Date of Award

2024

Document Type

Scholarly Project

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Jane Loscheider

Abstract

Title: Navigating the Wheelchair Recommendation Process: A Preventative Approach for Rural Providers

Background: Wheelchair procurement is a complex process that begins with patients seeing their physician for a prescription and guidance on where to go for step two. It is this critical second step that can make the difference for someone receiving a basic wheelchair meant for short-term use, or a referral to a practitioner specializing in seating and wheeled mobility. While getting to a physician's office can be challenging for all wheelchair users, a rural wheelchair user experiences additional barriers such as limited resources available locally, culture, and difficulties with traveling long distances to available services (Akinlotan et al., 2021; Frakt, 2019; Rural Health Information [RHI] Hub, 2018; Waite, 2015). When there is a disconnect at step two of the process, the wheelchair-seeking client could have an improperly fit wheelchair, which can lead to negative health outcomes such as pressure sores, contractures, pain, and negative psychosocial implications (Gowran et al., 2022; Sprigle, 2014; Valent et al., 2019). The purpose of this scholarly project is to create a tool to help educate and guide referring practitioners on the wheelchair procurement process.

Methodology: A thorough literature review guided by the Ecology of Human Performance (EHP) was completed to understand the barriers and supports for the wheelchair prescription and procurement process. A partnering site, located within a rural area, provided guidance and support to further understand the unique experiences of the rural occupational therapy practitioner and develop a tool to assist referring providers in the wheelchair prescription process.

Product: A flowsheet was designed to guide rural providers on the critical step of the wheelchair procurement process; when to refer for additional seating services or when a general wheelchair is adequate. The electronic medical record team was consulted for strategies to ensure a seamless transition with the best outcomes for the patient.

Implications: By providing physicians with the education and resources in the complex wheelchair procurement process, rural clients can secure a wheelchair for optimal occupational engagement and improved quality of life.

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