Michelle L. Lange, OTR/L, ABDA, ATP/SMS

In Part 1 of this Blog series, we discussed the Client and Caregivers and how they can help identify the Problem that needs a Solution. Nobody knows the Problem like the Client and Caregivers. In Part 2, we discussed the Supplier and how their knowledge of CRT equipment and the reimbursement process can help identify the best Solution. Part 3 presents the Clinician and their unique role on the team in determining optimal Solutions.

The Clinician

Clinicians can connect the dots between the Client and Caregiver’s identified Problem and the equipment and reimbursement knowledge of the Supplier

Clinicians on the Seating and Mobility team may include Occupational and/or Physical Therapists. The Clinician brings unique knowledge of range of motion, muscle tone, orthopedic challenges, and, most importantly, function. Clinicians are also trained in clinical observations, task/activity analysis, clinical reasoning, and problem-solving. In wheelchair seating and mobility, it is essential to correctly analyze the client’s posture and to determine the ‘whys’ of that posture in order to determine the best Solution. Clinicians also provide evaluation documentation used to justify the recommended equipment which is submitted with other materials by the Supplier to obtain funding approval.

Clinicians can connect the dots between the Client and Caregiver’s identified Problem and the equipment and reimbursement knowledge of the Supplier.

An Example

A young woman was using a Dynamic Rocker Back interface (DRBi), yet was not sitting with good posture. Upon closer examination, I realized her seat to back angle was too open as a result of the DRBi elastomers being worn. Once these were replaced, she was able to sit at the seat to back angle which was originally intended by her team, her posture and function were improved, and the elastomers could once more do their job - diffusing her extreme extensor forces.

Jumping to a Solution

I remember speaking with a Clinician who told me that they had tried over 20 cushions with a client and still hadn’t come up with a solution. When I asked her what the Mat Examination had revealed, she stated that she didn’t have time to do that. Time is short, productivity demands are high, but skipping vital areas of the assessment will either result in more time on the back-end (like trying 20 cushions) and/or poor outcomes. We need to complete a thorough assessment to determine all the Problems and the causes behind them in order to determine, with the Team, optimal Solutions.

I hope this short series has reminded all of us, Clients and Caregivers, Suppliers, and Clinicians, to not Jump to Solutions. Rushing to the finish line doesn’t always win the race. Let’s work together for the best outcomes.