deer movement, and the low hunting pressure on his property. Tom shares his shot placement and tracking experience, as well as his choice of broadheads. He mentions his plans to hunt on public land and donate deer to Kentucky Hunters for the Hungry. Takeaways: Music preferences can change over time and be influenced by personal experiences and exposure to different genres. Baiting can be an effective strategy for attracting deer, but its effectiveness may vary depending on the availability of natural food sources. Feeder schedules can be adjusted based on hunting regulations and the deer's feeding patterns. Understanding deer movement patterns and setting up at an appropriate distance from the feeder can increase the chances of a successful hunt. Deer behavior changes when they shed their velvet and become more aware. Agriculture, such as beans and corn, influences deer movement more than acorns or bait. Low hunting pressure on Tom's property allows for successful hunting. Tracking deer in tall grass or CRP can be challenging. Tom prefers using Rage Hypodermic broadheads. Tom plans to hunt on public land and donate deer to Kentucky Hunters for the Hungry. Learn more about your ad choices. Visit megaphone.fm/adchoices

In this episode of the Nine Finger Chronicles podcast, host Dan Johnson is joined by Tom Waters to discuss Tom's recent Kentucky Velvet Buck hunt. They start by reminiscing about the music they listened to growing up, including classic rock, country, and rap. Then, they dive into the details of Tom's hunt, including how he discovered the buck and his baiting strategy. Tom explains that he had been scouting the area for years but only saw the buck for the first time this summer. He also shares his feeder schedule and how he uses it to slow down the deer movement. The conversation concludes with a discussion about the buck's movement patterns and Tom's setup distance from the feeder. Tom Waters shares his experience of harvesting a velvet buck on his property. He explains that he was hunting from a blind near a feeder when the buck showed up. Tom discusses how the deer behavior changes when they shed their velvet and become more aware. He also talks about the deer population in his area, the influence of agriculture on deer movement, and the low hunting pressure on his property. Tom shares his shot placement and tracking experience, as well as his choice of broadheads. He mentions his plans to hunt on public land and donate deer to Kentucky Hunters for the Hungry. Takeaways: Music preferences can change over time and be influenced by personal experiences and exposure to different genres. Baiting can be an effective strategy for attracting deer, but its effectiveness may vary depending on the availability of natural food sources. Feeder schedules can be adjusted based on hunting regulations and the deer's feeding patterns. Understanding deer movement patterns and setting up at an appropriate distance from the feeder can increase the chances of a successful hunt. Deer behavior changes when they shed their velvet and become more aware. Agriculture, such as beans and corn, influences deer movement more than acorns or bait. Low hunting pressure on Tom's property allows for successful hunting. Tracking deer in tall grass or CRP can be challenging. Tom prefers using Rage Hypodermic broadheads. Tom plans to hunt on public land and donate deer to Kentucky Hunters for the Hungry. Learn more about your ad choices. Visit megaphone.fm/adchoices

We're looking at the benefits system and answering the questions likely being asked by government ministers: how can the rising costs of benefits be managed, and what changes could improve the system?With disability and incapacity benefit caseloads rising and the Universal Credit rollout still ongoing, what options does the government have to address these challenges? How might frozen housing support and past cuts to working-age benefits be impacting the most vulnerable? Should the government abolish the two-child limit?To tackle these questions, Paul is joined by Tom Waters and Carl Emmerson from the IFS.Become a member: https://ifs.org.uk/individual-membershipFind out more: https://ifs.org.uk/podcasts-explainers-and-calculators/podcasts Hosted on Acast. See acast.com/privacy for more information.

Hundreds of doctors - led by campaign group Long Covid Doctors for Action - are planning to sue the NHS over claims that inadequate PPE provision has left them with Long Covid, according to Sky News. One of those, Dr Nathalie MacDermott, joins Emma Barnett to discuss it. Emma is joined by the rapper Princess Superstar who, after a 30-year career, has finally hit the big time following her song, Perfect, featuring on the soundtrack for the blockbuster film Saltburn. Ahead of Holocaust Memorial Day, we speak to three Jewish women - one, a survivor who was born in a concentration camp - about how you keep teaching the lessons of the Holocaust as fewer and fewer survivors are around to tell their stories. The Chancellor Jeremy Hunt is facing pressure to fix "unfair" child benefit rules. Campaigners like Martin Lewis have called for it to be a focus of the Budget in March as he says single income families are being penalised. Emma talks to the chair of the Treasury Select Committee, the Conservative MP Harriet Baldwin, and Tom Waters from the Institute for Fiscal Studies.Presenter: Emma Barnett Producer: Emma Pearce

This week, the Chancellor delivered his Autumn Statement. After weeks of speculation about headroom, tax cuts and pre-election giveaways, the dye is cast and the policies are in.What was in it? What will the impact of his announcements be? And how sensible were the policies announced?Joining us today are Helen Miller, Head of Tax at IFS, Ben Zaranko, Senior Research economist and Tom Waters, Senior Research economist at IFS.Find out more: https://ifs.org.uk/Become a member: https://ifs.org.uk/individual-membership Hosted on Acast. See acast.com/privacy for more information.

Heat and dehydration go hand in hand. Emergency Department physician Dr. Tom Waters stresses how important it is to pay attention to your body on hot days, especially if you are being active.

To many, the start of the new tax year in April will seem quiet, more of the same with no big changes to the tax system announced by the government.But hidden beneath the surface lie a series of stealthy tax rises - freezes to thresholds which coupled with rising inflation are projected to raise around £30 billion for the Treasury over the next few years and hit household finances hard.Here to reveal the truth are Helen Miller, Head of Tax at IFS, and Tom Waters, Associate Director at IFS. Hosted on Acast. See acast.com/privacy for more information.

Invertebrate conservation charity Buglife is thrilled to announce that two new populations of one of Britian's rarest beetles have been discovered in Devon. The rare Blue Ground Beetle (Carabus intricatus) has been found at two new sites on Dartmoor – thanks to the efforts of Buglife staff, volunteers, and local naturalists. Laura Larkin, Buglife Conservation Officer shared “Previously, the Blue Ground Beetle was only known from 13 sites in Devon, Cornwall and South Wales, so these new sightings are really significant, and they show how much we still have to learn about this magnificent beetle!” Blue Ground Beetle, rare beetle discovered on Dartmoor Up to 38mm in length, the Blue Ground Beetle is the UK's largest ground beetle. Given its name as a result of the beautifully marked and strikingly blue-coloured wing cases, the Blue Ground Beetle makes its home in damp, deciduous, often ancient, woodlands of Oak and Beech. Both the adults and their larvae feed on slugs; upon finding their prey, the beetle will bite with its large jaws and inject digestive juices into the slug, eating it by sucking out its insides. Blue Ground Beetles are mainly nocturnal and can be found all through the year, although they are most active and easiest to see from March to June, when adult beetles can be found clambering up mossy tree trunks under cover of darkness, in search of prey. Blue Ground Beetles can be easily confused with some of their smaller, more commonly seen relatives including the Violet Ground Beetle (Carabus violaceus); these beetles can be found throughout the UK, are smaller in size and more purple in their colouring. It would be highly unlikely to find a Blue Ground Beetle outside of its known range. Buglife's Dartmoor Blue Ground Beetle project was established to survey Dartmoor woods; seeking undiscovered populations of the Blue Ground Beetle. Working with local volunteers and naturalist John Walters, the project team have spent many damp torchlit nights searching for the beetle. The hard work and late nights have been rewarded with the addition of two new Blue Ground Beetle sites on Dartmoor during 2022. Claire Hyne, from Papillon Gin who have funded the project said: “We are delighted to be able to provide funding for this important project on Dartmoor. It is very exciting that two new sites have been found this year. Great work from the Buglife team and volunteers”. Richard Knott, Dartmoor National Park Authority's Ecologist, said: “Dartmoor is of national importance for the Blue Ground Beetle, Britain's largest and rarest beetle, and the combination of ancient valley woodlands and humid climate create the perfect conditions for slugs, which adults and larvae feed on. The discovery of these new sites is very exciting and indicates that Dartmoor habitats remain favourable for this rare and fascinating species. There has been further excitement following a member of the public finding a deceased beetle whilst out walking near Bodmin Moor in Cornwall. Tom Waters, who discovered the beetle said “‘I was genuinely thrilled to discover the Blue Ground Beetle in what is one of my favourite spots, and also very proud to be able to provide a new record for the beetle in Cornwall.” Laura Larkin added “These new Blue Ground Beetle records are really exciting. To find two additional sites on Dartmoor and realise that a third site in Cornwall is much larger than we originally thought are very significant for this very rare species. The fact that we now know of 15 UK sites is an incredible boost for these magnificent beetles, and there is still more work to do.” If you're interested in learning more about Buglife's Dartmoor Blue Ground Beetle Project and would like to get involved please visit Dartmoor Blue Ground Beetle Project – Buglife projects Buglife is the only organisation in Europe devoted to the conservation of all invertebrates our aim is to halt the extinction of invertebrate species and to achieve sustainable populations of...

In recent weeks, the new Prime Minister has argued that the UK has been too focused on redistribution.But what role does the benefit system play in redistribution? Has this changed over recent decades? And should benefits be uprated in line with inflation?Joining us are Charlotte Pickles, Director of Reform, and Tom Waters, IFS Senior Economist.Find out more: https://www.ifs.org.uk/podcastBecome a member: https://ifs.org.uk/individual-membership Hosted on Acast. See acast.com/privacy for more information.

The current economic environment is shaped by inflation and a rising cost of living crisis. During this period of uncertainty, the Chancellor gave his Spring Statement, outlining his plans for the public finances and responding to the shocks facing the economy.In this episode, Paul speaks with Carl Emmerson, Deputy Director at IFS and Tom Waters, IFS research economist, about the Chancellor's statement and the implications going forward.Become a member: https://ifs.org.uk/donate See acast.com/privacy for privacy and opt-out information.

In this episode we are showcasing the Middle East District with Colonel Phillip Secrist III, District Commander for the Middle East District, and Mr. Tom Waters, Director of Programs for the Middle East District. Tune into this episode to learn about the Middle East District's mission and how they help USACE Build Strong!

On this episode of the Nine Finger Chronicles, Dan talks with Tom Waters of Kentucky about drawing an elk tag in his home state as well as the famous Iowa archery tag in the same year.  Tom knew that coming in to the 2021 season he was going to be busy. Aside from the Kentucky and Iowa tags he also had an annual trip to Texas on his schedule and of course his Kentucky deer tags.  Tom explains a little history of  the KY elk  lottery and how he has already drawn the tag once before in 2014  and found success. Then  Tom breaks down his process for how he was going to approach hunting in Iowa. He had thought about hunting public land and even knocking on doors to gain access, but because of a crazy schedule decided to use and outfitter. Tom talks about the process he used to choose and outfitter and shares this experience while on the 5 day hunt. This is a very interesting and informative episode you'll enjoy. Nine Finger Chronicles is Powered by Simplecast

On this episode of the Nine Finger Chronicles, Dan talks with Tom Waters of Kentucky about drawing an elk tag in his home state as well as the famous Iowa archery tag in the same year.  Tom knew that coming in to the 2021 season he was going to be busy. Aside from the Kentucky and Iowa tags he also had an annual trip to Texas on his schedule and of course his Kentucky deer tags.  Tom explains a little history of  the KY elk  lottery and how he has already drawn the tag once before in 2014  and found success. Then  Tom breaks down his process for how he was going to approach hunting in Iowa. He had thought about hunting public land and even knocking on doors to gain access, but because of a crazy schedule decided to use and outfitter. Tom talks about the process he used to choose and outfitter and shares this experience while on the 5 day hunt. This is a very interesting and informative episode you'll enjoy. Nine Finger Chronicles is Powered by Simplecast

Andrew Pierce speaks to royal commentator and former editor of International Who's Who Richard Fitzwilliams on Prince Harry's claim that the word ‘Megxit' is misogynistic, and speaks to Tom Waters of the Institute for Fiscal Studies on how people earning £50,000 a year can now claim Universal Credit. Plus, Guy Adams on the breathtaking amount Sir Geoffrey Cox earns every minute in his second job. See omnystudio.com/listener for privacy information.

At the start of the first pandemic lockdown the government announced a £20 uplift for those receiving Universal Credit, the benefit designed to help those of working age with their living costs. It made clear at the time that the extra money was temporary and, in the coming weeks, payments will start to be reduced. But is a cliff-edge drop in the income of more than two-and-a-half million families the right step to be taking? And how best are the UK's poorest to be supported with the country still recovering from the pandemic?David Aaronovitch and his guests evaluate how well Universal Credit has been helping those in and out of work and what the uplift has achieved for families and single person households. Is giving more money to claimants the most effective way of helping them in the post-pandemic economy? Or, with prices rising for household essentials, should the government now be thinking about other measures to help those struggling to make ends meet?How do we help the least well-off while being fair to taxpayers and not subsidising employers paying low wages?Those taking part (in order of appearance): Fran Bennett of the Department for Social Policy & Intervention at Oxford University; Tom Waters, Senior Research Economist at the Institute for Fiscal Studies; Gemma Tetlow, Chief Economist at the Institute for Government; and Deven Ghelani, founder of the social policy business, Policy in Practice.Producers Simon Coates, Jim Booth and Kirsteen Knight Editor Jasper Corbett

A sermon on Romans 12:9-13 by deacon Tom Waters, preached on Sunday 7th February 2021.

Universal Credit is a benefit for working-age people, which combines six existing benefits payments into one payment. Launched in 2013, there are now about 5 million households claiming Universal Credit in the UK. What was the thinking behind this new policy? Has it been successful? And how has COVID affected the trajectory of Universal Credit?This week, Paul speaks with Charlotte Pickles, Director of Reform and a member of the Social Security Advisory Committee, and Tom Waters, Senior Research Economist at IFS and expert on benefits. Support the IFS: https://www.ifs.org.uk/about/membership/individual See acast.com/privacy for privacy and opt-out information.

