An ecological perspective on implementing environmental control units for veterans with spinal cord injuries and disorders

Rachael N. Martinez*, Bella Etingen, Dustin D. French, Marissa A. Vallette, Balmatee Bidassie, Huberta T. Cozart, Frances M. Weaver

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Purpose: Guided by an ecological perspective, the purpose of this study was to identify multilevel factors that influenced the implementation of environmental control units (ECUs) in Veterans Health Administration (VHA) Spinal Cord Injury/Disorders (SCI/D) Centres. Materials and methods: Mixed methods including an online survey and qualitative interviews of VHA healthcare employees. Results: VHA healthcare employees participated in the online survey (n = 153, 21% participation rate) and semi-structured interview (n = 28; 54% participation rate). About 58.2% of survey respondents indicated that patients admitted to a VHA SCI/D Centre received ECU training. Interview participants reported that patients might benefit from educational materials on using ECUs. About 53.7% of survey respondents indicated that they did not receive ECU training. Interview participants emphasized that more healthcare employees needed to be trained to distribute ECU-related tasks including patient training and troubleshooting problems. The most common challenge was the coordination involved in moving patients out of rooms that were being outfitted with an ECU. Conclusions: Application of an ecological framework highlighted a range of factors at multiple levels that dynamically influence ECU implementation while accounting for the SCI/D care context. Integrating this technology with the care experiences of patients, the workflow of healthcare employees, and the structure of the organization may improve the implementation of ECUs.IMPLICATIONS FOR REHABILITATION An environmental control unit (ECU) is an assistive technology device that provides persons with a physical disability (e.g., spinal cord injuries and disorders) increased independence in a home, hospital, or rehabilitation facility setting. An ECU allows a person to access and control appliances like their hospital bed, lights, television, doors, nurse call button, telephone, and computer, thus, decreasing workload on attendants and family members while increasing independence for the user. Application of an ecological framework in this study highlighted a range of factors at multiple levels that dynamically influence ECU implementation while accounting for the SCI/D care context. Integrating this technology with the care experiences of patients, the workflow of healthcare employees, and the structure of the organization may improve the implementation of ECUs in an inpatient setting.

Original languageEnglish (US)
Pages (from-to)67-75
Number of pages9
JournalDisability and Rehabilitation: Assistive Technology
Volume15
Issue number1
DOIs
StatePublished - Jan 2 2020

Fingerprint

Spinal Cord Diseases
Veterans
Spinal Cord Injuries
Veterans Health
United States Department of Veterans Affairs
Delivery of Health Care
Interviews
Self-Help Devices
Workflow
Patient Care
Personnel
Rehabilitation
Organizations
Technology
Health
Patients' Rooms
Television
Workload
Telephone
Patient rehabilitation

Keywords

  • Spinal cord injuries and disorders
  • assistive technology
  • ecological model
  • environmental control unit
  • implementation
  • veteran

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Orthopedics and Sports Medicine
  • Biomedical Engineering
  • Rehabilitation
  • Speech and Hearing

Cite this

Martinez, Rachael N. ; Etingen, Bella ; French, Dustin D. ; Vallette, Marissa A. ; Bidassie, Balmatee ; Cozart, Huberta T. ; Weaver, Frances M. / An ecological perspective on implementing environmental control units for veterans with spinal cord injuries and disorders. In: Disability and Rehabilitation: Assistive Technology. 2020 ; Vol. 15, No. 1. pp. 67-75.
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An ecological perspective on implementing environmental control units for veterans with spinal cord injuries and disorders. / Martinez, Rachael N.; Etingen, Bella; French, Dustin D.; Vallette, Marissa A.; Bidassie, Balmatee; Cozart, Huberta T.; Weaver, Frances M.

In: Disability and Rehabilitation: Assistive Technology, Vol. 15, No. 1, 02.01.2020, p. 67-75.

Research output: Contribution to journalArticle

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AU - Martinez, Rachael N.

AU - Etingen, Bella

AU - French, Dustin D.

