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Siobhan McDonagh ensures that patients with disabilities in the waiting area of Neurology are comfortable as they wait for appointments or rides.
Making every patient’s visit as comfortable as possible begins with a phone call. When confirming upcoming appointments, Neurology clinic staff always say to patients, “We ask everyone this question: Do you have any special needs for this appointment that we should know about?”
The answer immediately lets staff plan ahead in scheduling larger rooms and rooms with power exam tables for patients who use wheelchairs, for example.
“We took the initiative to start identifying patients during that phone call so that we are prepared to make their visit as easy as possible for them,” said Laura May, practice manager for the Neurology Clinic.
The clinic this winter piloted initiatives to improve accessibility for patients with disabilities. A multidisciplinary BWH Disabilities Awareness Council is leading efforts on how to create a more accessible and welcoming environment for individuals with disabilities throughout the hospital. (See related story at right.)
In Neurology, that meant engaging staff and touring the area with Elizabeth Pillsbury, the disability awareness coordinator for Partners HealthCare, to identify areas for improvement, assess limitations and solicit suggested solutions. “There were a lot of simple changes we found we could make to improve our patients’ comfort,” said neurologist Farzaneh Sorond, MD, member of the BWH Disabilities Awareness Council.
Stroke patients, for example, saw physicians in exam rooms in the back of the clinic. “They had to walk 80 feet to those rooms, as opposed to 17 feet to the front two exam rooms,” Sorond said. “So we swap those rooms when we can to make it easier for stroke patients, many of whom are recently disabled. Everyone on staff is flexible and accommodating.”
Janet Razulis, administrative director of Patient Care Services, worked with the clinic to order two power exam tables and higher neuromuscular chairs for the waiting room. “These power tables, which can be as low as 18 inches from the floor, enable patients to transfer themselves from a wheelchair onto the exam table easily,” May said.
The clinic also secured a scale that weighs patients in their wheelchairs, which is helpful for pregnant women with neurological issues, bariatric patients and stroke patients with weakness.
At the front desk, patients who use wheelchairs found it difficult to speak to the receptionist behind the high counter. Now, new signage points them to a lower, side check-in area if needed. Receptionist Siobhan McDonagh keeps an eye on patients awaiting transportation, offering them water or checking on the status of their rides. For patients who arrive via ambulance for short appointments, she and May ask the drivers to stay on site and try to assure that the patients are seen immediately so they do not need to wait hours to be picked up.
Patients are noticing the improvements and reported an overall good experience at the clinic on a new, four-question survey that seeks their feedback and ideas for further improvements.
The processes which were applied in the Neurology Clinic to improve care for patients with disabilities were developed from what Sorond has been learning through the Brigham Leadership Program, a joint project between BWH and Harvard Business School. “Anyone can apply the operating system that we have developed in Neurology to make improvements like this in their area,” said Sorond. “A big part of this is about increasing awareness and empowering every member of the clinic to change what does not work and provide better care.”
In Neurology, a physician and staff champion were identified for each new clinic session to use new equipment and to promote sensitivity. Physicians receive updates at faculty meeting presentations and noon resident conference presentations, and it has positively changed the way many staff think about these issues.
“We all walk down the hall with a different attitude now. We are all responsible for customer service, and our work does not end in the clinic,” Sorond said.