If there is one thing that you can take a away from the last couple of Nine Finger Chronicles episodes, it's that persistency kills deer. And today's episode is no different. On this episode, Dan is joined by Tom Waters of Kentucky to talk about his season of close calls that led to his success. The guys discuss 3 different times that Tom got busted or messed up resulting in a blow opportunity. Finally, in December, Tom had one final opportunity where he was able to use all of the information from his previous encounters to help put him in the right position for the perfect shot. Nine Finger Chronicles is Powered by Simplecast

If there is one thing that you can take a away from the last couple of Nine Finger Chronicles episodes, it's that persistency kills deer. And today's episode is no different. On this episode, Dan is joined by Tom Waters of Kentucky to talk about his season of close calls that led to his success. The guys discuss 3 different times that Tom got busted or messed up resulting in a blow opportunity. Finally, in December, Tom had one final opportunity where he was able to use all of the information from his previous encounters to help put him in the right position for the perfect shot. Nine Finger Chronicles is Powered by Simplecast

It is serious work, physically demanding, and can put nurses, caregivers, and their patients at risk of serious injury. Assisting and moving patients happens hundreds if not thousands of times a day in each care facility or home depending on its size and capacity. No matter if you are recovering from day surgery or in hospice, This close quarters caregiving is essential to the recovery path for any patient. And it’s these movements that are putting caregivers and their patients at risk.  This is Peter Koch, host of the MEMIC Safety Experts Podcast and in this episode I speak with Lauren Caulfield, Director of the Atlantic Region Loss Control here at MEMIC about the Patient Handling Problem, it’s effect on providers and patients and how the MEMIC Safe Patient Handling Program is helping care facilities reduce the number of provider and patient injuries as well as increase the quality of care delivered.   Peter Koch: Hello, listeners, and welcome to the MEMIC Safety Experts Podcast. I'm your host, Peter Koch. So imagine for just a moment, if you can, that you're walking with your elderly grandmother or grandfather down the hall back to the kitchen table, or you're with a friend recovering from a medical procedure that's left them weakened, somewhat frail, or you're guiding a patient back to their room and then they stumble and fall. What do you do? Well, you go to help them get up because I don't know. That's what I would do. Or you try to help keep them from falling in the first place, because that's just the natural reaction. It's what we do. It could even be a compulsion to help others, especially when their loved ones or if it's your job. And so therein lies the problem that we're going to talk about today. It is the patient handling dilemma. We are compelled sometimes to help people. And when we go [00:01:00] to help them, when we try to lift them up or move them, we put ourselves at risk of injury. And there are statistics out there that show health care workers, that's the number one cause of injury for many health care workers, is patient handling when they try to move a patient either from the floor or across the bed. And it's a big challenge. Well, today, I have the pleasure of speaking with Lauren Caulfield, the director of the Atlantic region. Lost control here at MEMIC. Lauren has extensive experience within the health care industry before coming to MEMIC. We used to work with large accounts, both managing self-insured groups and providing lost control services once an injury has occurred. Lauren has been with MEMIC for more than 15 years, using her expertise to help our MEMIC health care accounts realize that patient handling injuries as a loss leader is a solvable problem. And then helping them to implement workable solutions. So, Lauren, welcome to the [00:02:00] podcast today. Lauren Caulfield: Thank you, Peter. I'm so happy to be here. Peter Koch: Very excited and great to have you on the line here today. So patient handling injuries is a real challenge within the health care world. Talk to me a little bit about the extent of the problem. How pervasive are they really and what's the cost? Lauren Caulfield: Well, as I look at the injuries that come through the door at MEMIC for our health care clients, it's no secret that overexertion injuries are definitely on the rise with our nursing employees. And I think part of that problem is that patients are getting bigger. They are harder to handle for sure. And what's also interesting is the patient acuity is higher. So what I mean by that is people that used to be in the ICU use are now on the med surge units. So if [00:03:00] you take that patient size issue, you take the patient acuity issue and then mix that in with a chronic problem with our health care clients. And that is that they're often short staffed. A lot of nurses are leaving the industry because of different types of overexertion injuries. And it's really a challenge for a lot of our clients. So as we look at that, you know, I was looking the other day at the most recent Bureau of Labor Statistics data. And what I found really interesting is they were looking at the overexertion injuries across all industries. OK. So we look at that rate and that rate for these overexertion injuries is 33 per 10000 full time workers. So I said, okay, let's take a look specifically at [00:04:00] our health care industry and how does that compare? And I was really kind of shocked when I saw really that the rate of overexertion injuries for hospitals being twice that average. Peter Koch: You're kidding. Twice the average? Lauren Caulfield: No, twice say the average. The rate was 68 per ten thousand full time employees. And then we all know that, you know, a lot of times the nursing homes and the long term care folks, they're getting injured at higher rates as well. So I went one step further and that, you know, I found out that it was three times the average or 107 per 10000 full time workers. Peter Koch: And that's for which group within health care? The hundred and seven? Lauren Caulfield: That is for our nursing homes. Peter Koch: For the nursing home. So, yeah, general health care was 68 per 10000 full time workers. And when you looked at nursing home, so like your long term care facilities, there was one hundred [00:05:00] and seven per 10000 workers. Yeah. Yeah. More than three times. Lauren Caulfield: Right. Right. So that's 68 per 10000 worth for your hospitals. So they are twice the average. And then our nursing homes are three times the average. And if you look at the data as well. We all think that, you know, our truckers and our roofers and our construction folks are the most hazardous. But one of the things that comes to light is health care is one of the top high risk industries. As you look at these musculoskeletal disorders, so they're at the height. And we have some statistics internally. And I think people would be surprised to see that one back injury can cost upwards of thirty six thousand dollars. So it's so important with, you know, the industry data that we're getting that we get a solid handle [00:06:00] on that because thirty six thousand dollars is a lot of money for one injury. And the good news is there's so much that we can do to help our clients. Peter Koch: Yeah, no doubt. And it is pretty amazing when you when you think about it, you think about health care being a healthy place. There's a lot of good stuff that's going on there. You don't really think about the musculoskeletal, the potential risk for back injuries and shoulder injuries as you would for your construction or your manufacturing or some of the other more traditionally we consider traditionally physically intensive jobs. So it is fairly staggering that we consider that long term care or long term care facilities are three times the national average. Hospitals are twice the national average for those musculoskeletal injuries. And is it mostly lifting or are there other causes [00:07:00] in there that are increasing that number of those musculoskeletal injuries? Lauren Caulfield: Well, as we look at the types of injuries that our clients are reporting, some of the more challenging transfers that we see generally are toileting are lifting people up off of the floor because the easy part is getting down and trying to, you know, get the patient all set up. But the hard part is actually when you manually lift somebody off of the floor and if you ever step back and really look at the body mechanics that people put themselves in and those awkward postures, it's a nightmare. And you know, that's the reason why so many folks get injured when they're doing those floor recovery type transfers. And then the other thing that we see is a lot of upper extremity injuries from moving patients over their bed. So those turning repositioning type [00:08:00] transfers are really presenting major challenges for our folks. So oftentimes the client will say, well, you know, when somebody gets up off of the floor, we do a proper assessment and then we get five or six people to move them up off the floor. And that's when we, you know, are able to provide some great education for our folks to say the safest transfer from the floor is with the use of the lift equipment, because ultimately what we tell our clients is there's no safe lift from the floor when you do it manually. Peter Koch: So elaborate on that a little bit, because you would think we talk about that in other, you know, not people handling. But in other manual material handling issues where if you have to move something by hand, then maybe have a team lift to be able to do that. And you had mentioned a client might [00:09:00] come in or they have a patient that's on the floor and they'll do an assessment or they'll be in a bed, they'll do an assessment and then they'll get more people to come in and help. So why isn't more people a good solution? Why do you still go back to if you have to move the patient from the floor? The best way to do it is with a mechanical assist. How come more people isn't the solution? Lauren Caulfield: It's not because our bodies were not made to lift this amount of weight. And it's not only the weight, it's actually the awkward postures that we put our employees bodies in every day that's creating the issues. So what's interesting, and I always point this out to my clients go to U.P.S. or some sort of delivery service, and they will tell their customers 70 pounds or 75 pounds is the lifting limit. Right. [00:10:00] So we're making sure that the customer is not putting in more than 70 or 75 pounds into a box because they have deemed that unsafe for their drivers. Well, when I say to my nurses, I'm going to give you ten,.0 Seventy or seventy five pound patients on your workload today. What do you think about that? That's a win win for that. Right. They say, wow, that's an easy day. So it's all in perspective. We're looking at nurses that say, wow. Seventy five pounds. That's just an easy day for us. That's an easy person to lift. But the reality is that it's not. And in fact, if you I'm not sure if you are aware, but there is a gentleman, Dr. Tom Waters, who is with NIOSH and him and several different researchers set out to answer the question, [00:11:00] how much can we safely lift without assistive equipment in some of the factors that they looked at? Is the fact that patients or residents are unpredictable? Right. So sometimes we might to go to move Mrs. Jones and she might get combative or aggressive and bite or hit or swat at the employee. So that was one of the things that we have. The other thing is we're not lifting boxes we're moving patients or residents. And when you're doing that, you can't always get them close enough to your body. Right. So we talk about when we lift boxes, make sure that you're getting that close to your body. Well, that goes out the window when you're moving patients. And then the other things that boxes have are handles. Right. So patients don't have handles. So [00:12:00] what do we do? We typically put a gate belt on them to provide those handles for that caregiver. So through their research, they concluded that 35 five pounds was the maximum acceptable weight for manual patient handling. And that is under ideal conditions. Okay. And many times when you are moving or transferring a patient or resident, you're not under ideal conditions. So as I talked to my customers about that many times, they'll say, oh, we have. Lift equipment, and so we have a program. But in fact, when I go and actually look more closely at their program, here's what we're finding. We're finding that lifts are not being consistently used on the floors. [00:13:00] We're finding that a lot of the nursing staff are still manually lifting and are not using that 35 pound acceptable weight limit as their guide. And I think it's about education and changing the client's mindset and perspective. And that's the reason why MEMIC decided to introduce our safe patient handling program. Peter Koch: Well, that's really that's interesting. So when we think about patient handling as a problem within the health care and because you can't get away from it, you have to manage patients looking at that from. How do you do it safely? You can't take the same structure that you might have in a warehouse or a package delivery service, but you have to look at it with some other factors. I like what you said about the unpredictability, because even if you are able to get a handle [00:14:00] on a patient using a gate belt and you're trying to get close to the patient, it's still the unpredictability what if they move? What if they reach out? What if they strike? What if they are more nervous? What if they pass out and all of a sudden the load changes? That doesn't happen with a package. That doesn't happen with a piano. That doesn't happen with another material that you might be handling. It's a human package that we're trying to care for and then add the human factor of the patient handler. The caregiver themselves, who doesn't want the patient to fall, doesn't want them to go back down. So they're putting themselves at greater risk even for that. So. Boy, it really is all about helping change perspective, because you're right. I've talked to health care accounts before. I don't have many of them, but I've certainly spoken to someone. I've talked to you before about this. And there are patient handling devices everywhere, but [00:15:00] they aren't used as much. We go back to that, the human contact, the human piece. So talk to me some about MEMIC's patient handling program and sort of way it came about. why do we go to such lengths to put this program in place? Lauren Caulfield: Well, I think the biggest reason was that our main goal with our employees is that they leave the building in the same condition that they arrive. And if you look at the data and you look at MEMIC data, patient handling injuries are really the top loss leader and then follow by slips and falls in aggressive or combative residents. So we really felt that it was our duty to work with our clients to come up with a program to address these musculoskeletal injuries that were occurring at alarming rates. And not only that, you [00:16:00] know, we want to make sure we're keeping our employees safe. But at the same time, it's you know, it's all about quality of care for the patient. Peter Koch: That's a really good point to think about this as well. We have to address it from both sides. It is the safety of the worker themselves, but also the quality of care for the patient, which doesn't always think about that. On the other side, we always talk about managing safety, quality and productivity from a safe workplace standpoint and the quality of the product. And we talk about, you know, if I drop this, there's going to be a quality issue if I'm picking up a package or moving material. But that really goes well beyond that. When we start thinking about handling another person, moving another person from point A to point B and helping them. So the quality of care is a key part to this, too. So sounds like the key impetus behind MEMIC creating this program is [00:17:00] obviously reducing the worker injuries, but helping to maintain a high level of care for the patients without putting the worker at risk. Lauren Caulfield: Sure. And I think, you know, when you're talking about families, it's important to get them on board with this concept because, you know, a lot of times families think that Hands-On care, a.k.a. manually lifting their loved one means good quality care. And when you introduce the concept of equipment, they say, oh, no, no, no, no, I don't want I want I don't want that to happen because they fear the equipment. Right. They're looking at they're afraid that you're going to put them in the sling and their loved ones are going to fall out of the sling. But in fact, it's the safest possible way to actually move a patient or resident. Peter Koch: So you're [00:18:00] really you're talking about not only changing the perspective of the worker in the workplace, the nurse, the nurse, case manager, management of the hospital or the long term care facility, but really giving them some tools to help change the perspective of the family, of the patient that they're caring for. That's a really unique concept. Lauren Caulfield: It is. And, you know, one of the important things that many facilities should do is to incorporate that into their welcome package or their admission kit, because when your loved one may come into the facility, the long term care facility, independent and everything's all good. But when that resident declines the families, it's a tough time for the families. It's emotional. They're making emotional decisions. They are feeling [00:19:00] terrible that their mom or dad is no longer able to be independent. So it's good that we introduce the concept and the benefits of a safe patient handling program by use of equipment and reducing that manual lift at the admission phase, because then they can understand the concept and the facility could say, you know what, we're not here yet. But later on down the road, as the you know, your loved one declines. This is what our you know, our strategy is. We want to keep our employees safe and we want to keep our, you know, your mom or dad safe as well. And this research shows this is the best way in order to do that. And not only that, what we have found and we talk about quality of care. We have found that this patient handling program [00:20:00] will actually increase the quality of care for the patient or resident. And let me tell you what I mean by that. First of all, when you're not manually handling somebody, there is a lesser chance that there's going to be skin tears. So the data shows that by using lift equipment and reducing that manual lifting, that it's having a very favorable impact on the rate of skin tears, which is great. Hospitals are also showing that they're having reduced length of stay because with the use of equipment, we have early mobility. We can get patients up sooner with the use of equipment. And it's a win and it's actually a lot. It really enhances the dignity of the patient. So one [00:21:00] of the things that we're finding. I wanted to explore that aggressive behavior topic a little bit more. And what we found is this. If you and I, Pete, transfer our resident today, Peter Koch: OK? Lauren Caulfield: And then tomorrow you go on vacation. And Arielle and I are transferring that same resident. Those two transfers could look very different. Peter Koch: Oh, yeah, sure. Lauren Caulfield: Because we're. Yeah. We're using different people. You might be taller than me. I mean, there's so many different things and components that come into that. So the patient or resident that might have dementia or Alzheimer's. They can't predict what's going to happen because every day it's going to be a little bit different. Makes sense. Peter Koch: It does make sense. Even if even just having two different personalities with a patient with dementia or a patient with cognitive challenges, just two different personalities [00:22:00] from one day to the other could be a very difficult position for that patient just mentally for them to understand what's going on. Not even to mention the physical differences in the lift of how that's going to work. Lauren Caulfield: For sure. And now we introduce the concept of lift equipment. Right. That patient now can anticipate what that lift is going to look like every single day because it's going to be consistent. And as a result, these behaviors are being impacted in a good way. Peter Koch: No kidding. So the aggressive behaviors are being impacted by somewhat of the consistency of the lift process by utilizing the equipment. Lauren Caulfield: For sure. For sure. So, again, as we look at these different things and selling these to our families, it is so important that we're pointing out how this can positively impact. The quality [00:23:00] of care of the loved one. Peter Koch: And that's what it's all about. I mean, having worked in emergency medicine, I mean that the comfort of the patient is always a critical piece. You're trying to manage what crisis they're going through, whether it's mental or it's physical. But the comfort of the patient and making sure that they trust what you're doing is really important. And I think that has to be a key part in your long term care or even in short term care in the hospitals, that making sure that the patient is comfortable and then making sure that the family understands because that's, oh boy. That's a huge part of that. Lauren Caulfield: For sure. And I think once you one of the things that we do is we will put this information into our brochure for the client so that they can put it into their admission kit. We also recommend that they have family nights so that you can [00:24:00] come in and bring in your families and get them in the equipment and, you know, get them comfortable with the equipment. And I think that's really important. And oftentimes when I train during my workshops, I will ask folks, you know, raise your hand if you've never been in a piece of lift equipment before. And it's interesting how many caregivers have not actually trialed the equipment and pretend to be the patient and get in the slings and all of that. And I think that that's critical because if you're going to really appreciate what that resident may be going through, especially a resident that may be scared. Right. Or feel uncomfortable, it's so important that you really put yourself in their position, get in these slings, you know, be transferred with it and all of that, and then you can help sort of put [00:25:00] that patient at ease because you've done it before and you can say with certainty it's going to be OK, this is what's going to happen. You're going to feel like this, you know, that type of thing. I always you know, it's kind of like getting a root canal. I always say to the dentist, OK, before we start, what's going to happen? You know, I need to preview it in my mind. So I think, you know, training is just so critical. And to go one step further. It's you know, sometimes facilities will train by use of video, which is good. it definitely has its advantages. A lot of the vendors will have training videos that you can use, but we always recommend to go one step further. Demonstration and return demonstrations are critical because it's sometimes it's so easy. The vendor comes in or the nurse educator comes in and does all this training. And you sit back and you watch and you say, yep, that looks great. And [00:26:00] this happens a lot with the friction, reducing devices that are used for repositioning and turning at the bedside or on the bed. And, you know, they get all this training. They don't have an opportunity to return demonstrate, and then they go back to the bed. They start using or trying to use the device. And they're like, no, it's not as easy as it looked when the vendor came in and did the training. And they're fumbling with it and they don't know how to use it. They're trying to figure it out. And meanwhile, you know, the resident is starting to complain because you there too long and this keeps taking too long. And what happens? They say this doesn't work. Peter Koch: I'm done. Lauren Caulfield: I don't want to use it. Peter Koch: Going back to my old habits right? Lauren Caulfield:  Yes. And so, so often. And this was, you know, one of the things I mentioned before [00:27:00] is that turning, boosting and repositioning in the bed is a top loss leader nationally as well as at MEMIC. And one of the best solutions to that, are these friction reducing devices. And they are being so underutilized in our facilities. And when we look at that, we say it is important to train, to give ample practice time and to have a competency process, not only for your friction reducing devices, but also for your lift equipment, because that should be annual, because you have to go back and make sure that people feel comfortable. And one of the things that we find that are on the rise is not only the back injuries to our nursing assistants, but also to our RNs. And why is that? Well, it's because RNs typically aren't [00:28:00] involved as much with the patient transfers. But getting back to that problem with people being short staffed. What do you do? You go to the RN and you say, hey, can you help me? And they say, sure. But the last time they used the equipment might have been months ago. And oftentimes people will say, well, we don't really include the RNs on our training because they don't do the transfers. Well, these transfers may be a non-routine task, but anyone that knows about non-routine tasks, those are the people that tend to get injured because they're not as familiar. So when I do observations on the unit, I'll often hear an RN say. Yeah just tell me what I need to do. And they will sort of educate them on the job and the use of that equipment. So as we look at our injuries and where they're happening, when we're doing our trending analysis, it's so important to pull in and look at. And if you're seeing [00:29:00] an increase in RNs being injured due to patient transfers, look at that training program and make sure they're getting training as well. Because I think that's really critical. Peter Koch: Yeah, absolutely. You may definitely miss those individuals that you don't expect because it's not part of their job. Their main job description. But they may very well be doing some of those non routine tasks almost assuredly. And you had mentioned it early on. One of the challenges that is pervasive across all of health care and really actually any industry, but health care specifically is the lack of people, the lack of staff. I don't have enough. we don't have enough nurses. We don't have enough nursing assistance to manage the number of patients that we have in the same way that we used to. So we are using people in different ways because we are short. So if that does happen. So training is pretty key. Let's take a quick break so I can tell you about the patient handling dilemma episodes, [00:30:00] parts two and three coming up over the next few months. We'll be going deeper into the problem of using outdated thinking for patient handling and how good safe patient handling programs can be successful. In future episodes we will address the barriers to implementing