Activities of suppliers and technicians during the provision of complex and standard wheeled mobility devices

Abstract

Purpose: The objective of this time-motion study was to document the type and duration of activities performed by wheelchair suppliers during the provision of wheeled mobility and seating devices. Method: Researchers observed eight rehabilitation technology suppliers and four rehabilitation technicians over two weeks in two metropolitan areas. Results: Data were collected on 500 client interactions, resulting in 864 activities that were classified as complex rehabilitation technology (CRT) or standard wheeled mobility equipment (STD). Data indicate that the majority of the activities were relatively short (median = 0.25 hours) but the distribution of activity durations was highly skewed. A difference existed in activity time across device complexity (p = 0.039), with CRT-related activities averaging about 0.1 hours longer in duration than STD activities. When assessing mobility types independently, activity times across device complexity differed for manual and power wheelchair at p = 0.0001 and p = 0.086 levels, respectively. When activities were tabulated into daily episodes for each client, CRT manual wheelchair times were higher than STD (p = 0.003), whereas power wheelchair episode times showed no difference across device complexity (p = 0.245). Conclusion: The results illustrate that the activities undertaken by suppliers during wheelchair provision vary widely and device complexity and device type impacts the types and duration of these activities.

Implications for Rehabilitation

• The provision of wheelchairs and seating systems include a range of activities that extend before delivery to well past delivery of the equipment.

• Providing complex wheeled mobility and seating equipment requires more time, on average, that providing standard wheeled mobility and seating equipment.

• Activities that precede the delivery of equipment – including evaluation and configuring the equipment – are the most prevalent and time-consuming activities

Keywords::

• wheelchair
• durable medical equipment
• service delivery
• time and motion

Acknowledgements

The authors thank Don Clayback and Rita Hostak for assisting in defining the methods and identifying potential participants, and the participants and their employers for allowing us to observe them.

Declaration of Interest: Primary funding for the project was provided by the Sam Schmidt Paralysis Foundation. Additional support was provided by the Rehabilitation Engineering Center on wheeled mobility, a project funded by the National Institute for Rehabilitation Research under grant number H133E080003. The opinions contained in this manuscript are those of the authors does not necessarily reflect those of the sponsors. The authors report no conflicts of interest.