Occupational Health Science

, Volume 2, Issue 4, pp 437–450 | Cite as

Identifying Safety Peer Leaders with Social Network Analysis

  • David A. HurtadoEmail author
  • Lisset M. Dumet
  • Samuel A. Greenspan
  • Yaritza I. Rodríguez
  • Gregory A. Heinonen
Brief Research Report


Injuries rates in healthcare are higher than in other industries (50.2 vs. 38.8 per 10,000 workers) (Dressner 2017). Safe patient handling programs reduce the risk of patient-assist injuries, an issue that accounts for 45% of workers’ compensation claims. Safe patient handling programs implement engineering (e.g., introduction of patient-transfer equipment), administrative (e.g., no-manual-lift policy implementation), and educational (e.g., peer coaching) control measures (Nelson and Baptiste 2006). A study across 141 Veterans Administration facilities over three years found that 23% of the variation in injury reduction was attributed to actions performed by peer leaders (Powell-Cope et al. 2014). Program effectiveness ranges from non-significant number of lost workdays in a five-year period (Nelson et al. 2006), negative benefit-to-cost ratios over seven years (Tompa et al. 2016), to decrements in injury rates of 50–65% in one to seven years (Tompa et al. 2016;...



This study was funded by the Oregon Institute of Occupational Health Sciences at Oregon Health & Science University. Special thanks to our organizational healthcare partner as well as to W. Kent Anger, PhD, Leslie B. Hammer, PhD and the Oregon Healthy Workforce Center.