a safe patient handling program, as well as talk with different health care teams to find out what has made their safe patient handling program work. Check back to the MEMIC podcast page for updates or subscribe to get notified when the next episode drops. If you're a MEMIC policyholder check out all of our safe patient handling resources on MEMIC's Safety Director Web site at www.MEMICsafety.com. Now let's get back to today's conversation. Lauren, you mentioned a whole lot of different steps and different concepts and different things to do. They all seem to be part of this MEMIC patient handling program. Can you talk [00:31:00] about like what is in the program? So how does the program work? What is it? What does it do? Lauren Caulfield: So for our MEMIC policyholders, we made a commitment that we were going to really provide some good, solid research, evidence based training for our customers and in that our job. I really look at our role as making sure that we are in the forefront. We are going to conferences. We're looking at the latest data in research and all of that and incorporating that into our safe patient handling program. So that is what we did several years ago. We realized that if we are going to have solid outcomes with our clients, we had to really get the right people around the table. So it starts out with what do they say, get the right people on the bus. And that's really what we [00:32:00] did. So we started with hiring RNs, occupational health nurses, physical therapists, OTs people that had been in the industry before. And I think our clients appreciate that because there's nothing better than sitting across the table and talking to somebody that has done the job before. It lends instant credibility with our customers. So when we go and try to help them and make recommendations, they're all ears. Right. Because they say, wow, it's nice to have somebody that understands all of the different nuances that come into play with our customers. So that was the first thing getting the right people. And then we developed a process, so to speak. So when a new client comes on board, I always say you can't make recommendations from a conference room. So we do what we call our transfer resident [00:33:00] transfer observations. And what we're doing is we're rolling up our sleeves. We're spending a couple hours on the nursing units and we're just observing transfers in real time. So we're looking at those floor recovery transfers. We're looking at how are we getting patients or residents out of the bed? How are they bringing them to the toilet? How are they repositioning that resident in the bed as well? We're tying it to those known injury sources that we have researched. So, as I said, we're rolling up our sleeves. And one of the things my directors of nurses always say to us, this is probably one of the most valuable things that you bring to the table. And it's really about reinforcing those positive behaviors that we see that the employees are doing. Are they planning for the lift right [00:34:00] you know? Are they moving things around that need to get out of the way, that are going to come into and be a barrier for them when they're, you know, when they're in the middle of a transfer? Are they using the right sling? Do the residents know what sling to use? Are they the proper size? Are they accessible? We're looking at. Are they manual lifting or are they using the equipment consistently? We look at their communication tools. So Mrs. Jones was just transferred with a sit to stand lift. OK. Let's go back to that modified care plan and let's see what that modified care plan says in terms of the transfer method. Many times, unfortunately, how they're transferring and what the care plan or the modified care plan says do not jive. So that gives us an opportunity to help them not only with tricks of the trade in terms of the transfer, [00:35:00] but also to look at their communication tools, because really that's what it's all about, making sure that our communication tools are updated. And we look at just a variety of things in terms of locking wheelchairs and locking beds. So. And I could go on and on, but I think you get the drift with that. Peter Koch: I just wanted to kind of frame that. So the first step is before the program was put in place was you got the right people at MEMIC. So you pulled in the people that would have the best knowledge. They had experience within not just within healthcare, but people that had experience with handling other people. So your physical therapist, athletic trainers, agronomists to be able to provide information to create the plan. And then instead of just getting to going to a client saying here's a written program. Have fun with it. You start with observing what's going on, on the floor within [00:36:00] the unit itself and seeing what's actually happening. So getting real time information and then comparing that real time information into what's actually supposed to happen, to be able to provide some guidance and some feedback. So that's great. Got the right people getting some good information. Real-Time information that's happening right at the facility itself, comparing it with what's supposed to happen. Once that's done, what's the next step in the program? What do you do next? Lauren Caulfield: Well, the next step is really to help that client take that process and adopt it themselves. So we're all about helping clients put systems in place. So we will ask that either their peer unit leaders, their rehab aides, maybe the nurse managers actually do these types of observations because it provides you with an opportunity to reinforce positive behaviors. But it [00:37:00] also provides you with an opportunity to provide just in time training where you see it's necessary. So from them, we now have a good understanding of what that program looks like. We then provide an onsite, full day safe patient handling workshop. It's nationally accredited. They can get CBUs for this. And what that is, is it's not death by PowerPoint. I can assure you it's more getting all levels of nursing in one room. We start out the workshop and we talk about the challenges that we're seeing and tie that back to the observations that we just did. And then what we do is, you know, certainly there's PowerPoint slides at the beginning to sort of set the foundation and the key concepts for everybody. But from there, once we get that all in hand, we now look at the challenges that we have seen [00:38:00] from the beginning. And everyone participates in that. We go around the room, they ultimately tell us what their challenges are that they see on a day to day basis. And then we have group work. And usually it goes like this. So we assign topics to each of the groups. So it could be change of shift, you know, really assessing that whole process. It could be looking at the patient assessment program, looking at their training programs, because what we see is people have great training programs. But you know what? People don't attend. How do we get them to attend? What is the content? What are the different learning styles that we incorporate into the training. You know, everyone has different learning styles, as we know, some people are visual. Other people can read a manual and learn that way. So really looking at the different learning styles that they have introduced into their training programs, some of the groups are assessing communication, overall [00:39:00] communication with physical therapy or from nurse to nurse or nurse to C.M.A. So basically what they do is they spend the second part of the workshop reviewing and assessing and analyzing these very key topics. And then what they do is come up with recommendations that they present to the class. And what that allows them to do is to have a solid action plan going out of the class, because I don't know about you. I go to a conference, I attend all these great classes, and I get home and I got, you know, a binder so thick and I sit there and I say, oh, my gosh. Now, where do I start? That takes that guesswork out of it. They walk out of that class. They have structured a safe patient handling task force that will work on the different recommendations and concepts and challenges that we identified during the class. And [00:40:00] they setup a time to meet and a schedule and hour lost control. Consultants who are health care specialists will actually attend some of these task force committee meetings and help them not to run the meetings, but just to be there if they get stuck or provide some guidance around that. And that's really a key to the process. So we start out with a patient transfer observations. We help them incorporate that into their program. We provide the full day safe patient handling workshops. We help them with their safe patient handling task force. And through that, we're making sure that key people in the organization are involved in that process. So we tie in the Safe Patient Handling Committee into the Falls Committee. We make sure that we have a quality person on the task force. We make sure there's a nursing representation purchasing [00:41:00] because, you know, certainly there is purchasing of equipment that may be needed. This nurse educator, the rehab staff, all of these key people come together to work on the initiative because safe patient handling programs do not mean you just have equipment. And I think one of the other things that we work really hard with customers on is their system of accountability, because oftentimes you have equipment. And that's the easy part. The hard part is getting people to use the equipment. Peter Koch: And I think that's a key part to think about that accountability. You couldn't get the accountability with having the right people in the room and you couldn't get a system in place without knowing where the challenges are through the observations. And you couldn't do any of that, have it work well without getting the group together to be able to buy in to the solutions [00:42:00] that were created. So this is really it's not a one size fits all solution. There are some guidelines that you're helping them work within, but they're really taking those guidelines and developing a safe patient handling solution that works in their facility that they developed, that you helped facilitate and then will help them maintain that through observations and assistance going forward. Is that a good description of how it works or why it works? Lauren Caulfield: That is a perfect description. And when, you know, clients will always say to us, so, you know, this is a commitment. Absolutely. It's a commitment. But what are we going to get out of it? And in looking at the injury statistics from before they came on board and didn't have this formal approach to afterwards. What we're seeing is an average reduction in the cost of their employee injuries related [00:43:00] to overexertion averaging at about 35 percent reduction in cost, which I think is phenomenal. Peter Koch: That is phenomenal. That's truly phenomenal. It's interesting. I've had the pleasure quite a while ago now, but I've had the pleasure of sitting in part of one of those daylong safe patient handling workshops that you've done. And the dynamic was really interesting. So at the beginning of that workshop, everyone was sitting their arms crossed like it's another training. Can I just get back to my work and using the real world situations that not only you've been through and have seen But also the observations that you've seen on the floor and talking about stories and the impact and then getting people in the audience to talk about their challenges. And it's real. It's so real to them. And all of a sudden the arms start to get un-crossed and they're leaning [00:44:00] in a little bit more. And by the break, by lunchtime, by the time you're getting them to work as a group, everybody or the majority of everyone are leaning into the problem. They're excited about trying to problem solve that. They all know what the challenge is. You've just brought it to an actionable process. And now they're able to take action. And it's something that they can own. And I thought that facilitation process was fantastic. And then the results that you're talking about, if they're able to implement the plan that they're developing to see on average of, you know, with 25 to 35 percent reduction in claims. That's amazing. It's a real testament to the process that you've been putting in place to facilitate safe patient handling across the different health care organizations that we work with. Lauren Caulfield: Sure. You know, it's a great thing to see. And I smile when you're saying, you know, the arms crossed and all of that. [00:45:00] You know, we pull in the patient transfer observations and you come in and you certainly have your book of paper or your clipboard or what have you, because you're going to do observations and make some notes and you meet with the CNAs and, you know, your nursing assistants and they are looking at you like are you the state and oh no, what is she here to do? I'm going to have somebody looking over my shoulder. This is horrible. And we you know, we try to say, you know, we’re the friendly people not the state. We're just looking at what a day in your life looks like so we can make it safer. But they're always skeptical and I get it right. So then, you know, you'll say, OK, well, when you transfer these residents, please come and get me so I can observe the transfer and what happens. They'll say, oh, I forgot. So, you know, and that's OK. And you know what? And then over time, we start observing a few and we're working with them. And then we're saying, you know [00:46:00] what? Let's stop for a second. Maybe. Can we just come in at a different angle with the lift or if we raise the bed a little bit higher? That might be a little bit more helpful for you. So you're not bending over and all of a sudden those same folks that didn't want to be , you know, shadowed are now coming to me saying, hey, can you come down here and look at Mrs. Jones? Because you know what? This is a really challenging transfer. Not only is it challenging because sometimes she tends to drop to the floor or she's resistant, but the other thing is she can be very aggressive. So we go in and we're not only looking at patient transfer techniques, we're looking at the whole, you know, how are we approaching that resident so that they don't become aggressive or at least we're limiting or showing them techniques about positive approaches and all of that. So it all goes hand in hand. And what [00:47:00] we're definitely seeing with our customers is not only are our patient handling injuries going down, but our aggressive behaviors are also going down. So it is definitely a Win-Win. Peter Koch: That's fantastic. I think the thing that I'm finding about this, is it's not just a canned program. It's not a notebook that someone can download from the electronic resources. And then here it is. It's a comprehensive assessment, training, guidance and ongoing feedback loop that you've put together to help address not only the injury itself, but the cause of the injury. And that could be the interaction with the patient to begin with, to help reduce the aggressive behavior or really just the tense behavior of the patient not understanding what's happening, but then the way the patient is moved [00:48:00] as well, and having providing the resources to or not so much the resources, but helping the different clients understand that it's not just a one and done. You can't do this training just once there's a system of observations and continued training and return demonstration that really makes the not just the program work, but the results come out. And that, to me, Lauren, is a key concept that folks need to take away when they start looking at this, because it's a huge problem. We started talking about this as the problem of patient handling or the patient handling dilemma. There are so many facets to it. There is a cost and a quality to it, but it's not just a one cause it's not my battery is not strong enough in my car. That's why it won't start on a cold morning. I replace the battery. I fix it. Done deal. I give the package handler a cart that they can use. Done [00:49:00] deal. It's not a done deal. There's so many facets to this. And the interesting part about the program is it addresses all of those facets. Lauren Caulfield: You are spot on Pete because it is definitely not a cookie cutter approach. Every facility is different. They have different cultures. They have different staffing patterns. Patients change can change every single day depending upon what's going on with them at any given moment. And these changes can be very unexpected. So as we work with customers, it's important to tailor these programs to the different challenges that they have. The culture that they have in really in order to be successful. And it is a collaborative effort. We don't go in and just tell them, oh, gosh, here you go. Here's the laundry list of recommendations and head out. We listen to them and sometimes, you know what? I may make a recommendation then like, no that's not going to work for us because of this. OK. Let's [00:50:00] go back to the drawing board. What will work? And we develop plans that are going to be feasible for our customers. And I think that's really a key. Peter Koch: Yeah, that's a fantastic unit. And it has to happen that way. From my experience, working in different industries, that even though the industry might be the same. Like you work with a restaurant someplace or a construction company someplace. And the stuff that they're doing is the same. But you identify that, well, the culture is different. The clientele is different. The environment is different. How the team works together is different. And if you don't address those things or don't allow those things to be part of the plan and you just give a cookie cutter solution, the solution is bound to fail. As soon as you step away from it, I think that's a really key part, is you want this program to be successful without your involvement. You want this to keep going regardless of who [00:51:00] is there at the meetings or who is there at the at the facility. Lauren Caulfield: Right. And I think that comes from the top. The first thing that we always do is meet with the top management before we roll any program like this out. And we make sure we have the key players around and say, are you ready for this? Some clients have competing priorities. And, you know, we make sure we do it at a time. That makes sense. And once we get that commitment and we roll out what that plan looks like, we typically are going to get some really good commitment and support from the top because it's going to take time and it's going to take resources from the facility in order to make this work. And I throw out something because it's sort of my Bible, if you will, for those that are looking for a great book that will help you to determine and give you a good best practice check and balance on where your program [00:52:00] is and what you need to work on. The American Nurses Association put out a publication called Safe Patient Handling and Mobility Interprofessional National Standards. And it's excellent. I would highly recommend it. And at the bottom, it says across the care continuum. And they basically took all different disciplines across the care continuum to come up with these standards. And I refer to this all the time. And what was really enlightening was as I went through this book and I looked at all the key components that they suggest need to be in place. And I compared it to our workshop and our process. We hit each and every one of these. So I felt that it was a really nice way to evaluate our program and make sure that it was in line with what the industry is telling us the best practices were. So that's [00:53:00] just I wanted to throw that out there for folks that might be interested. Peter Koch: That sounds like a great resource. And we can put a link to that publication within the show notes for this podcast itself. But so. All right. How would a health care facility use that? Could they could they look at that, evaluate their program based on the publication that you just spoke about? And if they're missing different parts and pieces, then how does a company know that they're ready to change their patient handling process? How do they know that  they're, it's time for them to do that? Not just they have a lot of injuries. Great. It's going to happen. But how do they know that they're ready to make a change? Lauren Caulfield: I think it's just looking at their overall program, getting feedback from the staff that do the job on a day in and day out basis. And you can generally tell by walking around what [00:54:00] that culture, what that environment looks like. You know, look at the patient and the injuries that you're seeing. Hopefully not a lot and none, actually. But, you know, are you starting to see an uptick with these areas? Are you starting to see that? We have a lot of holes in the management team. We have a lot of people that have left the company. And there's a great amount of turnover in clients that come to me and say, you know, we just can't keep good people. They're leaving for five cents an hour more and going down the road. One of the things that I offer is you have a great patient handling program. Make that a marketing tool for you when you're looking at recruiting really good employees. Put that in your ads because I don't know about you, but if I had a choice in three different places to work [00:55:00] and two of the places require me to manually lift all day long and put me at risk, and one place has a solid patient handling program that has great devices and equipment to make it safer for my job. which facility do you think I'm going to? Peter Koch: I'm going there. Lauren Caulfield: Absolutely and get that message out when you're advertising. And you know what? For clients that had done that. They are getting people through the door. So there's often many, many different things that come up that you say, you know what, I can't do this anymore like this. It's it behooves us to make some changes to make it safer for our employees and our residents or our patients. And when you do that, I think everyone just wants to keep their employees safe. You know, there's nobody likes to see that somebody had a back injury under their watch. There are solutions out there. Does it take time and energy? [00:56:00] Absolutely. But in the long run, you are going to see a lot of benefits to that. Peter Koch: Yeah, absolutely. And it sounds that the patient handling process, having a good, safe patient handling program can not only be a tool that can be used to well, like you said, pull good people in and keep them there. But it can also be something that if it's not so up to snuff in your particular company or you're looking at some of those lagging indicators like you've got a lot turnover or there are injuries that are happening both on the patient side and the worker side, that if you made some changes to your patient handling program, that could not only reduce the injuries, but it might also be a retention tool for you. And you could keep some of those good workers that you have and they won't go someplace for 10 cents an hour more or five cents an hour or more. Lauren Caulfield: Absolutely. Yes, [00:57:00] absolutely. Peter Koch: Well, hey, Lauren. Jeez, we've been talking here for just about an hour as time just flies and we're right about the end of where we are on the podcast. Is there anything else that you'd like to share with our audience, our listeners today about the safe patient handling program or any parts of it or any challenges? Lauren Caulfield: I just think that I just encourage folks, keep doing what you're doing. Keep looking for continuous improvement. It's so important once you put these programs together and make that investment, it's an investment in your employees and you will get so much back from your employees. I laugh. I have a hospital down in Connecticut and we worked with them on a very formal program. And their program has absolutely just done a whole turnaround. And the medical director I was at a meeting with him the other day and he said, Lauren, you're like the mayor in this [00:58:00] place. Everyone talks about, oh, my gosh, look, what these folks did they came in and it's so awesome to come in, my back doesn't hurt at the end of the day. I don't feel fatigued. I can go home and actually play with my kids and not be exhausted. And I said, you know, it's not what I did. It's what you folks did. You made the commitment and you made this a better place to work. And that's really what it's all about. So I encourage everyone to look at your programs and see what are the good things that you're doing that should be reinforced and keep the momentum going. And then just identify some opportunities for improvement and start working on them one issue at a time. Don't try to do too much and get overwhelmed. Don't try to roll out too much. Make it a very methodical process and you will do just fine. Peter Koch: That's fantastic. That's great advice. And if you're not a MEMIC client, I guess one of the resources that they could use would be that publication you referenced before as [00:59:00] a as a guide. But if they are a MEMIC client and they're thinking, you know, I'm ready to make some changes, how do they how did they find out more about the safe patient handling program that MEMIC has to offer? Lauren Caulfield: The first place to go is call your loss control consultant and they will have all the resources you can talk about a plan that's going to fit your needs and that is the first place to go. I think that they'll be able to provide some great guidance and direction for you. Peter Koch: Fantastic, Lauren. Thank you very much for all the time and sharing your expertise with us today. Lauren, it's been fantastic. I really, truly appreciate you being here today. Lauren Caulfield: Thank you, Peter. I appreciate you having me. It's been a great discussion. Peter Koch: Fantastic. So thanks again for joining us. And thanks to all of our listeners out there who continue to listen to us. And we've been talking with Lauren [01:00:00] Caulfield, the director of the Atlantic region, lost control at MEMIC about safe patient handling and the program that MEMIC has and the challenges that safe patient handling or handling patients safely has for the health care industry. And if you have any questions for Lauren or like to hear more about a particular topic on our podcast, e-mail podcast@MEMIC.com. Also, check out our show notes at MEMIC.com/Podcast, where you can find more links to resources for a deeper dive into this topic. Check out our Web site MEMIC.com/Podcast Where you can find all of our podcasts in an archive. And while you're there, sign up for our Safety Net blog so you never miss any of our articles or safety news updates. And if you haven't done so already, I'd really appreciate it if you took a minute to review us on Stitcher, iTunes or whichever podcast service that you find us on. If you've already done that, I really thank [01:01:00] you. Because it helps us spread the word. Please consider sharing this show with a business associate friend or family member who you think will get something out of it. And as always, thank you for the continued support. And until next time, this is Peter Koch reminding you that listening to the Mimics Safety Experts Podcast is good, but using what you learned is even better.

