Category: Health Services Research; Quality Improvement and Implementation Science
To standardize the process for referral, scheduling, evaluation, documentation completion, submission, and delivery of a complex wheelchair (WC).
A quality improvement, administrative case report.
Specialty WC clinic in an urban freestanding inpatient rehabilitation center.
Participants (or Animals, Specimens, Cadavers) :
All key players involved in the process of WC procurement
Roles were defined for all key players involved. Information systems project focused on revisions of electronic medical record including physician referrals, scheduling and documentation. Increased accountability of external suppliers. Establishment of staff goals for timeframes for paperwork completion and performance review evaluation. Education with key players on revised process. Centralization of processing of all paperwork regarding specialty WC established for staff.
Main Outcome Measure(s) :
Scheduling of appointments with required referral and mobility device visit, timeframe for definitive WC delivery. Direct patient care hours for appointments, staff productivity and overall time frame from initial order of WC to delivery of definitive WC.
Established template for seating therapist schedules increased staff productivity from 47-52% and allowed for an increase in direct patient care hours from 49-66 total per week. Out of a random sample of 311 patients who received a WC over a 6-month period, 23% received their chair in 90 days or less from evaluation, 21% received in 91-120 days, and 17% received their definitive WC 121-150 days. Patients utilized loaner WCs a much shorter period of time.
Conclusions : Standardized workflow for the entire WC ordering process is essential to ensure that the process is occurring as efficiently as possible. This enables patients to receive their definitive WC earlier.
Sally Taylor– Therapy Manager, Wheelchair & Seating Center, Shirley Ryan AbilityLab, Chicago, Illinois