  1. Alamgir, H., Drebit, S., Li, H. G., Kidd, C., Tam, H., & Fast, C. (2011). Peer coaching and mentoring: A new model of educational intervention for safe patient handling in health care. American Journal of Industrial Medicine, 54(8), 609–617. Scholar
  2. Alexopoulos, E. C., Tanagra, D., Detorakis, I., Gatsi, P., Goroyia, A., Michalopoulou, M., & Jelastopulu, E. (2011). Knee and low back complaints in professional hospital nurses: Occurrence, chronicity, care seeking and absenteeism. Work, 38(4), 329–335.PubMedGoogle Scholar
  3. Allen, D., Weinhold, M., Miller, J., Joswiak, M. E., Bursiek, A., Rubin, A., et al. (2015). Nurses as champions for patient safety and interdisciplinary problem solving. Medsurg Nursing, 24(2), 107–111.PubMedGoogle Scholar
  4. Baptiste, A., Boda, S. V., Nelson, A. L., Lloyd, J. D., & Lee, W. E. I. (2006). Friction-reducing devices for lateral patient transfers. AAOHN Journal, 54(4), 173–180. Scholar
  5. Bauer, T. N., & Green, S. G. (1996). Development of leader-member exchange: A longitudinal test. Academy of Management Journal, 39(6), 1538–1567. Scholar
  6. Borgatti, S. P. (2006). Identifying sets of key players in a social network. Computational & Mathematical Organization Theory, 12(1), 21–34.CrossRefGoogle Scholar
  7. Borgatti, S. P., Everett, M. G., & Freeman, L. C. (2002). Ucinet for windows: Software for social network analysis. Harvard: Analytic Technologies.Google Scholar
  8. Borgatti, S. P., Everett, M. G., & Johnson, J. C. (2013). Analyzing social networks. Thousand Oaks (USA): SAGE Publications Limited.Google Scholar
  9. Caspi, C. E., Dennerlein, J. T., Kenwood, C., Stoddard, A. M., Hopcia, K., Hashimoto, D., & Sorensen, G. (2013). Results of a pilot intervention to improve health and safety for healthcare workers. Journal of occupational and environmental medicine/American College of Occupational and Environmental Medicine, 55(12), 1449.CrossRefPubMedCentralGoogle Scholar
  10. Cho, Y., Hwang, J., & Lee, D. (2012). Identification of effective opinion leaders in the diffusion of technological innovation: A social network approach. Technological Forecasting and Social Change, 79(1), 97–106.CrossRefGoogle Scholar
  11. Dearing, J. W. (2009). Applying diffusion of innovation theory to intervention development. Research on Social Work Practice, 19(5), 503–518.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Dressner, M. A. (2017). "Hospital workers: An assessment of occupational injuries and illnesses,". Monthly Labor Review: U.S. Bureau of Labor Statistics.Google Scholar
  13. Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly, 82(4), 581–629.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Holliday, J., Audrey, S., Campbell, R., & Moore, L. (2016). Identifying well-connected opinion leaders for informal health promotion: The example of the ASSIST smoking prevention program. Health Communication, 31(8), 946–953.CrossRefPubMedGoogle Scholar
  15. Hurtado, D. A., Kim, S.-S., Subramanian, S., Dennerlein, J. T., Christiani, D., Hashimoto, D., & Sorensen, G. (2017). Nurses’ but not supervisors’ safety practices are linked with job satisfaction. Journal of Nursing Management. Scholar
  16. Iyengar, R., Van den Bulte, C., & Valente, T. W. (2011). Opinion leadership and social contagion in new product diffusion. Marketing Science, 30(2), 195–212.CrossRefGoogle Scholar
  17. Kaissi, A., Johnson, T., & Kirschbaum, M. S. (2003). Measuring teamwork and patient safety attitudes of high-risk areas. Nursing Economics, 21(5), 211.PubMedGoogle Scholar
  18. Krill, C., Staffileno, B. A., & Raven, C. (2012). Empowering staff nurses to use research to change practice for safe patient handling. Nursing Outlook, 60(3), 157-162. e151.CrossRefGoogle Scholar
  19. Kutash, M., Short, M., Shea, J., & Martinez, M. (2009). The lift team's importance to a successful safe patient handling program. Journal of Nursing Administration, 39(4), 170–175.CrossRefPubMedGoogle Scholar
  20. Lawton, R., & Parker, D. (2002). Barriers to incident reporting in a healthcare system. BMJ Quality & Safety, 11(1), 15–18.CrossRefGoogle Scholar
  21. Lee, S.-J., & Lee, J. H. (2017). Safe patient handling behaviors and lift use among hospital nurses: A cross-sectional study. International Journal of Nursing Studies, 74, 53–60.CrossRefPubMedGoogle Scholar
  22. Matz, M. (2005). Unit-based peer safety leaders to promote safe patient handling. In A. Nelson (Ed.), Safe patient handling and movement: A practical guide for health care professionals (pp. 139–150). New York: Springer.Google Scholar
  23. Neal, A., & Griffin, M. A. (2006). A study of the lagged relationships among safety climate, safety motivation, safety behavior, and accidents at the individual and group levels. Journal of Applied Psychology, 91(4), 946–953. Scholar