Tom Waters, the managing director of partypoker, has seen lots of changes and improvements inside partypoker over the past year. Tom and Jaime discuss software updates, how partypoker keeps the game honest, and how they’ve massively up-leveled the mobile site. Listen in to hear what he thinks about some competitor product releases – and learn why Tom is optimistic about the future of live tournament poker online. Time Stamped Show Notes: 00:00 – 06:30 – Online poker news, the Poker Masters main event results, title winners, upcoming tournaments, Spins Ultra information, and a unique everyday player success story. 06:30 – 14:00 – Millions Online, the software updates at partypoker over the past year, the partypoker game integrity team, and the newest information on real names and aliases. 14:00 – 21:30 - On Project Phoenix, Mobile Client, figuring out a mobile-friendly poker game, the fixes they’ve made, and how mobile games have been made more fun. 21:30 – 27:00 - Information on Spins Ultra, why they created it, how partypoker caters to regular and new players, and why he doesn’t agree with some of the product releases on other sites. 27:00 – 35:30 - On his own poker playing, people loving live tournaments online, what he sees for the future of live poker, and what he thinks about the manager of Premier League club Tottenham Hotspur. 35:30 – 37:00 - The weekly JS Poker Hero challenge and an update from last week’s challenge. 3 Key Points Partypoker has become much more mobile-friendly! People are loving live poker tournaments online. Partypoker makes an effort to support regular and new players - and they stick to poker. Contact/Resources partypoker

Chad Holloway joins Jeff Platt as co-host for the latest episode of the PokerNews Podcast. This week they talk to guest Tom Waters, marketing director of partypoker. Among the topics covered are the Irish Poker Open, Poker Masters, WPT Online, and the signing of Kevin Hart as a Global Ambassador. They also recap the exciting finish to the Galfond Challenge, look at the World Series of Poker and GG Poker partnering for the WSOP Super Circuit Online Series, and explore Tony Miles taking another shot at American Ninja Warrior. This week's sponsors: GG Poker, Oddschecker US, and Run It Once.

In this episode, Tom Waters, the PartyPoker Managing Director, discusses the future of mobile poker. He reveals PartyPoker’s best features, why they anonymize hand histories, and how players can customize their experience. He shares the evolution of their mobile experience and what they’ve done to even the playing field among PartyPoker players. Tune in to hear about their challenges, promotions, and games – and learn how you can maximize your playing potential. Visit Jeff Gross - The Flow Show or find us on iTunes to subscribe, visit previous episodes, and learn more about your host, Jeff Gross.  Time Stamped Show Notes: 00:00 – 15:30 – Tom’s professional journey and the inside scoop on PP’s software. 15:30 – 30:00 – The mega-sets coming up, their buy-ins, and what you can do on fast-forward. 30:00 – 45:00 – On HUDs, unfair advantages, and what PP is doing to even the field. 45:00 – 01:00:00 – The processes and protection PP deploys for their players. 01:15:00 – 01:30:00 – Promotions for players, competition in the industry, and challenges. 01:30:00 – 01:40:00 – Details on PP features, Tom’s favorite hand, and where they see player support. 3 Key Points The poker world is always evolving. The playing field should be as even as possible. PartyPoker works hard to give players the best experience possible.  Contact/Resources Partner - Party Poker Website - Jeff Gross Poker