AU - Vallette, Marissa A.

AU - Bidassie, Balmatee

AU - Cozart, Huberta T.

AU - Weaver, Frances M.

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N2 - Purpose: Guided by an ecological perspective, the purpose of this study was to identify multilevel factors that influenced the implementation of environmental control units (ECUs) in Veterans Health Administration (VHA) Spinal Cord Injury/Disorders (SCI/D) Centres. Materials and methods: Mixed methods including an online survey and qualitative interviews of VHA healthcare employees. Results: VHA healthcare employees participated in the online survey (n = 153, 21% participation rate) and semi-structured interview (n = 28; 54% participation rate). About 58.2% of survey respondents indicated that patients admitted to a VHA SCI/D Centre received ECU training. Interview participants reported that patients might benefit from educational materials on using ECUs. About 53.7% of survey respondents indicated that they did not receive ECU training. Interview participants emphasized that more healthcare employees needed to be trained to distribute ECU-related tasks including patient training and troubleshooting problems. The most common challenge was the coordination involved in moving patients out of rooms that were being outfitted with an ECU. Conclusions: Application of an ecological framework highlighted a range of factors at multiple levels that dynamically influence ECU implementation while accounting for the SCI/D care context. Integrating this technology with the care experiences of patients, the workflow of healthcare employees, and the structure of the organization may improve the implementation of ECUs.IMPLICATIONS FOR REHABILITATION An environmental control unit (ECU) is an assistive technology device that provides persons with a physical disability (e.g., spinal cord injuries and disorders) increased independence in a home, hospital, or rehabilitation facility setting. An ECU allows a person to access and control appliances like their hospital bed, lights, television, doors, nurse call button, telephone, and computer, thus, decreasing workload on attendants and family members while increasing independence for the user. Application of an ecological framework in this study highlighted a range of factors at multiple levels that dynamically influence ECU implementation while accounting for the SCI/D care context. Integrating this technology with the care experiences of patients, the workflow of healthcare employees, and the structure of the organization may improve the implementation of ECUs in an inpatient setting.

AB - Purpose: Guided by an ecological perspective, the purpose of this study was to identify multilevel factors that influenced the implementation of environmental control units (ECUs) in Veterans Health Administration (VHA) Spinal Cord Injury/Disorders (SCI/D) Centres. Materials and methods: Mixed methods including an online survey and qualitative interviews of VHA healthcare employees. Results: VHA healthcare employees participated in the online survey (n = 153, 21% participation rate) and semi-structured interview (n = 28; 54% participation rate). About 58.2% of survey respondents indicated that patients admitted to a VHA SCI/D Centre received ECU training. Interview participants reported that patients might benefit from educational materials on using ECUs. About 53.7% of survey respondents indicated that they did not receive ECU training. Interview participants emphasized that more healthcare employees needed to be trained to distribute ECU-related tasks including patient training and troubleshooting problems. The most common challenge was the coordination involved in moving patients out of rooms that were being outfitted with an ECU. Conclusions: Application of an ecological framework highlighted a range of factors at multiple levels that dynamically influence ECU implementation while accounting for the SCI/D care context. Integrating this technology with the care experiences of patients, the workflow of healthcare employees, and the structure of the organization may improve the implementation of ECUs.IMPLICATIONS FOR REHABILITATION An environmental control unit (ECU) is an assistive technology device that provides persons with a physical disability (e.g., spinal cord injuries and disorders) increased independence in a home, hospital, or rehabilitation facility setting. An ECU allows a person to access and control appliances like their hospital bed, lights, television, doors, nurse call button, telephone, and computer, thus, decreasing workload on attendants and family members while increasing independence for the user. Application of an ecological framework in this study highlighted a range of factors at multiple levels that dynamically influence ECU implementation while accounting for the SCI/D care context. Integrating this technology with the care experiences of patients, the workflow of healthcare employees, and the structure of the organization may improve the implementation of ECUs in an inpatient setting.

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