PHIRES Project

What is PHIRES?

The Patient Handling Injuries Review of Systems (PHIRES) toolkit is a systems-thinking toolkit for reviewing and revising risk control measures following the report of a staff injury relating to patient handling.

The toolkit was developed through a co-design process with two Universities (Monash University & University of the Sunshine Coast), WorkSafe Victoria and subject matter experts from a range of health care providers in Victoria. It is based on an existing systems accident analysis method, Rasmussen’s Accimap* technique. The toolkit includes guidance and standardised templates for reviewing information and risk controls following an injury relating to patient handling.

The PHIRES toolkit has been specifically designed to collect information about the contributory factors of a patient handling injury. The tool has targeted prompts and an accompanying data collection guide (with specific questions) that assists in identifying why risk controls were ineffective in an injury events sustained through patient handling.

Grounded in systems-thinking principles, the PHIRES toolkit asks questions related to the injury event, beyond that of usual incident investigations.

*The Accimap approach is a systems-based technique for accident analysis, specifically for analysing the causes of accidents and incidents that occur in complex sociotechnical systems.

VIDEO: Systems Thinking in Action: Preventing Patient Handling InjuriesPHIRES video


PHIRES provides an opportunity for healthcare to improve existing practices to reduce musculoskeletal injuries. It allows the healthcare service to adopt an evidence-based approach to incident investigation in order to identify and implement systemic control measures to prevent patient handling injuries to workers.

Monash University provides expert training, support and data analytics for implementing the PHIRES toolkit in healthcare.

Benefits of implementing the PHIRES toolkit in your health service

  • Training on the concept of systems-thinking for injury investigations (as a result of patient handling)
  • Receive technical support and guidance by the Monash University
  • Obtain a better understanding of the factors influencing the success of risk control measures for patient handling staff
  • Optimise risk controls used to prevent patient handling injuries
  • Improving collaboration across all levels of the healthcare system (e.g. patients, staff, health service management, regulators and government departments).

What does participation in this pilot involve?

Your healthcare service will be required to nominate a key WHS practitioner (e.g., Manual Handling Co-ordinator), to lead implementation of the PHIRES toolkit within their facility. This practitioner will be required to participate in the following activities.




Attend a systems-thinking webinar

2 hours

Practitioner to attend online using Zoom facilities

Attend a face-to-face workshop on use of the PHIRES Toolkit

4 hours

Practitioner to attend face to face workshop* Workshops can also be facilitated using Zoom facilities

Engage in a follow-up coaching session following completion of the first PHIRES investigation. The consultant will provide feedback and advise on each step of the completed investigation.

Approx. 1 hr

Either face to face, or via phone.

Feedback from Victorian healthcare:

  • Helped identify trends that influenced incidents, especially higher levels of the system
  • Encouraged a more comprehensive and considered approach to investigation and development of controls
  • Facilitates collaboration around investigation and development of controls
  • Provides justification to senior management for implementing controls

Who do I contact to get involved in the training?

Assoc. Professor Sharon Newnam
Associate Professor (Research), Accident Research Centre
M: 0422 723 957

Research project

Monash University, in collaboration with WorkSafe Victoria and the healthcare sector in Victoria are undertaking a project to build upon the success of the PHIRES Project. This new project has been funded by WorkSafe Victoria and aims to:

  1. Develop a digital application (App) to support the sustainable implementation of the PHIRES Toolkit across the healthcare and social assistance sector;
  2. Develop an online training/coaching program on using systems-thinking to review and revise risk controls to support the reliable implementation of the App; and
  3. Evaluate the cultural, safety and financial benefits health services and aged care providers realise by using the Toolkit to review and revise their risk controls following the report of a musculoskeletal disorder (MSD).

We are currently recruiting health services (hospitals and aged care facilities) to participate in this project.

If you would like more information on involvement in this project, please contact:

Assoc. Professor Sharon Newnam
Associate Professor (Research), Accident Research Centre
M: 0422 723 957