Does your back hurt? Is work literally a pain in your neck? Find out from MEMIC’s Director of Ergonomics Allan Brown if workplace ergonomics could be the culprit to some of your most common aches and pains. Good ergonomics is fitting the work to the worker, not the other way around. If you sit down at a workstation or desk or sit in a new vehicle and you don’t adjust anything, then you have to adapt yourself to the machine or tool. If you don’t make adjustments, then you may be exposing yourself to unsafe situations and blind spots. Pete Koch: Hello, listeners, and welcome to the Safety Experts podcast. Does your back hurt? Is work literally a pain in your neck? On today's episode, we're gonna find out if workplace ergonomics could be the culprit to some of your most common aches and pains. The Safety Expert podcast is presented by MEMIC, a leading worker's compensation provider based on the East Coast. A new episode of the podcast drops every two weeks featuring interviews with leaders in the field, top executives, MEMIC staff and other industry experts discussing how safety applies to all aspects of our lives. I'm your host, Peter Koch. And for the past 17 years, I've been working for MEMIC as a safety expert within the hospitality and construction industries. What I realized is safety impacts every part of each position that you have or tasks that you do. Yeah, sure, you can get lucky, but there's just no way to be successful in the long term without safety. There was a time when I believed that safety was important, but it was something extra that had to be done for those most dangerous jobs and in some cases an unnecessary concern that would slow you down. The realization that a safe job is also a productive job is when it came when I was clearing ice from towers here one winter in New England. The tools that I had to keep me from falling also allowed me to work hands free in a better position and with a lot less fatigue during the shift than some of my co-workers. So, as the shifts rolled on, I got more done. I didn't go any faster. I didn't just slow down as fast and was able to move more confidently in the environment. And it was a few years later that I realized that if we had the same tools and training, that level of productivity could have been multiplied. So, for today's episode of putting the person at the center of work or industrial ergonomics, I'm going to speak with Al Brown, the director of ergonomics at MEMIC, to better understand what ergonomics is and how it impacts our business. Al has been with MEMIC for more than a decade and helping hundreds of businesses get a handle on ergonomics in the workplace. So, Al, welcome to the podcast today. Al Brown: Thank you Pete. Happy to be here. Pete Koch: Awesome. I really appreciate you coming down. Today we wanted to focus on ergonomics in the industrial environment. So manual material handling, order picking and even housekeeping. But before we get into all those topics and unpack ergonomics, I want you to just give us a little bit of your history here at MEMIC and how you got to where you are as the Director of Ergonomics. Al Brown: Sure, Pete, thanks. I'm actually a physical therapist with a safety background and started onsite industry prior to being at MEMIC, which we when we were at industry, we would often go and they were manual material handling industries, mostly shipyards, retail, distribution centers. And the clinic was there. And if someone had an injury, we would often walk back with the person to the job to look at where they felt they were having problems. So sometimes we would re-engineer and we would analyze it and then re-engineer out that particular task or modify it or educate the person a better way to do it then we'd do the treatment.  It was very successful, and it seemed to be a win, win, win for everybody involved. That led me to Maine Employers Mutual Insurance Company and who partners with industry, and I felt the skills that I had learned in my previous life as an onsite physical therapist were well tailored for this type of industry. And it's great because we do partner with industry and we do get to go into industry. Look at, you know, there might be high exposure in particular area and we just have a different set of eyes. So, I tend to look at things from a physiological standpoint. We have a lot of safety professionals onboard. Sometimes I have to defer to them about safety issues, but I tend to look more at the human being and the ergonomics of work environments. And that's what has led me to where I am today. Pete Koch: To where you are right here today at the podcast. So, you talked about ergonomics. Let's define ergonomics. So, what is it? And then can ergonomics be tied to worker discomfort or pain in the workplace? Al Brown: Sure. I mean, ergonomics, the term ergo it's looking at work and the mechanics of work from the human perspective.  What are the tolerances of a human being? What are the reach distances? When you look at, for example, human beings, probably 5'1" to 6'2" represent about 90 percent of the population. Anything outside that becomes an outlier and so design a lot of times within the workplace is for that range of folks. Look at clothing, you know,  you get outside that range and it becomes extra tall or petite. Look at anything, look at door design in terms of people going in and out. Old homes have very short doors because there wasn't really a standard. Now there's a standard so that the majority, 99.9 percent of the population can go through the door without ducking. So, this has been it actually started with Department of Defense looking at tool and equipment and aircraft design because of issues they had, and it has morphed into more things. Another example is going down the interstate, you'll see a green and silver sign because that's the best unlit colors for the human eye to see. So again, these are all a little subtle inroad of ergonomics, but we tend to overlay it within the industry where we look at what are the tasks at hand, what are the critical demands of that job? How do we measure those and are things that are they outside the range of tolerance for the human being? And we understand that tolerance with human beings and there are things we can do to bring it back inside the tolerance level, be it automating or just changing the process. Pete Koch: So really the effect on the job, on the human person, and then how to redesign the job or the task or the environment they're in to fit that person. Al Brown: Right. We're trying to fit good ergonomics, is fitting the work to the worker, not the other way around. Oftentimes, you know, you sit down at the desk, you sit down in a manufacturing plant, you sit in a car. If you don't adjust anything, then you the worker has to adapt to the machine or the tool or whatever and often creates awkward postures, awkward reaches. Where in fact, good ergonomics, that tool should be fit to you, just like in your car. You adjust the seat, you adjust the mirror, you prepare yourself to drive so that you can safely see and drive and reach the gas pedals in a comfortable position. Pete Koch: So, when we look at the design, either designing the task or environment specific to the person who's doing it or providing adjustments to allow the worker to make those adjustments real time, like the car that you would. Al Brown: With adjustments, you can meet a greater range of people. Pete Koch: Yes. Al Brown: Unfortunately, like in the old manufacturing plants, the tool and die. Pete Koch: One size fits all. Al Brown: 1940 equipment, it's one size fits all. So, it's a bit more of a challenge when you deal with older tooling. Modern day tooling, we tend to see a lot more of that adjustability to adapt to different statured workers. Pete Koch: Yeah, it's interesting you bring that up. One of my first jobs back when I was 14 years old, I was working in a manufacturing facility and my job was to bring the dyes from the dye room onto the factory floors, to switch the dyes out for the metal stamping process. And so, all the machines, it's one size fits all, but it wasn't one-person size. So, you had someone like yourself who's more than 6' standing at a particular task and the work is down by their belt. And then you've got the little old lady who is there; who is 5'6" or 4'6" right, just there.  And her shoulders, I remember this specifically cause it just a wonderful woman. Really kind of was friendly to me, which was not what most of the people were when the little 14-year-old kid is tooling around the factory floor. But her shoulders were at the level where the tooling was happening. So her arms were basically, she spent most of her day with her hands at shoulder level.  I didn't realize then what an issue that could be. But now I can't even imagine spending even half an hour or 15 minutes, 10 minutes with your arms at that level. There'll be a lot of fatigue and challenge with it. Al Brown: Energy expenditure for her was exponentially much higher than someone where the tooling or the work area was at elbow level. Pete Koch: And that wasn't all that long ago even. So, there's been leaps and bounds made in a lot of the new machines that are out there. But we still find a lot of tools, a lot of machines that have been built in the ‘50s or the ‘60s or the ‘70s and even in the ‘80s where they're not as adjustable. So we're gonna get into some of those pieces. So, let's talk about risk factors, because without understanding risk factors, I think it's hard to understand how a particular machine or a task would affect the worker negatively. So, what are some of the risk factors that can cause or, if you can notice them, predict future discomfort? Al Brown: Risk factors can range. You know, there's exertion. Heavy lifting that one is obvious. And the perception is that's the cause for a lot of things. And in fact, as we go through this podcast you may discover that everything is not what it appears, that it's not necessarily always the heavy lift, but exertion, repetition. How often am I doing this task, how often is it repeated? In the manufacturing world it's not one widget, it can be a thousand widgets an hour. So just repeated motions, so that you create fatigue and exhaustion, muscle tendons, ligaments. So, it's exertion, repetition. Pete Koch: Force was there. Al Brown: Yes, kind of exertion. Awkward posture, yes. So extended awkward reaches, just like the person you were talking about earlier in the podcast where it was an extended awkward reach. So, when the body is in those awkward positions, you can have a considerable reduction in the ability to generate force. So that shoulder on that the woman you were talking about earlier, she's going to have to generate a lot more force or a lot a greater percentage of her force that she can generate in that awkward position in order to do the task compared to the person that was standing in more of a working neutral position. So, the force requirements or the percentage of force required is much greater for her. So, she's almost maxing out every time she does something at that level. So, you're looking at exertion, awkward postures, repetition. Those seem to be the high sort of risk factors that we are looking at when we look at a work environment. Pete Koch: So, when I look at my job as I'm looking through a whole cycle of the tasks that I'm going to do. So, start to finish. I'm looking at so where are the person's position versus where the work is positioned? How many times they have to do that? How much force do I have to exert in order to get it done, whether it be pressing a button or moving a raw material into a machine, removing the raw material from or produce machine material from the machine into something else.  All those pieces that you're looking at. Al Brown: All those pieces you're looking at, you know, where's the workflow? Where is it? You know, we try to get folks to keep work between knee and shoulder. Pete Koch: Okay. Al Brown: And we'll probably get into that a little bit later on. But you try to keep that sort of your power zone. That's where when we look at a lot of the research that's been done out there, trying to keep that work in that area is of greater benefit.  When you start to go beyond that, for example anything, I always go into industry and say, "Don't put anything on the ground that you don't have to."  Placing it on the ground, particularly if it's a light thing, our perception is no big deal. I'll throw it on the ground, and I'll bend over to pick it up.  And bending over to pick it up, oftentimes it's a bend at the waist, a reach down and a pickup with the hand.  And you, when if you can visualize this, the buttock and the head end up on the same plane for the reach down to that object. And we refer to that as the butthead maneuver because the forces on the back often exceed what the National Institute of Occupational Safety and Health deems sort of a safe limit. And all you're doing is picking up a small object. It might be a pen, piece of paper, the scrubbing bubbles if you're in housekeeping, whatever the case may be. That you don't realize it's the little things that cause a lot of the increased force on the low back.  Pete Koch: And that movement to the ground to pick something up from the ground is habitual, really. That movement, the bend from the waist to lift something from the ground comes more from habit. Because if we were going to lift something that was very heavy. So you take that piece of paper or the squirt bottle or the spray bottle, that might weigh a pound more or less. That's a pretty easy pick. But, if I'm going to pick up 60 pounds of concrete or one hundred and twenty pounds of something, or a bag of whatever from the ground, I'm going to do more because I have to exert more force to do that. But what you're saying is that you can exert just as much force on your back picking up something small when you've got the butthead effect going on. So, your head and your butt are in line and I go to lift something light up, I'm putting a lot of force on the lower portion of my back and all I'm doing is picking up that one piece. And I'm doing it from habit. So heavy thing I might think about more, but that little thing that I don't think about that I'm going to bend over at my waist to pick up is what's really going to cause the bigger problem, especially over time, is that correct?. Al Brown: Right. And again, we're always searching for that big thing. And your perception's right that typically when there's a big thing to lift, people are more cautious about lifting because in their mind, it's a heavy object. So, I have to be careful how I do this. Not everybody is good at proper lifting technique. But we all pause when we look at that thing and say that's gonna be heavy. And we either choose to lift it and we get pretty close to using good technique or we get help, or we use a device to lift it.  The little object where everybody is guilty of just bending over to pick that up. Think of this. How many times when you're making a bed? Do you think a housekeeper just takes some sort of reaches out with her arm to sling the sheet out over like a double, or a queen, or king-sized bed instead of walking around the other side? It's just really quick and easy. But that's a huge load on the back and the shoulder, because you know what? In today's work environment, we probably see backs and shoulders kind of lead the way in regard to injuries. So, both of them are exposed to these awkward heavy loads; shoulder more, you know, when you're working overhead, backs, the little things. Pete Koch: Mm hmm. And statistically, shoulders and backs from a soft tissue injury are not only leading the way from a frequency standpoint, but they also are quite expensive over time for our clients and also for the individual and not so much expensive from a cost perspective. But it could have an expense on the pain side for someone and not just at work, but it could be a home. If my back hurts all the time, my quality of life starts to change substantially. I know a number of my friends have sustained back injuries, whether it be through work or play, and they've gone through periods where they've had chronic back pain for weeks or months at a time. And it changes personality, it changes how they work or their job and how they can work at their job. But it also changes what they like to do outside of work as well. So I think it's important to understand these risk factors and not just because it's a workplace thing, but it's because if we can protect what we have, we can do more for longer with what we have and the things that we enjoy, whether it be being outdoors hiking, whether it be something active or even inactive. If you have low back pain, sitting in a chair watching a movie can be excruciating over the long term. Al Brown: It's funny, you know, you talk about back pain and again, going back to that, little things can cause back pain. Education is so important when it comes to those types of injuries, shoulders and back. And again, that's kind of one of the key elements of when we go into industry, we try to work with industry to understand that, you know, for example, a back injury, you sitting will place more force on a back than you and I standing right now. And it can be up to 50 percent more force on a back in terms of disk pressure, if we were to measure that. If you look at some of the studies done by Al Makinson and the folks in the past, they actually have documented that, you know, sitting places more force on the back. So, you going home with a sore back and thinking, I'm going to sit down and watch a show -- "Oh, my back hurts worse."  If you don't understand those nuances, you can actually make things worse. Pete Koch: Yeah, because that that connection between if it hurts, rest it, I mean, it's been driven in our heads for years and years. So, it's good that you go to the doctor. Something hurts. Oh, so take some time, rest, come see me, take some ibuprofen or whatever that is, and the rest is going to be good for you. But many times the rest that he's talking about or she's talking about as a doctor is not that my back hurts after work and when I go spend the rest of the day seated to take the load off, because what we're you're actually saying is that if it's a back issue and it's a disc issue, you're putting more force on your back sitting in that chair, or sitting on that sofa, or on that couch, or in that movie theater seat than you would be standing or even walking. Al Brown: 30 to 40 years ago the treatment of choice was, you know, if you had a rupture or herniated disc was to put you to bed for two weeks. And the problem was that, you know, again, we live in a world of gravity and you take muscle tissue, tendons, ligaments and all those structures in your body and they actually begin to decondition. So, after two weeks, the core musculature, which actually gives our body stability and the back stability have become weakened. So, if you can think of a radio tower and these tethered wires that stabilize it, we've actually loosened those all up, so we've actually made the back more prone to further injury or recurring injury down the road. So today we've gotten smarter and people are much more active, and they begin to understand that, you know, the mechanism of injury and the things that kind of help improve health and start to allow for the rehabilitative process. Pete Koch: Yeah, let's talk a little bit more about lifting. Because lifting is a task that gets done in every job. It doesn't matter what it is. You could be seated at a desk and you will lift something. It could be the telephone, it could be the stapler, it could be the mouse, whatever it is. It could be a book off a shelf. Or you might be in manufacturing and you're lifting material or you're in housekeeping and your lifting laundry or product or whatever.  There's lifting everywhere. So, you'd mentioned before that there are possibly safe lifting limits that one could follow, but depending on how you lift, it might not be quite so safe. So, can you speak to that a little bit, what those safe lifting limits might be and how it all works. Al Brown: Right. Sure. I mean, it's based on science. Tom Waters back in '91 with a host of other folks, Vern Putz and then some contributing from the folks at University of Michigan, Chaffin, Tom Chaffin, Armstrong collaboratively put together what's called the NIOSH lifting equation. And about 3 years later, they had the modified NIOSH lifting equation. It's an equation you can go online and Google NIOSH lifting equation, but it's based on science and in that equation there's 51 pounds, which is the load constant that is started.  And I don't to want to get too deep into the weeds on the science here, but, as industry out there has kind of grabbed on to that number and said that's a safe amount of weight for workers to lift. And here's the deal. It's the load constant that starts the equation. And they figured that that was 99 percent of male, 75 percent of female could safely handle that if these particular factors exist and those factors without, again, getting too deep in the weeds. It's a perfect lift. It's only 10 inches from our center of gravity. It only goes up or down 10 inches. There's no rotation, there's good coupling blah blah blah.  