Real World Accessibility Project

Project

Spinal Cord Injury & Assistive Technology

Role

Accessibility Research, User Interviews

Team

Sneha Joshi
Tawny Apsley
Roger Ludy

Duration

October-December 2016

Project Problem

Our aim was to identify the assistive technology that’s currently available or advertised for Spinal Cord Injury (SCI) patients and what nurses at the University of Michigan Health System (UMHS) currently have.

Our Recommendation

We identified some of the barriers to adopting newer technology (for both nurses and patients).
My team and I then conducted a 'Gap Analysis' of the high and low-technology available at the UMHS and provided some suggestions to improve SCI care provided at hospitals, rehabilitation centers as well as outpatient facilities. 

Courtesy: theunchargeables.com

Spoon Theory

*The Spoon Theory is a disability metaphor used to explain the reduced amount of energy available for activities of daily living and productive tasks that may result from disability or chronic illness. Spoons are an intangible unit of measurement used to track how much energy a person has throughout a given day.

Project process

We focused our research mainly on the following topics:

  • What is SCI ?
     
  • Interview results
     
  • Barriers to tech implementation for patients (from literature)
     
  • Future of SCI Tech

We conducted interviews with four UM PM&R nurses at the U of M Main Hospital. Our team researched about the gaps between what types of assistive technology the nurses currently use and what they would like to have when caring for SCI patients.

We also asked about some barriers to implementing newer and more high-tech aids and what technologies Physical Therapy (PT), Occupational Therapy (OT), and rehab engineering are currently using.
(Fager (2013) Paper about inpatient rehab with patient interviews used in lieu of interviewing patients and dealing with HIPAA).

Infographic: Types of Spinal Cord Injury

Observations

What is Being Used by PT & OT at UMHS?
We found that the some of the technical aids being used at UMHS for SCI patients were:
Functional electrical stimulation (FES) equipment, Pressure mapping, “Slings to stand SCI patients upright” and some iPads with their video recording ability.

“I work night shift, so I don’t get to see what PT/OT is using.
”
— Issue raised by a nurse (UMHS)
““We did have the grant for iPads, but [...] we either don’t have many [iPads] left or we aren’t using them as we should.”
”
— Rehab Engineering unit
“I have seen [many technologies] utilized in the therapy gym, although these are not readily available on the unit.
”
— Access issue for nurses

We discovered that adapting newer technologies in the current hospital environment had their share of challenges and barrier.
We highlighted some of them (as stated by nurses) :

Barriers to new technology - Nurses

  • “Nurses tend to be set in their ways”
     
  • Too much to do in a work shift already
     
  • Not all nurses are willing to learn new things in terms of technology
     
  • No time for the amount of training needed to use new technology

 

Reference: Lawrence, Q. (2016). A Reboot for Wheelchair that can Stand Up and Climb Stairs. National Public Radio.

Reference: Lawrence, Q. (2016). A Reboot for Wheelchair that can Stand Up and Climb Stairs. National Public Radio.

Barriers to new technology - Patients

  • Generational gaps in tech usage
     
  • Patients already overwhelmed with adjusting to their “new normal”
     
  • Budget/cost
     
  • Accessibility to resources
     
  • Bedsides staff that is not well-trained to use new technology
Reference: ReWalk Robotics. (2016). About Products

Reference: ReWalk Robotics. (2016). About Products

Future of SCI-related Tech

  • Wearable robotics / Personal exoskeletons

  • Neuroprosthetics

  • Recommendations to Designers from Nurses

  • Brain-mapped Exoskeletons

  • Facial-muscle controlled wheelchairs

  • Adaptive environment

What nurses would like?

  • Having FES equipment on the floor

  • Zero-gravity arm support systems (SaeboMAS)

  • Automatic pressure-relieving cushions/mattresses

  • Better communication technology

  • Teaching tools available on tablets

 

 

Recommendations for Designer by Nurses

  • Ease of use is critical
     
  • Mobility devices cannot move too quickly when standing patients up
     
  • Be mindful of the Spoon Theory* (for patients and nurses)
     
  • Try to be respectful of cost constraints
     
  • Communicate usefulness very well and be respectful of nursing workflow

 

© Sneha Joshi. All Rights Reserved.