Actionable Nuggets for SCI (3rd ed., 2016)
Conduct an accessibility audit of your office space and procedures using attached Primary Care Accessibility Checklist.
The first concern in providing good care to a patient with a spinal cord injury is the accessibility of the office and examining space. Recent research shows that 80-90% of primary care settings are compliant with accessibility requirements.
Evidence-based Best Practice:
You may think that your office is accessible, but in fact, only half the doctors who think they have accessible offices actually do – 45% of patients with spinal cord injuries report difficulty accessing their doctor’s office, and 5% can’t access it at all, due to stairs or other major barriers.
The most common barriers encountered once inside the practice include non-adjustable exam tables, lack of transfer or lifting equipment, the need to bring someone to assist with transfers or dressing/undressing. Patients routinely report being examined in their wheelchairs, not being weighed, and missing out on routine screening and prevention.
The addition of an adjustable examining table and ceiling-track lift in one examining room benefits not only SCI patients, but many other patients in the practice as well. In most jurisdictions, accessibility is now the law, and there are published guidelines for accessibility of family physician’s offices, based on systematic reviews of literature and principles of universal design.
Stillman, M. D., Frost, K. L., Smalley, C., Bertocci, G., & Williams, S. (2014). Health care utilization and barriers experienced by individuals with spinal cord injury. Archives of Physical Medicine and Rehabilitation, 95(6), 1114–1126. http://doi.org/10.1016/j.apmr.2014.02.005
Additional References (chronological order):
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Stillman, M., Williams, S., Stillman, M., & Williams, S. (2016). interdisciplinary primary care clinic for patients with spinal cord injury A more perfect union : Reports from an interdisciplinary primary care clinic for patients with spinal cord injury, 0268(September), 1–3. http://doi.org/10.1179/2045772313Y.0000000189
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