That doesn't exist in industry. So, the way the equation works is we begin to look at the other factors.  Where's the starting of the lift?  Where's the termination of the lift? Is there good coupling, is there rotation in the body? What's the distance? Vertical distance? Horizontal distance? So how far my travelling with it. How far out am I placing it. You know, think about reaching across a pallet and placing something way across a pallet. Well, that's going to be a 20 to 25 inch reach across a pallet to lay a box down. With those increase in critical demands or those increase in exposure, you begin to take that 51 pounds and chisel away at it. And they do that by, they have multipliers. So, it's something less than one. And obviously the higher the critical demand, the smaller that multiplier and it starts cutting that number down so that we can actually look at a job task, put it through the NIOSH lifting equation. And, you know, it might be a 35-pound object. But really, when we get done with the equation, it says that lift is only safe for 99 percent of males and 75 percent of females if it's 14 pounds. Pete Koch: Wow. Al Brown: So, if you think of the 51 pounds, it's probably not a good indicator of what everybody can do within a working environment. You know, NIOSH has actually come out and looked at the healthcare industry and said, "Let's call it 35 pounds." And again, I'm not totally happy. I mean that's a great number. And you know, a good way to feel that is to go out and buy a bag of cat litter or dog food that's in and around that and have people handle it so they can get a sense of what 35 pounds is. It's still Pete, if you think about it, when we go back to that butthead maneuver, that was just a pencil that we were picking. So, it had nothing to do with the weight. So sometimes we get locked in on this weight, but it's those other factors that will impact what is a safe limit. So, you know, just a rule of thumb for industry is to think about nothing below your knees, nothing above the shoulders and 35 pounds. But still, there are other issues you have to think about within those ranges. How far is a person reaching when they're putting things down, that kind of stuff. Pete Koch: So, it comes really it comes down, what affects that 50 pounds or a safe lifting? 51 pounds for safe lifting is all about posture. And it seems that the more awkward the posture is, the harder or the less weight that you are able to lift safely for that 99 percent of males and 75 percent of females. Can you look at it as simply is that?  Like the more awkward the posture is, the less weight you're gonna be able to do move safely? Al Brown: Yeah, that's probably it. You know, and again, it's better to keep it simple when you're thinking about it. So, the more awkward the lift, the less force, the less mass, the less weight that that person can safely handle.  And you know, you begin to look at, if you're a, an owner of a company, you know, a quick walk or just a walk through and start looking at the job tasks within your industry, as you know, who's what stuff are you putting on the ground?   You know? And that's a good start. And then how much is that stuff that I'm putting on the ground? What weight is it? And can I raise that thing up? And it might be simple as instead of having a single pallet on the ground, you double the pallet. So now instead of four to six inches, we're eight to 12 inches, you might triple the pallet so that it actually gets up into that 15 inch about knee height. That's a cheap, easy way to do it. Obviously looking at pallet lifts or a more automated way. But, you know, you start to look for those exposures within industry. Pete Koch: So that concept of keep it off the ground, keep it below your shoulders in that lift. So, I'm looking at lifts between my knees and my shoulders is a good, again, simplistic way to try to limit some of the awkwardness of the posture and how things are going to function. So that's two good pieces. But it's not always the lift from low or high, but it's the reach out that can also cause some of the challenges. So how far can I reach? Where's my, where's my reach to keep it safe? Al Brown: Yeah. I mean, if you think of the primary power zone, we actually have a resource in a chart that actually shows kind of a power zone.  You can actually go online too and just Google manual material power zone and you'll actually see it's a graphic. But when you're looking at it arm extended, so staying within that 10 inches from your core out to where your hands are approximated on the thing that you're holding. That's kind of the real power zone. You can extend beyond that maybe out to 15 or so inches. But again, it depends on the mass and weight that you're handling. So, staying within that power, almost elbows at your side is probably the safe zone. So, think about just flexing your elbows and coming to your shoulders or extending down to your knees where your elbows kind of stay in close to your core. That's your safe zone to work. Soon as you go out a little further, it turns into a yellow zone. And then finally, you get out to the no go zone, which is the red zone. Pete Koch: How does, and I might be getting a slightly off topic here, but how does posture, human posture, affect that? So, you know, if I have that forward head posture or I have a slouched posture, how does posture affect my ability to safely lift that that load? Al Brown: Well, think of it this way. You see a forward head posture. For example, if you take your head, which weighs somewhere in the neighborhood of 13 to 15 pounds for every 10 degrees, you tip your head forward. So think about looking at your eye, your cell phone. And we all tend to look down at our cell phones. So, for every 10 degrees, you tip your head forward, you add 10 more pounds of force. So with a head that's tipped forward, 30 degrees, which is kind of almost like your chin down on your chest a little bit, looking down at something instead of 13 pounds, we now have 43 pounds of force that we are adding to our axial skeleton and our ability to hold. So now we've loaded our back up with that head position. And then if we round our shoulders and bring our core forward, we add that much more force and we haven't even initiated a lift. So again, going back to just body posture and where you're located, you can create a huge load on your back just from your body position. Think of a kitchen. Go to the kitchen, and if you look at the bottom of your cabinet in the kitchen, there's a toe kick space and I'm not sure where that was invented, but the toe kick space allows you to almost belly up to the counter and your toes can go in that extra three to four to five inches. And that allows you to stay upright as long as the counter fits you. If it didn't exist, you would have to lean in on that counter. And you've already loaded your back up simply because of that minor little difference. So toe kicks, have a significant role in the world of happy back in the kitchen. Pete Koch: And you can take that into the industrial kitchen also. And I know going into some industrial kitchens, so I have my prep table and I've never been in a kitchen that has enough space. To put things so sometimes you find things that are actually stored at floor level, so you can't get that close because that toe kick space is being filled with something. Stuff. Al Brown: Stuff. If we go, even at a workbench people end up using that area underneath for storage and all of a sudden, they have no toe kick space. So just because of that storing of things there, you've already loaded your back up simply because you have to lean forward into the job. Pete Koch: And that's a pretty interesting part to think about, like most people wouldn't think. They always think about height, like what's the height of the workplace that I have to work at and how close I can get to it makes a big difference, too.  Because it will change my ability to stand up straight versus just that little forward posture and even just a few degrees forward as you mentioned, you know, how many pounds of force was it again if I tip my head for again? Al Brown: For every 10 degrees, it's 10 pounds of force, just for the head. We haven't talked about the weight of the core, because those measurements are taken, if you go back and look at the Natkinson research those forces are taken at like L5, S1, the low back area. So, anything that you tip forward of your pelvis, above your pelvis, impacts that disc pressure and like I said it will go up exponentially because we live in a world of gravity, so it's not a one to one relationship. It's like a game of Jenga. The further out you start moving those blocks, the more unstable the stack. And sooner or later, it's going to fall over. Pete Koch: Yeah, that's interesting. If you think about it that way, you're really working like a machine, like a crane, and you take a skilled crane operator, he's always or she's always, take into consideration how far out do I have to have the stick? What's the weight of my load? Where does it have to swing to and move to so that they stay within the capacity of their crane or their machine? And we as humans don't often think about all those pieces. We just think about how heavy is it? Not so much where it's located first. how do I muckle onto it? How high do I have to lift it? How far do I have to go with it? We just take for granted that our body can do it because we might have done it before. But as we get older and I think across the nation where we're finding that our workforce is aging, we are as we get older, we struggle to do the same amount of things or lift the same amount or recover faster from doing something incorrectly that we might have been able to do before. Al Brown: Our physiology's slower. And it's as we as we age, we also bring along comorbidities to define that term those are the aches and pains. That's the sprained knee from hiking the hill. That was the old football injury. That was the cheerleading, "Oh I hurt myself." So those aches and pains that kind of come along with life, heal but there's always a little bit of scar left over. And when we start to get to that point in life where we're we consider ourselves aging, and that seems to be a moving target nowadays for me, I'm trying to push it back as far as I can. Those aches and pains come with you and our posture indicates it will impact those comorbidities, too. So, the more awkward or, or forward, or leaning posture as we age, we tend to drop down a bit the more you will impact the joints, ligaments and tendons in your body because they weren't originally built for that posture. So now something has to take up those forces and that's when you begin to get chronic pain and discomfort and strain muscles sooner and easier and tear muscles and tendons and ligaments. So, we're a little bit more exposed. So, when you're taking care of the body and trying to maintain that body in an upright position.  Again, it's like that crane, you've got a preventive maintenance.  It allows you to do more. But still at the end, gravity wins. It's undefeated. So, you're gonna go. So, you're trying to compress your comorbidities as much as you can in the manual material handling world. Pete Koch: So, let's look at those risk factors again. So, exertion, repetitive motion or movements and then awkward postures. So, when you're in the workplace, give me some examples of where you see these either three combined into something that could be very challenging for somebody or just where you might see these in the workplace. Al Brown: Well, you know, it can be a low work area, you know, where you have a tall worker that comes in and they might be doing auto parts, where they're reaching and then they have a box to the side of them that they're stacking these parts and the box might be a little too high. So, or it's just in an awkward position. So, they have to kind of reach up and over the box and place it. And then when the box is filled, they close it up, they pick it up, they turn around and then they put it on a pallet which is on the ground. So, we've got we've got, you know, awkward posture. Static standing, reaching for the parts, to rotating, to put it in a box, up and over with a shoulder being exposed to kind of an up awkward overreach. And then you finished with this I pick it up, it's a heavy lift and I place it on the pallet. So, I'm very exposed.  Now, let me tell you something. Just a little physiology about disks. Disks are, we hear about slip disks. That's actually a bad term.  Disks don't slip.  They are well attached to the vertebrae above and below.  The vertebrae are the bony structures, and through those bony structures go your nerves. And there's lots of tendons and ligaments that hold this all together. And the discs are well attached. However, they are the weak link.  And so, they're a little bit like a jelly doughnut is always used as an example. So, with bending forward slightly, you will create sort of a forward compressive force on the front side of the disc and a forcing that gel inside the disc sort of posterior backwards.  And behind that disc are your nerves that kind of go to different parts of your body.  So, you can create sort of a bulging to that disc.  A natural bulging. And that's why you, me and everybody else, when we've been sitting or even leaning, we have this, some of us will have this natural instinct to stand up and do sort of a backward bend. And all we're trying to do is reset that gel back where it belongs. And with industry, we try to encourage workers to do that. We do that with drivers that are delivery drivers or truck drivers because they're sitting. They change that disc and it takes about anywhere from three to 10 minutes to get that disc to reshape, because you're at great exposure to a to a back injury if you just go and muckle on and pick something up.  So that person I was talking about earlier that is doing the auto parts, they're bent forward, they're loading the disc, they're placing in the box. And then the next thing they do, they turn around and they pick the box up and put it on a pallet and they go, "Oh, my gosh, it was the heavy lift." And it wasn't so much a heavy lift, but it was that awkward leaning forward posture that prepared the disc for injury. Pete Koch: Yup. The movement of the inside of the disc or that gel inside the disc, as I sit forward it's not a quick change all the time, So the longer I stay in one position the longer it takes for that to then reset. Al Brown: Physiologically you have do have a limit. I mean it's like I said three, maybe five minutes. We usually encourage folks to go longer because what happens is sitting flattens your there's an inward curve in your low back. So, it actually flattens that curve and that changes the physics of the compression on that disc. And again, it depends on all the comorbidities you bring along for that disk and how weak the back wall is. But let's call it a healthy disk, when you stand up, that curve doesn't just spring back to its normal shape. It will as you stand and walk around just because it's resetting, it's the gel is re-shifting. And it's not a like a water filled water balloon in there that just squirts around, it takes a moment for it to change. So, it's a slow process, but it resets. But you can assist that by doing a little bit of a back extension. A lot of times we, we encourage that with like I said, drivers or folks that are in manufacturing, where they're doing a lot of stuff in front of them, that during that stretch break they sort of reset their back. Pete Koch: And I think the key right there is it's a stretch break. So, it's a break from doing what's in front of you. Again, the repetition to help change the effects of the awkward posture. So if I'm gonna be in that forward position for a while, if I can't change what's in front of me, then before I go to lift the heavy part, I need to take a not just a moment, but I need to actually take maybe a minute or two and reset before I go to lift that. Al Brown: Yup and in that case, you know, here's an example of working with a company to realize that they're going to say, I can't wait three or five minutes for them to move that box. So that's where you look at can I automate.  Is there a spur? Can we roller conveyor once it's filled? Can we just kind of push it off? So, we eliminate that risk factor because you can't you know, you don't want to interrupt production.  You don't, you know there's a fallacy that ergonomics actually creates a slowdown in the world of production, but in fact, it sort of enhances it and minimizes the risk. But in that particular case, you have to find that kind of a solution. For example, the roller conveyor or, you know, a vacuum lift or whatever to kind of move the box up and out. Pete Koch: Well, you know, talking about that part like ergonomics slows it down so that story I told at the beginning of the podcast about clearing ice from towers one winter.  So, the task we had a group of people we were clearing ice from towers, we were up anywhere between 30 and 60 feet in the air working in the wintertime. The environment was very slippery. So, we're in a full body harness and we have fall protection. And so, in my kit, I have work positioning that allows me to connect into something, lean back into it and sit into a good spot and then work hands free with it and not having to muckle onto something, where my co-workers didn't. They either leaned into their fall protection equipment, which you don't want to do. Or they had to hold on with one arm and do all the work with the other arm. So, what happened throughout the day is that I got more done because I had less fatigue throughout the day. So, production can come from many different ways. Either it's a solution that allows the worker to exert less throughout the day, therefore getting more done throughout the day.  Or it eliminates or reduces one of those risk factors and allows the production to move more quickly.  Like a roller conveyor instead of a pick and a lift. Anytime you can put something on a piece of machinery and move it from point A to point B, it's gonna be a lot more efficient than it is if you're going to give it to somebody to move it someplace else. Al Brown: And think of it, you're just more efficient, you're working more efficiently. So, your fatigue factor is a lot less compared to that person that's struggling and lifting and kind of reaching around. They're going to use much more force or much greater percentage of their force that they can generate. We always do a grip dynamometer; it measures your grip strength. So, we'll have someone in their power zone grip and for ease of math and for everybody listening. Say the person can generate 100 pounds of force and then we'll have them do a reach across the table, maybe an awkward position of the wrist and we have them squeeze that grip dynamometer again. And often, more often than not, that person will generate only half the force that they can in their power zone. And it's not because they gave us less effort, that was their maximum grip because of that awkward position. So, they lose half of their force. So, if they're doing a task that requires 50 pounds of force when they're in their power zone, that's half of their ability to generate force. So, they're much more efficient. They have to reach because they're in an awkward position and reaching across the bed to make the bed. They're reaching around to remove the ice, that's a maximum grip every time. So, they're exerting everything they've got every time. So, their fatigue factor sets in much quicker.  Get clumsy. They start to trip and fall. They make mistakes. Boom: injury occurs. So that efficiency factor and the ability, it's all about positioning the person, whether they're on a tower or in front of a manufacturing plant, how can we get that product again, fitting the work to the worker into their power zone? And again, another quick example. I worked in an industry that was a wood manufacturer and they would bring in these 50-pound bins, back to that 50-pound number again, and we watched raw product to finished product. And in that process, those 50-pound bins got picked up and set on the floor 14 times. So those are 14 opportunities to create back injury. Plus, if you just did a time study on "I Pick It Up and I Set it Down".  The amount time they spent doing that, lifting up, setting down, they were spending a lot of wasted time, non-productive time that was high risk time. So, we actually got to the point where we created a roller conveyor where this product would just stay at the same working level and those 14 lifts went away. Pete Koch: Yeah. Not to mention the fact that you start doing the math and, you know, 14 times 50, you start thinking about, all right, I'm going to I'm going to go work out today. I'm going to go lift that 50-pound dumbbell or whatever, 14 times like that's a lot of weight -- at work. Laundry, picking up a 50-pound bag of laundry from the floor 10 or 15 times because I'm not putting it in a place where I don't have to lift it from the floor.  