Optimising wheelchair returns in a PAN Hospital Wheelchair Service

Project completed as part of the Great Ormond Street Hospital Green Team Competition.

Team members:

Caroline Haynes and Tayana Harding, Clinical Specialist Occupational Therapists

Setting / patent group:

PAN Hospital Wheelchair Service for paediatric inpatients at GOSH

Issue:

The return of wheelchairs from home loans is increasingly becoming an issue as wheelchairs are often out for longer than the agreed loan period. This then leads to a shortage of chairs and has resulted in the past in the need to purchase more wheelchairs. Currently wheelchairs over their expected date of return are only followed up on when a specific wheelchair is needed or availability is extremely low, which may delay access for another patient. As a team, we saw an opportunity to evaluate and improve this process, bringing sustainable value to our service

Intervention:

Following a review of our current processes and staff perceptions and use of current process, we plan to create a new standard operational procedure to facilitate improved stock flow of wheelchairs in the wheelchair store. Our proposed changes include:

• Updating our loan form with clear and simple wording regarding the loan process, highlighting the key points, such as ways of return and loan timing with aim to draw attention of the family.
• Monthly loan monitoring data, on the number of wheelchairs available for loan and number of chairs still on loan pass due return date.
• Change to loan process and communication: OT will always inform the family of the loan length and the need to return the wheelchair within a week of the date and the need to contact the therapist if there is a significant reason why the wheelchair cannot be returned.
• Identify one member of staff to contact and remind patients / parents the date of the return.
• A member of staff to contact parents 2 weeks past return loan date if the wheelchair has not been returned or the parent has not been in contact.
• Team engagement and education to ensure staff understand the criteria and process of loaning and returning loaned wheelchairs.

Outcomes

The team identified 80% of home loans are currently returned however this could be improved through standardisation of the loaning and return process. Based on a 10% increased return rate (of 4 specialist and 8 standard chair) the team could save £12,376 and 1,893 kgCO2e per year, equivalent to driving 5,590 miles in an average car. Clinically, Children may have faster access to the most suitable chair for them which may be beneficial in several ways, e.g. sitting up helps reduce chance of chest infections as well as prevent musculoskeletal contractures. Socially, faster access to chairs may reduce stress and frustration to patients and their families. Children more readily able to engage socially with family, to see friends, go to school, etc. A streamlined process may reduce frustration and time spent finding and loaning wheelchairs due to increased availability, boosting staff well-being and job satisfaction.

Key learning point

The key to increasing the availability of wheelchairs in the Pan Hospital Wheelchair service will be to ensure timely returns of loaned wheelchairs through staff and patient engagement.