(c) 11/29/06 Hop Up | [email protected] 1 Just Hop Up, Look Here, Read This, Listen Up, Don’t Breathe &...

(c) 11/29/06 Hop Up | [email protected] 1

Just Hop Up, Look Here, Read This, Listen Up, Don’t Breathe & Stay Still!

Access to Medical Equipment – Where are We?

ILRU Web Cast 11/29/06


June Isaacson Kailes Associate Director

[email protected]

310.821.7080


Western University of Health Sciences

Pomona, California

www.cdihp.org

(c) 11/29/06 Hop Up | [email protected]

4

www.cdihp.org Western University

of Health SciencesPomona, California

Established 1998

TTY: 909-469-5520, FAX: 909-469-5503


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CDIHP works to enhance health of people with disabilities through:–public policy, –consulting,–training, –research & –dissemination activities.


www.jik.com/disaster .html


www.cdihp.org–Products–Evacuation

Preparedness

http://www.cdihp.org/


www.cdihp.org–Products–Emergency Health Information



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Objectives –Review

• Survey results from National Consumer Needs Assessment

• Strategies for getting accessible equipment into offices of health care providers.

• Existing accessible equipment resources.


Objectives

• Present new & reinforce known tools/strategies that bridge gaps between safe, quality health care & reality of health care experiences today


Intended Outcomes • Motivate you to advocate for

increased accessibility of medical equipment

• To get this on the radar screen of health care providers

• To create the ground swell, the tipping point to make change happen!


HOP HOP UPUP


Look Look herehere


ReadReadthisthis


LISTEN LISTEN UPUP


Stay Stay stillstill


Don’tDon’tbreathebreathe


Accessibility and Usability of Medical Equipment for People

with Disabilities: A National Survey

Jill M. Winters, PhD, RN,1 Molly Follette Story, MS,3

Kris Barnekow, PhD, OTR,1 Brenda Premo, MBA,2

June Isaacson Kailes, MSW,2 Erin Schwier, OTD,2 R. Sarma Danturthi, PhD,1 & Jack M. Winters, PhD1

1. Marquette University 2. Western University 3. University of California-San Francisco


Study funded in part by:

• National Institute on Disability and Rehabilitation Research grant H133E020729


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www.rerc-ami.orgwww.rerc-ami.org

RERC-AMI Vision

All people should have All people should have access to healthcare access to healthcare

products, facilities & services products, facilities & services & to & to employment in healthcare employment in healthcare

professions.professions.


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• Marquette University

• Western University of Health Sciences: Center for Disability Issues and the

Health Professions

• University of California: Ergonomics Lab

• Human Spectrum Design

• University of Wisconsin at Milwaukee

• University of Connecticut

PARTNERSPARTNERS

RERC-AMI Objectives

Assist individuals with disabilities: To utilize full range of healthcare services To gain access to employment in healthcare

Assist instrumentation developers: To produce accessible/usable medical devices

Assist healthcare providers to better serve: The needs of their patients with disabilities The needs of their employees with disabilities


Health – Providers

Plans

Educators

People with disabilities

Advocates

Manufacturers

Vendors / Sales Reps

Policy Makers

AudienceAudience


Intended Outcomes • Reduce costly health disparities

among people w/ disabilities by removing barriers to health care services.

• Create new accessibility standards for accessible medical equipment.


457 people completed part or all of survey,

408 provided usable data


50 states represented

National Consumer Survey

Exploratory cross-sectional design;Choice of format:

computer: online computer: Word document paper: PDF document

(standard or large print) over telephone (voice or TTY) In person

Overview

Survey divided into three sections:1. Demographic information2. Functional capabilities

appraisal3. Difficulties experienced with

specific equipment

Survey: Problems with Specific Equipment

Your experience with [equipment]: None, Little, Moderate, Frequent, Extensive

Your difficulty or discomfort with [eqmt.]: None, Little, Moderate, Extreme, Impossible

What difficulties did you have with [eqmt.]? (Please describe.)