Or raw product or completed product, the more times you handle it, like you said, the less efficient it is overall for lean manufacturing. But also, it takes away from the person's capacity throughout the day. Al Brown: Yeah, fatigue. I mean, it's just it's energy.  Housekeeping. You know, the butthead maneuver, if you go back to the butthead maneuver and typically, if you're looking at an average individual and they're bending down and it's an extended reach, they can generate up to a thousand pounds of force inside that disc. Now, in the NIOSH lifting equation, sort of references 770-inch pounds as kind of a safe force that's tolerable by the back, so you’re reaching a thousand pounds of force. So, if I'm a housekeeper and I know we've worked together with a housekeeping company, and they're in condos and they put things on the floor. Every time they needed something; they'd bend over to pick up that thing. And if that was 30 times in the day, that's 30,000 extra inch pounds of force on the back, that if I had just taken that same object and placed it on a table, I've eliminated 30,000 extra inch pounds of force on the back that day. Pete Koch: And that's, you talked about doing a time study.  That same thing, doing a lifting study or a moment study when you're looking at the workplace throughout. Where are those times where you're putting something that's below your power zone or above your power zone? Because if I asked you, "Al, thanks for coming in today, I want you to lift a thousand pounds 30 times for me." You'd look at me and go, "There's no way I'm doing that. I'm going to find a different job" Al Brown: Maybe if I warmed up Pete Koch: Oh, possibly. But we're asking or inadvertently causing that same piece to happen with some of our workers. And no wonder that we get to the end of a long week or a long day or increased productivity or I've lost somebody on the shift for whatever reason, I have more work to do that you get a fatigue-related or repetitive motion style injury or cause to one of the workers. Where if we understood more about the effect of the work on the worker, we might be able to manage some of those risk factors. Al Brown: Yeah, I mean, it's like I said, when we go into industry, that's one of the big things is we help industry sort of identify those. We actually have a little 10 tips for good manufacturing or manual material handling environment. So, you begin to look at those 10 parameters, you know, and you can begin to identify where the where the issue might be. And then that's where you might find your root cause and you back up and go, "OK, what can we do to make a change there?" I mean, that's always what we're trying to do. And we, sawzall and duct tape, we try to, you know, provide a solution that is low tech. Because obviously, people can't just throw hundreds of thousand dollars at a solution. But in the long term, you know, you may suggest robotics, you may suggest automation, you know, vacuum lifts. And those things can be worked in the capital budget over time. But prior to that, you know, we've got to find the low hanging fruit, or we've got to find the thing that we can do now to reduce that exposure. And let me just as a caveat here, or as an outlier, you know people go, "Can you teach them proper lifting?"  And proper lifting is not going to solve bad ergonomics. It is not going to solve bad ergonomics. And sometimes I have to sit down and go, OK, we have to have a conversation because that's just not going to solve it. That's an administrative thing that you can teach. A proper lifting is a skill. Not everybody has it. Soon as you walk away, they're going to go lift it the way they're going to go lift.  And you're better off to engineer out the problem. So, so proper lifting, you know, it looks great on paper. It sounds good when you do the presentation, but in reality, you're better off to address the ergonomics of it. Pete Koch: So, it's one component that addresses the outlier that couldn't be managed by the engineering solution.  Al Brown: Yes. Yes. Pete Koch: Hey, so let's take a quick break and we'll be back in just a moment with the Safety Experts podcast. Pete Koch: Welcome back to the Safety Experts podcast. And today, we're talking with Alan Brown, Director of Ergonomics at MEMIC. And today, we're talking about industrial ergonomics and putting the worker center in the workplace. And so, let's jump back in with more questions. So, prior to the break, we've been talking about how ergonomic risk factors affect the worker. And we talked about repetitive motion and awkward posture, excessive reach and excessive force. So, talk to our listeners about how they might be able to evaluate their work area. So, if they're at a workspace right now, they're listening to this podcast through headphones and they're hanging out at their workspace or they're thinking about their workspace. It could be an assembly station. They could be order picking. They can be in a laundry space. They could be in a kitchen space. What would they look for? And then what might they be able to do to make some adjustments? Al Brown: Sure. Pete, thanks. The very first thing is if you go back to that NIOSH lifting equation and you have folks handling weight beyond 50 pounds, that's a red flag.  That's a good place to start and ask yourself, why are they handling 50 pounds? And is that a two-person lift? And if it's not that you need to reassess, why are we handling, what can we do to change the 50 pounds? Do we bring in smaller bags? You know, we think of like the beer brewing industry, where there are bags of hops that come in that are 50 pounds.  Or flour, that has to be lifted into a vat. And in that particular case, if it's not going to be a two-person job, they actually are using, actually, this was a real-life assessment it was, where actually went to a vacuum lift. So the very first thing is if you're handling things greater than 50 pounds, you have to look at how can I bring that back to more of a 35 pound force or do I have to automate or find a mechanical way to handle that? There are all kinds of mechanical material handling devices out there. I think of barrels, barrel tippers, you know, those kinds of things. Al Brown: The second thing is to add anything you're putting on the ground, stop putting it on the ground if you don't have to put it there. Go back to that wood manufacturing plant I talked about where they would put the 50-pound bin on the ground 14 times. So, don't put anything on the ground that doesn't have to go there. Use the knee as sort of a guideline that anything below the knee, ask yourself, "Why are we doing that and how can we get it above the knee?" And again, early on it can be stacking pallets to bring the load up. It can be something fancy like a pallet lift or you know, that will actually with a rotating top so you can load the pallet and you don't to reach across the pallet and spin it around.  And then nothing above shoulder level. So, you go to that and we throw numbers at it, and again, looking at the average individual, think of 15 inches at the knees, nothing above 60 inches at the shoulder and 35 pounds in between. Al Brown: So, when you start to find outliers in your industry that go beyond those critical demands, you have to ask yourself, is that an essential function of that job? And if it is, how can I change it? And if I can't change that weight, then mechanically I have to figure out how to move that.  In the health care industry, in nursing homes and extended care facilities. Human beings are really starting to get much larger.  We have bariatric units. We have folks that are 400, 500 pounds.  And poor handles, no handles. So, we actually are very focused on using mechanical lifts. Now, now part of the issue there too, is you have to apply the belts and things and that can be those little things that causes back pains. They have to be more aware of those. So, in an industry, you have to look at where you're outside those critical demands. Housekeeping is another challenge. You know, getting folks educated about reaching across the bed because that when you reach across the bed -- here's one of these funny little awkward things -- when you bend forward at the waist and you reach out with your arm to pull the sheet up. Is that above your shoulder or below your shoulder? Pete Koch: As I'm looking at you right now it's above your shoulder. Al Brown: It's above your shoulder, right?  And most folks don't realize that when they're bending over and they're reaching way out, that's actually above shoulder work. And it's actually provides greater force than if I was to stand straight up and reach above my head because I've at least got the game of Jenga lined up. And, you know, the forces are compressing me down through my axial skeleton. And when I reach across the bed, I'm that long extended crane and that's above my shoulders. So very inefficient. So, in that case, we can't change a bed configuration. So, you have to do some education and that becomes a two-person task. So, you'll look at situations like that. So, it depends on the kind of industry you're or you're in.  Just moving product around. Take a look at the flow of your product and going from raw product to finished product. Is it a linear process moving through your industry or is it zigzagging all over the place? And if it's zigzagging all over the place, you're taking a lot of time to move stuff around that you probably don't have to and you're probably moving at multiple times. So how can we actually line up the process to minimize all that extra movement and risk of injury? And certainly, look at, you know, automation and the mechanical lifts that are out there because they've gotten very sophisticated. You might think that a bag of flour can't be vacuum lift. But it can.  You know, it's amazing the stuff that you can do. Big awkward things might not be 50 pounds. I'm thinking of like a window, you know, but it's a big awkward thing that also is gonna create awkward postures to kind of pick it up and put your shoulders or your back in an awkward position or an inefficient position.  So you might use a vacuum left to move that around. So, it depends on the thing you're doing.  So those are some of the when you're walking through your industry or when you're first taking a glance at it. Think about that, 50 pounds. Am I exceeding that? I like 35. So, if you see things above 35 pounds, that's also a red flag for me. Pete Koch: Well I think that's a that's a key point to bring up and even though 51 pounds, is that NIOSH Lifting limit, as we talked about before, there are so many factors that cut into that 50 pounds that don't make it 50 anymore. So, 35 is a much place.  Al Brown: 35's a much more realistic number. Pete Koch: Because I have never seen anybody in a in a non-laboratory, you know, testing standpoint be able to pick up 50 pounds and keep it no more than 10 inches away from them and no more move at no more than 10 inches up and down and not twist with it. You always have to do something else like that. So, yeah, 50 pounds. Great place to start. But let's start at 35 because that's more realistic throughout anything. Al Brown: And if you look at a lot of the research that's been done the past, I've always asked this question of the researchers, "What age were these workers?"  Because oftentimes they're young college students that they, you know, volunteered to do this or get a little extra money for the research project. And I'm thinking that is not our workforce nowadays, particularly Maine. You know, we are the oldest workforce in the nation with an average working age of about 47.8 years old. So, you know, 35 pounds is much more realistic. And again, as we get older, we lift less and are less tolerant of those kinds of forces. Pete Koch: And I think in a lot of the manual jobs and a lot of the jobs that that require someone to do lifting or reaching or those physical tasks, you're gonna find an older workforce regardless of what state you're in. The workforce as aging overall, not just in Maine, but overall. And we're finding that to be more of a challenge. So, yeah, I think just from an efficiency standpoint, it makes sense to think to think about it in that perspective. So again, kind of recapping so the, anything above 35 pounds we're really paying attention to and then location of where that product is. So where is it? And you referenced your knee and your shoulder as being those two pieces.  What were the measurement that you had in there? Al Brown: Well, I said 15 to 60, but that's the average worker, when you look at shoulder height, knee height. But to include all workers always think knee and shoulder, because if I have someone that's five foot one in that job, their knees are gonna be a little bit lower than someone that's 6’2”. And again, that 5'1" to 6'2", you know, that's going to be 90 percent of your workforce is going to fall between those two heights. If you have someone that's not 5'1" and they're less than you have someone greater than 6'2", you may have to make some accommodations simply because they are at the extremes. But you want to try to find, you know knee to shoulder is kind of what you're looking at. And you had mentioned it earlier on, Pete, in the podcast and that is adjustability. So, knee and shoulder, if your workspace has adjustability, I know at one of these large retail distribution center in the Freeport area, a lot of their work benches do height adjust. Pete Koch: And I was thinking in that same example. Al Brown: They walk in and the first thing they do is they adjust it to their stature. Pete Koch: I’ve seen it happen actually; it was actually at one of the checkout stations that they had. There was a little guy who came in. He probably was, I don't know, maybe 5’4”. So pretty small in stature. And then the next person that came in was close to 6'4". So almost a two-foot difference. And when they came in, the first thing that the person did was not go right to work, but they adjusted the workstation to bring it up to. So, each person was working at the same level, but they adjusted the workstation. So great training on that, the company's part to instill it into the heads of their workers that this is where we expect you to work and we're providing you some tools in order to accomplish that and work to accomplish that. Al Brown: And that's a that's a high level. I mean, when you get to adjustability, I mean, that's a company that's really forward thinking. And they've been, oh, 40 years kind of through this process, you know, as long as I've been involved and to current day. So that's been an evolution. So, you might have you know, you don't need to be that fancy, but that's where you would like to get where you could actually have a workspace that is adjustable that fits multiple statured individuals. Pete Koch: And I think if that's your plan, as you begin to look at your workplace like that would be the ultimate thing to be able to adjust the work place or the workstation or the work area to the myriad of different workers that I have. If that's the goal, then you can always make incremental steps towards that goal. But if you don't start with that goal, then chances of you ever getting there, it might take you 40 or 50 years and that's not really functional. And as quickly as we move these days, you need to be more thoughtful as you're working towards those ergonomic solutions towards adjustability. So even though it is advanced, I think if you set that as the goal, then that would be you're more likely to achieve it than if you don't set it from it from the beginning. Al Brown: And I'm going to tell you, one of the greatest resources you have is the worker.  When I go into an industry, I go talk to the person doing the job task and ask them where the low hanging fruit is. What do you see as a solution or what would make this job easier? And they can often give me one through three bullet points that are like this would make this job a lot easier if I could do this. And enlisting that worker is invaluable. In instituting a change, because if I came in and just dictated a change, I might get some folded arms and that closed body posture looking at me going, I don't think so. Pete Koch: That's not going to happen, you don't know my job. Al Brown: If I collaborate and work with the worker, the change comes much easier. And also there's process improvement because they're going to try something, then they're gonna go back and go, you know, if we tweak this and that has been repeated time and time again through industry throughout the US that we've been working with. You go to that valuable resource at the front line. Pete Koch: That's a really great point. That change is difficult for everyone. And when you change something at work that's been constant for a long time, it becomes very challenging regardless of how awkward or uncomfortable it is. So enlisting the person that will have to manage the change, to develop the change and to tweak the change. It helps with that productivity helps them become more comfortable as there is a great way to eliminate some of those change challenges that you're gonna have in the workplace. Fantastic. So, I think we've hit just about all the points that we wanted to make today. There's certainly a myriad of other concepts and discussions that we can have around industrial ergonomics, but I think we'll leave those for a different episode. So, I really do appreciate all those suggestions today about how to make changes in the workplace and industrial ergonomics. And we're going to wrap up today's episode with maybe some final comments from you about industrial ergonomics and how employers might help manage some of their challenges in the workplace. Al Brown: Sure. You know in the news, if you listen to the news nowadays, everything is going to go to robotics. And as often as I've been out in industry, I haven't seen robots take over all the jobs. And the human factor is still there. And as long as the human factor is there and I think it will be there for a very long time, there is always going to be risk and exposure. And we have to know the limits of a human being. Know the limits of human physiology. And if you understand those and you work within those limits, you find that you actually will have a very efficient work environment that can be very productive and that workers can come in happy and go home happy without aches and pains. And a lot of times the pearls of wisdom that you share or enlist in your workplace, they can overlay those in the non-work environment, too. So, it's kind of a win, win, win. And robotics won't take every job. So, we're here to help out that that that human equipment. Pete Koch: I think that's great. So, know the limitations, understand them and how they will affect your workforce is a great piece. And that ties right into the definition of ergonomics and how it fits in within industry. So, thanks Al for joining us today and to all of our listeners out there who have spent the hour with us. If you have any questions for Al or would like to hear more about a particular topic or from a certain person on our podcast, email podcast at MEMIC.com. The podcast is presented by MEMIC, we are a leader in workers compensation insurance and a company committed to the health and safety of all workers. And to learn more about how MEMIC can help your business visit MEMIC.com. Don't forget about any of our upcoming workshops and webinars, and if you do, you can always go to MEMIC.com for a listing of topics and dates. And when you want to hear more from the safety experts, you can find us on iTunes or right here at MEMIC.com. And if you have a smart speaker, you can tell it to play the safety experts podcast and you can pick today's episode or a previous episode if you'd like. You can also enable the safety experts podcast skill on Alexa to receive safety tips and advice from any of our episodes. We really appreciate you listening and encourage you to share this podcast with your friends and co-workers. Let them know where they can find it and they can go right to their favorite podcast player and search for safety experts. Thanks again for tuning into the Safety Experts podcast. And remember, you can always learn more by subscribing to the podcast at MEMIC.com/podcast. Resources/People/Article Mentioned in Podcast MEMIC - https://www.memic.com/ Peter Koch -https://www.memic.com/workplace-safety/safety-consultants/peter-koch Allan Brown - https://www.memic.com/workplace-safety/safety-consultants/allan-brown US Department of Defense - https://www.defense.gov/ NIOSH - https://www.cdc.gov/niosh/index.htm NIOSH Lifting Equation - https://ergo-plus.com/niosh-lifting-equation-single-task/ University of Michigan - https://umich.edu/ Alf Nachemson - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2200702/ Tom Waters - https://www.cdcfoundation.org/blog-entry/thomas-r-waters-receives-niosh-lifetime-achievement-award Vern Putz Anderson - http://behavioral.cybernetics.cc/index.php/2-uncategorised/19-vern-putz-anderson Tom Armstrong - http://www-personal.umich.edu/~tja/ta.html Don Chaffin - https://bme.umich.edu/people/don-chaffin/

