| Sumario: | Patient handling remains a leading cause of work-related musculoskeletal injury among health care workers. Engineering controls such as ceiling-mounted lifts are widely recommended within safe patient handling programs, yet their realworld effectiveness varies across clinical environments. To assess whether installation of H track ceiling-mounted lifts with extension into restrooms was associated with changes in health care worker exertion and patient-handling injury rates across inpatient units and to examine variability in effects between units, we performed a retrospective steppedwedge, interrupted time-series study across 37 inpatient units at a large tertiary academic medical center between January 1, 2012 and December 31, 2020. Injuries were classified as pre-or post-installation using unit-specific implementation dates. Incidence rates per 200,000 worked hours were compared using incidence rate ratios (IRRs) with 95% confidence intervals. Results: After lift installation, overall exertion and patient-handling injuries declined by 20% (IRR 0.80, 95% CI 0.72-0.89; p < 0.001). OSHA-recordable injuries fell by 34%, DART cases by 39%, and lost-time injuries by 41% (all p < 0.001). Effects varied notably across units. Ceiling-mounted lifts were associated with meaningful injury reductions, higher severity outcomes, but unit-level variability indicates that equipment alone is insufficient without strong implementation support.
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