What changes might be made to improve the ease and/or comfort of using [eqmt.]? (Please describe.)

Survey Results: The Big 4

Type of Equipment

Examination tables (n = 291)

X-ray equipment (n = 258)

Rehab./exercise eq. (n = 203)

Weight scales (n = 222)

≥ Moderate Difficulty

74.9%

68.2%

55.1%

53.6%


Exam Tables 225 people 75%

experienced > moderate

difficulty


35

0

5

10

15

20

25

30

35

None Little Moderate Frequent Extensive

Problems with Examination Tables (n=263)

Pe

rce

nta

ge

Experience:


Percentage 0 7.5 31.7 31.7 22.6


36

0

5

10

15

20

25

30

35

None Little Moderate Extreme Impossible

Problems with Examination Tables (n=263)

Difficulty/discomfort:P

erc

en

tag

e


Percentage 10.3 15.2 32.3 33.5 8.7


“ “it takes a it takes a village to get village to get

me on the me on the table”table”


Examination Tables

– Height: too high– Width: too narrow– Comfort: hard surface, nothing to lean on– Getting on: nothing to hold on to– Fear: being alone; long wait– Other:

• Step: too small, nothing to hold on to• Stirrups: hard to use• Paper: slippery; contrast; notes


X-Ray Equipment

Problems with X-Ray Equipment (n=238)General x-ray, MRI, CT scan, PET scan,

mammogram, bone density scan, ultrasound, etc. P

erc

en

tag

e

Experience:

0

5

10

15

20

25

30

35

40

45



Percentage 0 17.0 40.7 35.7 20.6


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Problems with X-Ray Equipment (n=238)

General x-ray, MRI, CT scan, PET scan, mammogram, bone density scan, ultrasound, etc.

Pe

rce

nta

ge

Difficulty/discomfort:

0

5

10

15

20

25

30

35


None Little 33 Frequent Extensive

Percentage 16 17 40.7 32 3


X-Ray Equipment181 people, 68% experienced

> moderate difficulty

General x-ray; MRI, mammogram, ultrasound, Scans: CT, PET & bone

density; etc.


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Problems with Weight Scales (n=203)

Pe

rce

nta

ge

Experience:


Percentage 0 28.9 37.3 18.6 15.2

0

5

10

15

20

25

30

35

40


e.g., standing, chair, wheelchair, bed, etc.


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Problems with Weight Scales (n=203)

Difficulty/discomfort:P

erc

en

tag

e


Percentage 30 15.3 25.1 16.7 12.8

0

5

10

15

20

25

30


e.g., standing, chair, wheelchair, bed, etc.


Weight scales 120 people,

54% experienced > moderate

difficulty


Examination & Procedure Chairs132 people, 50% experienced

> moderate difficulty

Dental, oral surgery, eye exam, laboratory, reclining procedure

(chemotherapy, dialysis, transfusion)

Where do we go from here???

RERC-AMI Needs Analysis

Goal: Knowledge of instrumentation problems & needs

R1.1 / Healthcare Consumers Surveys, focus groups

R1.2 / Healthcare Service Providers Surveys, interviews with 2 key subgroups

R1.3 / Device Manufacturers Interviews with 8 subgroups

R1.4 / Problem Definition Prioritized lists and work plans

R2 / Usability Testing of Specific Equipment

Four current studies:Radiology equipment – at UCSF

Pill splitters and containers – at community senior centers

3. Blood glucose monitors and syringe dosing devices – at centers for the blind

4. Exam tables, pads, poles, and steps – at UC Ergo Lab


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Bridging the Accessible Bridging the Accessible Equipment GapEquipment Gap


What you What you can do!can do!


You – one person can

make a difference!


We can’t do it!


Speak Speak Up!Up!


Direct the Show


One person can make a difference.

