A descriptive analysis of wheelchair repair registry data

Power wheelchair usage and repair are associated: a retrospective analysis

Purpose: This study evaluates the effect of power wheelchair telemonitoring and battery charging training on user charging behavior and repair measures and assesses the relationship between wheelchair usage and repair measures to support technician-led servicing.Methods: This is a retrospective analysis of two matched cohorts with a total of n=237 users from the NHS service dataset. In the training cohort, a wheelchair usage telemonitoring device monitored the battery usage of n=119 power wheelchair users for 12 months. Users whose battery charging behavior was not optimal were instructed on appropriate charging practices. Wheelchair usage parameters of wheelchair drive and power time every month were used to predict repairs and associated costs.Results: Fifty-four out of 119 users in the training cohort did not charge batteries regularly and were instructed on appropriate charging. Twenty-six of them changed their behavior and charged their batteries every night. This cohort experienced reduced battery repairs by 18%, wheelchair repairs by 11%, and repair costs by £3,092 compared to a matched standard care cohort (n=118). User age and drive time were associated with repair measures. Drive time predicted time-to-failure for wheelchair parts and classified failure risk with the area under the receiver operating characteristic curve as 0.71 (95% CI 0.61 to 0.82; p<.001). Conclusions: By leveraging the significant relationships between wheelchair usage and repairs, wheelchair users at risk of part failures can be identified, and technician-led servicing tools for proactive interventions can be developed. Wheelchair battery health telemonitoring and instructing users on appropriate battery charging reduced repairs and associated costs.

A cross-sectional descriptive analysis of complex rehabilitation technology (CRT) supplier opinions on the current state of wheelchair repair services

PURPOSE

It is documented that wheelchair failures occur frequently, repair times are lengthy, and users often experience adverse consequences. This study aims to gather evidence on efficiency of current wheelchair repair processes from the perspective of complex rehabilitation technology (CRT) suppliers who perform repairs within the United States.

MATERIALS AND METHODS

A 20 statement survey was developed to identify barriers and facilitators related to wheelchair repairs across the domains of administrative and operational factors as well as to identify future opportunities for improvement. Key statements in these areas included time to perform a repair, documentation requirements, tracking repair progress, reimbursement, technician competency, emerging strategies and preventative maintenance. The online survey was broadly disseminated to a nationwide network of CRT suppliers for data collection.

RESULTS

A total of 127 responses were received. Results showed that administrative statements received the lowest scores while those statements dealing with future opportunities received the highest scores. Areas of the industry that suppliers were in most disagreement with included wait time for insurance approval, reimbursement for parts, reimbursement for technician travel time and lack of coverage for preventative maintenance. Telehealth system usage, preventative maintenance coverage, tracking repairs and repair scheduling were future opportunities that suppliers were in most agreement with.

CONCLUSIONS

Administrative issues exist in the CRT industry due to restrictive insurance policies associated with repairs and maintenance. Future opportunities to improve the process exist including payment models and the application of telehealth, device monitoring and service-based performance incentives to reduce adverse consequences to the user. Implications for rehabilitationHighlights the direct importance and barriers faced within the wheelchair repair industry by CRT suppliers.In a sample of CRT suppliers, there is agreement there exists many administrative and operational issues related to wheelchair repairs.There is agreement among survey respondents of opportunities to investigate further telehealth and remote strategies, preventative maintenance coverage and online tracking for wheelchair repairs.

Repair strategies for assistive technology in low resource settings

PURPOSE

To investigate the practices of repair that exist for users of mobility assistive products in low resource settings, as well as the psychosocial impact that the repair, or non-repair, of these devices has on users' lives.

MATERIALS AND METHODS

This article collates data on repair practices and the responses from participants on the topic of repair from studies conducted by the authors across four different low resource settings in Kenya, Uganda, Sierra Leone, and Indonesia. This data was then analyzed to identify the common themes found across geographies.

RESULTS

Three major models of repair practice emerged from the data: "Individual or Informal Repair in the Community"; "Local Initiatives"; and "Specialist AT Workshop Repair". Additionally, the wider impact on the participants' lives of "Problems & Concerns with Repair"; "Experiences of Breakages & Frequencies of Repair" and the "Impact of Broken Devices" are explored.

CONCLUSIONS

The results of this analysis demonstrate the paramount importance of community-based repair of devices, and how despite this importance, repair is often overlooked in the planning and design of assistive products and services. There is a need to further incorporate and support these informal contributions as part of the formal provision systems of assistive device.IMPLICATIONS FOR REHABILITATIONA lack of available specialist repair services in low resource settings hinders the potential impact of assistive technology provision systems.Community-based repair is the major route by which assistive devices are repaired in low resource settings.Appropriate community-based repair strategies should be incorporated into and supported by the formal assistive technology provision models in order to optimise outcomes.A lack of data on outcomes across the lifecycle of assistive products hinders progress on improving focus on follow-up services - in particular repair & maintenance.By supporting community-based repair, repairs that are inappropriate for that approach could be better directed to specialist repair services.

Powered mobility device use in residential aged care: a retrospective audit of incidents and injuries

BACKGROUND

Powered wheelchairs and motorised mobility scooters, collectively called powered mobility devices (PMD), are highly valued by older Australians, including those living in residential care, to facilitate personal and community mobility. The number of PMDs in residential aged care is expected to grow proportionally with that of the wider community, however, there is very little literature on supporting residents to use PMDs safely. Prior to developing such supports, it is important to understand the frequency and nature of any incidents experienced by residents whilst using a PMD. The aim of this study was to determine the number and characteristics of PMD use related incidents occurring in a group of residential aged care facilities in a single year in one state in Australia including incident type, severity, assessment, or training received and outcomes on follow-up for PMD users living in residential aged care.

METHODS

Analysis of secondary data, including documentation of PMD incidents and injuries for one aged care provider group over 12 months retrospectively. Follow-up data were gathered 9-12 months post incident to review and record the outcome for each PMD user.

RESULTS

No fatalities were recorded as a direct result of PMD use and 55 incidents, including collisions, tips, and falls, were attributed to 30 residents. Examination of demographics and incident characteristics found that 67% of residents who had incurred incidents were male, 67% were over 80 years of age, 97% had multiple diagnoses and 53% had not received training to use a PMD. Results from this study were extrapolated to project that 4,453 PMD use related incidents occur every year within Australian residential aged care facilities, with the potential for outcomes such as extended recovery, fatality, litigation, or loss of income.

CONCLUSION

This is the first time that detailed incident data on PMD use in residential aged care has been reviewed in an Australian context. Illuminating both the benefits and the potential risks of PMD use emphasizes the need to develop and improve support structures to promote safe PMD use in residential aged care.