Introduction: Long Term Care (LTC) facilities are fast-paced, demanding environments placing workers at significant risk for injuries. Health and safety interventions to address hazards in LTC are challenging to implement. The study assessed a participatory organizational change intervention implementation and impacts. Methods: This was a mixed methods implementation study with a concurrent control, conducted from 2017 to 2019 in four non-profit LTC facilities in Ontario, Canada. Study participants were managers and frontline staff. Intervention sites implemented a participatory organizational change program, control sites distributed one-page health and safety pamphlets. Program impact data were collected via Survey (self-efficacy, control over work, pain and general health) and observation (Quick Exposure Checklist). Interviews/focus groups were used to collect program implementation data. Results: Participants described program impacts (hazard controls through equipment purchase/modification, practice changes, and education/training) and positive changes in culture, communication and collaboration. There was a statistically significant difference in manager self-efficacy for musculoskeletal disorder (MSD) hazards between the control and intervention sites over time but no other statistical differences were found. Key program implementation challenges included LTC hazards, staff shortage/turnover, safety culture, staff time to participate, and communication. Facilitators included frontline staff involvement during implementation, management support, focusing on a single unit, training, and involving an external program facilitator. Conclusion: A participatory program can have positive impacts on identifying and reducing MSD hazards. Key to success is involving frontline staff in identifying hazards and creating solutions and management encouragement on a unit working together. High turnover rates, staffing shortages, and time constraints were barriers as they are for all organizational change efforts in LTC. The implementation findings are likely applicable in any jurisdiction. Practical Application: Implementing a participatory organizational change program to reduce MSD hazards is feasible in LTC and can improve communication and aid in identification and control of hazards.

简介：长期护理 (LTC) 设施是快节奏、苛刻的环境，使工人面临重大的受伤风险。解决 LTC 危害的健康和安全干预措施实施起来具有挑战性。该研究评估了参与式组织变革干预的实施和影响。方法：这是一项具有并行控制的混合方法实施研究，于 2017 年至 2019 年在加拿大安大略省的四个非营利性 LTC 设施中进行。研究参与者是管理人员和一线员工。干预站点实施了参与式组织变革计划，控制站点分发了一页的健康和安全小册子。通过调查（自我效能、对工作的控制、疼痛和一般健康）和观察（快速接触清单）收集计划影响数据。访谈/焦点小组用于收集计划实施数据。结果：参与者描述了计划影响（通过设备购买/修改、实践变化和教育/培训来控制危害）以及文化、沟通和协作方面的积极变化。随着时间的推移，控制点和干预点之间的经理对肌肉骨骼疾病 (MSD) 危害的自我效能有统计学显着差异，但没有发现其他统计差异。关键的计划实施挑战包括 LTC 危险、员工短缺/流动、安全文化、员工参与时间和沟通。促进者包括在实施过程中一线员工的参与、管理支持、专注于单个单位、培训以及外部项目促进者的参与。结论：参与式计划可以对识别和减少 MSD 危害产生积极影响。成功的关键是让一线员工参与识别危险并制定解决方案，并在一个共同工作的单位中鼓励管理层。高流动率、人员短缺和时间限制是 LTC 中所有组织变革努力的障碍。实施结果可能适用于任何司法管辖区。实际应用：实施参与式组织变革计划以减少 MSD 危害在 LTC 中是可行的，并且可以改善沟通并帮助识别和控制危害。