• Survey of 379 Massachusetts health care providers found they made access changes based on:– 60% ADA compliance – 49% State requirements – 33% PATIENT RECOMMENDATIONS FOR 33% PATIENT RECOMMENDATIONS FOR

IMPROVEMENTIMPROVEMENT– 25% because they completed an ADA checklist– 25% JCAHO and other certifying agencies


Commercially Commercially available devices available devices

are more are more accessible, but they accessible, but they are not widely used!are not widely used!


How do you handle getting:

• A height adjustable (high/low) exam table,

• Or assistance transferring to an exam table.


Just Hop up ….Just Hop up ….

http://www.examtables.com/general/5140.htm

http://store2.yimg.com/I/seniorshops_1706_2373277


How do you handle getting weighed?


Do provider directories indicate degree of physical access?

• Parking

• Routes

• Offices

• Restrooms

• Equipment – Exam / diagnostic


Good Practice• Rhode Island’s Mammography Centers

Database – can be search via “wheelchair access”

• Is the mammography equipment wheelchair-accessible?

http://www.ricancercouncil.org/http://www.ricancercouncil.org/resources/mammography.phpresources/mammography.php

www.inclusivefitness.org

Weight Pin Colour

Before: After:


Weight Pin Grip

Before: After:


Reaching High Handles

Before: After:


Preventable medical Preventable medical condition that was condition that was far more costly to far more costly to treat than it would treat than it would

have been to have been to prevent.prevent.


ADA Enforcement

• To get to

• Enter

• Use

• Communicate with providers


We are not receiving medical & preventive care that is as

EQUALLY EFFECTIVE as that provided to others.


CASE TYPE/ISSUEOffice

SettingHospital Setting

Clinic or ServiceCenter Setting TOTAL

Deaf or Hardof Hearing (effective communication) 34 25 6 65Mobility Access 27 4 4 35HIV Status 5 1 2 8Blind/Low Vision 2 2Access toExamination Tables 0 1 2 3Intellectual Disabilities 1 1

TOTAL 68 32 14 114

Source: US Department of Justice Status Reports – April 1994 – March 2003


File Complaints


• Don’t compromise your access to quality & safe care

• Get access on health care providers’

radar screen


ResourcesResourceswww.jik.com/hwawd.htmlwww.jik.com/hwawd.html


www.cdihp.orgCLICK - on ProductsCLICK - on Products

CLICK - on Online ResourcesCLICK - on Online Resources



• Accessible Health Care Series –Tools For Decreasing Health C

are Barriers

–Importance of Accessible •Examination Tables •Weight Scales

–Health Care Facilities Access

For more thorough discussion visitFor more thorough discussion visit

http://cdihp.org/briefs/brief-intro.html

http://cdihp.org/briefs/brief-intro.html

http://cdihp.org/briefs/brief1-exam-tables.html

http://cdihp.org/briefs/brief1-exam-tables.html

http://cdihp.org/briefs/brief2-weight-scales.html

http://cdihp.org/briefs/brief3-facilities-access.html


• Accessible Health Care Series – Choosing and Negotiating an Accessible Busines

s Location

– Barrier Removal: Improving Accessibility with Limited Resources

– Providing Information in Alternative Formats – Accessible Web Site Design– Tax Incentives for Improving Accessibility

• ADA Resources (forthcoming)

• Tax Incentives for Hiring People with Disabilities (forthcoming)

For more thorough discussion visitFor more thorough discussion visit

http://cdihp.org/briefs/brief4-choosing-loc.html

http://cdihp.org/briefs/brief4-choosing-loc.html

http://cdihp.org/briefs/brief5-improve-access.html

http://cdihp.org/briefs/brief5-improve-access.html

http://cdihp.org/briefs/brief6a-alt-formats.html

http://www.washington.edu/doit/Brochures/Technology/universal.design.html

http://cdihp.org/briefs/brief6-tax-incentives.html


Medical Instrumentation Medical Instrumentation Accessibility and Accessibility and

Usability ConsiderationsUsability Considerations

Edited by Winters & Story

CRC Press

#651x

(c) 11/29/06 Hop Up | [email protected] 1 Just Hop Up, Look Here, Read This, Listen Up, Don’t Breathe &...

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