Inpatient rehabilitation wheelchair management quality improvement project: Implications for patients with spinal cord injury

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2021.2019656 · Published: May 1, 2023

Spinal Cord Injury Healthcare Rehabilitation

Simple Explanation

This project evaluated how quickly patients with spinal cord injuries (SCI) received wheelchairs (WC) for use during inpatient rehabilitation. Physical therapists (PT) submitted WC requests, and the study looked at the delivery timeframe and type of WC requested. The study found that many patients did not receive their wheelchairs within the hospital's established timeframe guidelines, especially those with cervical level SCI needing power wheelchairs.

Study Duration

March 25, 2017, and September 30, 2019

Participants

750 patients with SCI

Evidence Level

Quality improvement project secondary analysis

Key Findings

1
Less than half of patients (49.9%) received their requested wheelchair within the facility's established timeframe guidelines.
2
Patients with cervical level SCI had the longest wait times for power wheelchairs, averaging 8.28 days.
3
Roho cushions were the most frequently requested cushion type for all levels of SCI.

Research Summary

This quality improvement project explored the delivery of hospital fleet wheelchairs (WCs) in an urban inpatient rehabilitation hospital for patients with spinal cord injury (SCI). The study found that a significant percentage of patients did not receive their requested WCs within the facility's established timeframe guidelines, particularly those with cervical SCI requesting power WCs. The findings highlight the need for improvements in the WC delivery process to ensure timely access to appropriate wheelchairs for patients undergoing inpatient rehabilitation for SCI.

Practical Implications

Improve Wheelchair Inventory Management

Hospitals should organize their wheelchair inventory efficiently and consider purchasing additional wheelchairs, especially power wheelchairs, to meet patient needs.

Optimize Wheelchair Department Staffing

Adequate staffing levels in the wheelchair department are critical to ensure timely wheelchair delivery. Addressing staffing shortages can improve fulfillment times.

Streamline Wheelchair Request Workflow

Examine and improve the wheelchair request and delivery workflow to reduce delays. This may involve process improvements and better organization within the wheelchair department.

Study Limitations

1
The data may not be applicable to every facility due to the study’s large inpatient rehabilitation hospital size, available resources, and WC department space.
2
No education was given to the PTs by our researchers, which could impact WC request form completion.
3
Many different transition periods took place during our data collection timeline including reorganization of the WC department storage room, WC technician staffing changes, and a capital refresh of inventory.

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