On this episode, Dan reconnects with returning guest Tom Waters about his recent success from a ground blind in Kentucky. Tom shares the story of how a really good friend helped him gain access to a small farm 3 years ago not too far from where he lives. This year, there was a huge bachelor group of bucks that called this farm home with one buck in particular that stood out from the crowd. Tom shares the strategy that he used to sneak in and get an arrow in his target buck.  

On this episode, Dan reconnects with returning guest Tom Waters about his recent success from a ground blind in Kentucky. Tom shares the story of how a really good friend helped him gain access to a small farm 3 years ago not too far from where he lives. This year, there was a huge bachelor group of bucks that called this farm home with one buck in particular that stood out from the crowd. Tom shares the strategy that he used to sneak in and get an arrow in his target buck.  

On this week's pod, Nick and Mike discuss the changes at partypoker with analysis of the interview of partypoker's Tom Waters and Rob Yong and a recap of the information that has come out since. Pennsylvania is set to open its online poker market in 2 weeks time, and the guys discuss what they know about which online poker rooms will be ready at launch. Live poker in Sochi, Russia has become a priority for all of the major online poker operators and the guys discuss why.

In our second special edition on the pokerfuse podcast, your hosts Mike Gentile and Nick Jones sit down with Tom Waters, Head of Poker at partypoker, and Rob Yong, partypoker partner, to discuss the latest ecology changes at the online poker room. Topics discussed in this wide-reaching interview include:- The end of HUDs at partypoker.- The reasons for ending hand histories saved to the hard drive.- Rob's new #fairplay concept.- How the operator will police the game in a post-hand history world.- The planned use of moving to real names instead of screen names.- Other ecology changes coming up at partypoker.- Plans for its live poker tour and the synergy with online.

Fred Ramsay and Mark Tobin talk to Chairman of the Missouri Levee and Drainage District, Tom Waters about the flooding problems for the farmers in the area. They also talk to biologist for Lake Taneycomo and Table Rock about fishing in the area.See omnystudio.com/listener for privacy information.

Highlights from this episodeEd loves pugs and pug paintings. - (0:13) Nobody puts baby in the corner! - (1:06) Just for the record, Tom has not gone swimming with the manatees. - (4:21) What is Easter Seals? Tom gives an excellent answer! - (5:10) Spoiler Alert! Tom Waters is Captain America. - (16:11) Woof Wednesday saves lives! - (16:25) All of the many ways YOU can help Easter Seals today! - (18:15) What is The Giving Challenge? - (20:30) Quite possibly the best answer to any interview question we have asked a guest - ever. - (31:00) Ed is serious for almost a full minute - it's a near miracle! - (41:15) Interview with Tom Waters of Easter Seals Southwest Florida - (3:22) Easter Seals of Southwest FloridaEaster Seals Southwest Florida provides quality lifespan services to children and adults with developmental disabilities such as autism, spina bifida, Down syndrome, cerebral palsy, and sensory processing disorders. Operating in Manatee and Sarasota counties, Easter Seals Southwest Florida creates solutions that change lives for children, adults and families with developmental disabilities through high quality therapeutic, educational and support services. Our mission is to ensure that each person we serve reaches his or her full potential and enjoys life to the fullest.  Easter Seals Southwest Florida Inc 350 Braden Ave Sarasota, FL 34243 941-355-7637 http://easterseals-swfl.org/ (http://easterseals-swfl.org/) 2018 Giving ChallengeCommunity Foundation of Sarasota County   The Community Foundation of Sarasota County is a public charity founded in 1979 by the Southwest Florida Estate Planning Council as a resource for caring individuals and the causes they support, enabling them to make a charitable impact on the community.   Community Foundation of Sarasota County, Inc. 2635 Fruitville Road, Sarasota, FL 34237 (941) 955-3000 (Phone) (941) 952-1951 (Fax) info@cfsarasota.org (Email) https://www.cfsarasota.org/ (https://www.cfsarasota.org/)   The Patterson Foundation   The Patterson Foundation strengthens the efforts of people, organizations, and communities by focusing on issues that address common aspirations, foster wide participation, and encourage learning and sharing.   The Patterson Foundation 2 North Tamiami Trail Suite 206 Sarasota, FL 34236 Phone: 941-952-1413 Fax: 941-952-1435 https://www.thepattersonfoundation.org/ (https://www.thepattersonfoundation.org/)   Easter Seals Giving Challenge Information https://givingpartnerchallenge.org/npo/easter-seals-southwest-florida-inc (https://givingpartnerchallenge.org/npo/easter-seals-southwest-florida-inc) What is Woof Wednesday? (#woofwednesday) - (16:25)Nate's Honor Animal RescueMISSION: To save the lives of homeless pets by changing the way our community views animal sheltering and shelter pets. To provide an educational and family friendly environment that will change their future one animal, one family, and one generation at a time.   LOCATIONS:   The Ranch Adoption Center 4951 Lorraine Road Bradenton, Florida 34211 Adoption Hours: 11am to 4pm: W Th F Su; 10am to 4pm: Sat 941-747-4900   NATE’S PLACE RETAIL & ADOPTION CENTER 8437 Cooper Creek Blvd Bradenton, FL 34201 Adoption Hours: 11-4: W Th F Su; 11-4: Sat 941-747-4900   PAWS ATTIC THRIFT STORE 3518 53rd Avenue West Bradenton, FL 34207   PETCO 131 N Cattlemen Rd Sarasota, FL 34243   https://www.nateshonoranimalrescue.org/ (https://www.nateshonoranimalrescue.org/)   The Local Flavor - (36:04)Trivia Night at Truman's Tap RoomLocated in Lakewood Ranch, Florida. With an inviting, warm atmosphere and neighborhood feel, Truman’s is the ideal casual setting to enjoy

On this episode Tom Waters of Kentucky shares his thoughts on new products he used during the 2017 hunting season. OnX Maps digital app and hunting clothing from Sitka Gear. Tom discusses what made him decide to purchase these products, how the products functioned, and if he would recommend them to other hunters.

On this episode Tom Waters of Kentucky shares his thoughts on new products he used during the 2017 hunting season. OnX Maps digital app and hunting clothing from Sitka Gear. Tom discusses what made him decide to purchase these products, how the products functioned, and if he would recommend them to other hunters.

Holiday decorating can be one of the most joyous times of the year. But according to the CDC, tens of thousands of people will be treated in emergency departments for holiday decorating-related falls. Dr. Tom Waters from the Cleveland Clinic talks more about this.This podcast is a joint effort of Today's Health and The Central Ohio Health And Wellness Magazine.Subscribe to the podcast on Apple Podcasts, Stitcher, Google Play or iHeart Radio, or your favorite podcast player.http://www.ohiohealthandwellness.comFacebook - @todayshealthohioThanks to Dr. Tom Waters from the Cleveland Clinic.HELP US SPREAD THE WORD!We'd love it if you could please share this podcast with your social media friends! If you liked this episode, please leave us a rating and a review in your podcast player.Contact us at bjohnson@nabco-inc.com

Holiday decorating can be one of the most joyous times of the year. But according to the CDC, tens of thousands of people will be treated in emergency departments for holiday decorating-related falls. Dr. Tom Waters from the Cleveland Clinic talks more about this.This podcast is a joint effort of Today's Health and The Central Ohio Health And Wellness Magazine.Subscribe to the podcast on Apple Podcasts, Stitcher, Google Play or iHeart Radio, or your favorite podcast player.http://www.ohiohealthandwellness.comFacebook - @todayshealthohioThanks to Dr. Tom Waters from the Cleveland Clinic.HELP US SPREAD THE WORD!We'd love it if you could please share this podcast with your social media friends! If you liked this episode, please leave us a rating and a review in your podcast player.Contact us at bjohnson@nabco-inc.com

Returning guest, Tom Waters, shares with us the story about the time he went on a vacation to Hawaii with his wife and ended up killing a 275 lb. wild hog with just a knife. Learn more about your ad choices. Visit megaphone.fm/adchoices

Returning guest, Tom Waters, shares with us the story about the time he went on a vacation to Hawaii with his wife and ended up killing a 275 lb. wild hog with just a knife.

Returning guest, Tom Waters, shares with us the story about the time he went on a vacation to Hawaii with his wife and ended up killing a 275 lb. wild hog with just a knife.

Today we talk with Tom Waters as he opens up about his addiction to buying hunting related gimmick products. Learn more about your ad choices. Visit megaphone.fm/adchoices

Today we talk with Tom Waters as he opens up about his addiction to buying hunting related gimmick products.

Today we talk with Tom Waters as he opens up about his addiction to buying hunting related gimmick products.

Podcast summary of articles from August 2016 edition of Journal of Emergency Medicine from the American Academy of Emergency Medicine.  Topics include QT prolongation in dialysis patients, Blood Transfusions, Vitamin K deficiency, IV Fat Emulsion Therapy in Overdose, Malignant Hyperthermia and Board Review on Exertional Heat Illness and Thyroid Storm.  Guest speakers include Dr. Tom Waters and Dr. Bryan Graham.

    Tom Waters of Kentucky shares his experiences with three different products from X Stand, HECS, and Cuddeback. Thanks for listening, Dan (DFW) Learn more about your ad choices. Visit megaphone.fm/adchoices

    Tom Waters of Kentucky shares his experiences with three different products from X Stand, HECS, and Cuddeback. Thanks for listening, Dan (DFW)

    Tom Waters of Kentucky shares his experiences with three different products from X Stand, HECS, and Cuddeback. Thanks for listening, Dan (DFW)

This episode we discuss concussions, the sequelae that happen as a result of concussions, and the long term effects of repeated head trauma. We seek answers from “Captain Cortex”, Prof. Stuart Swadron. Medical team physician for the Cleveland Indians, Dr Tom Waters, explains the process of assessing when an injured player in the NFL can go back in the game. Dave’s personal trainer, Steven Yates, talks about his experience with concussions, as a former college football player. And Jess speaks to a young patient and his mother, who recently came into the ER after a head injury, about their story.

Second of three reports from the Community Service Society, authored by Vic Bach and Tom Waters, "What New Yorkers Want From the New Mayor: An Affordable Place to Live," outlines the significant shortfall of affordable housing, making concrete proposals.

Supernatural Girlz Helene Olsen & Patricia Baker unravel the mysteries of ancient and contemporary alchemy with modern day alchemist Tom Waters.  Although the mysteries of this ancient art are hidden in the mists of time, the transformative power of alchemy is within our reach.  Tom, an alchemist of the Hermetic Tradition of ancient Egypt, explains the true motive behind the alchemists singular pursuit~ unravelling powerful mysteries in the face of persecution.  Alchemists then and now are inspired by a vision of man made perfect, free from disease and the limitations of the physical, standing as a mirror to God in Perfection, Beauty, and Harmony.  Is this possible and are there revolutionary new products to help us reach that enlivened and enlightened state?  Tune in and find out!