  24. Nelson, A. L., & Baptiste, A. S. (2006). Evidence-based practices for safe patient handling and movement. Clinical Reviews in Bone and Mineral Metabolism, 4(1), 55–69. Scholar
  25. Nelson, A. L., Matz, M., Chen, F., Siddharthan, K., Lloyd, J., & Fragala, G. (2006). Development and evaluation of a multifaceted ergonomics program to prevent injuries associated with patient handling tasks. International Journal of Nursing Studies, 43(6), 717–733. Scholar
  26. Olinski, C., & Norton, C. E. (2017). Implementation of a safe patient handling program in a multihospital health system from inception to sustainability: Successes over 8 years and ongoing challenges. Workplace Health & Safety, 65(11), 546–559.CrossRefGoogle Scholar
  27. Ørhede, E., Hottinen, V., Skogstad, A., Knardahl, S., Elo, A.-L., Dallner, M., & Gamberale, F. (2000). User’s guide for the QPSNordic: General Nordic Questionnaire for psychological and social factors at work. Copenhagen: Nordic Council of Ministers.Google Scholar
  28. Ploeg, J., Skelly, J., Rowan, M., Edwards, N., Davies, B., Grinspun, D., et al. (2010). The role of nursing best practice champions in diffusing practice guidelines: A mixed methods study. Worldviews on Evidence-Based Nursing, 7(4), 238–251.CrossRefPubMedGoogle Scholar
  29. Powell-Cope, G., Toyinbo, P., Patel, N., Rugs, D., Elnitsky, C., Hahm, B., et al. (2014). Effects of a national safe patient handling program on nursing injury incidence rates. Journal of Nursing Administration, 44(10), 525–534.CrossRefPubMedGoogle Scholar
  30. Rickett, B., Orbell, S., & Sheeran, P. (2006). Social-cognitive determinants of hoist usage among health care workers. Journal of Occupational Health Psychology, 11(2), 182.CrossRefPubMedGoogle Scholar
  31. Rogers, E. M. (2010). Diffusion of innovations (5th ed.). New York: Simon and Schuster.Google Scholar
  32. Schneider, J. A., Zhou, A. N., & Laumann, E. O. (2015). A new HIV prevention network approach: Sociometric peer change agent selection. Social Science & Medicine, 125, 192–202. Scholar
  33. Springer, P. J., Lind, B. K., Kratt, J., Baker, E., & Clavelle, J. T. (2009). Preventing employee injury: Implementation of a lift team. AAOHN Journal, 57(4), 143–148.CrossRefPubMedGoogle Scholar
  34. Spruce, L. (2015). Back to basics: Implementing evidence-based practice. AORN Journal, 101(1), 106-114. e104.CrossRefGoogle Scholar
  35. Sullivan, G. M., & Feinn, R. (2012). Using effect size—or why the P value is not enough. Journal of Graduate Medical Education, 4(3), 279–282.CrossRefPubMedPubMedCentralGoogle Scholar
  36. Tompa, E., Dolinschi, R., Alamgir, H., Sarnocinska-Hart, A., & Guzman, J. (2016). A cost-benefit analysis of peer coaching for overhead lift use in the long-term care sector in Canada. Occupational and Environmental Medicine, 73(5), 308–314. Scholar
  37. Tsai, J., Valente, T. W., Miller, K. A., De La Haye, K., Pickering, T. A., & Cockburn, M. G. (2016). Friendship networks and sun safety behavior among children. Network Science, 4(03), 314–335.CrossRefGoogle Scholar
  38. Valente, T. W., & Davis, R. L. (1999). Accelerating the diffusion of innovations using opinion leaders. The Annals of the American Academy of Political and Social Science, 566(1), 55–67.CrossRefGoogle Scholar
  39. Valente, T. W., & Pumpuang, P. (2007). Identifying opinion leaders to promote behavior change. Health Education & Behavior, 34(6), 881–896. Scholar
  40. Valente, T. W., Hoffman, B. R., Ritt-Olson, A., Lichtman, K., & Johnson, C. A. (2003). Effects of a social-network method for group assignment strategies on peer-led tobacco prevention programs in schools. American Journal of Public Health, 93(11), 1837–1843.CrossRefPubMedPubMedCentralGoogle Scholar
  41. Valente, T. W., Ritt-Olson, A., Stacy, A., Unger, J. B., Okamoto, J., & Sussman, S. (2007). Peer acceleration: Effects of a social network tailored substance abuse prevention program among high-risk adolescents. Addiction, 102(11), 1804–1815.CrossRefPubMedGoogle Scholar
  42. Zadvinskis, I. M., & Salsbury, S. L. (2010). Effects of a multifaceted minimal-lift environment for nursing staff: Pilot results. Western Journal of Nursing Research, 32(1), 47–63. Scholar
  43. Zohar, D., & Luria, G. (2005). A multilevel model of safety climate: Cross-level relationships between organization and group-level climates. Journal of Applied Psychology, 90(4), 616.CrossRefPubMedGoogle Scholar
  44. Zohar, D., & Tenne-Gazit, O. (2008). Transformational leadership and group interaction as climate antecedents: A social network analysis. Journal of Applied Psychology, 93(4), 744.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • David A. Hurtado
    • 1
    Email author
  • Lisset M. Dumet
    • 1
  • Samuel A. Greenspan
    • 1
  • Yaritza I. Rodríguez
    • 1
  • Gregory A. Heinonen
    • 1
  1. 1.Oregon Institute of Occupational Health SciencesOregon Health & Science UniversityPortlandUSA

Personalised recommendations