How to build consensus from the very beginning

YARMOUTH, Maine - It takes a team to provide complex rehab, but when family members and clinicians can't agree on a course of action, it's up to providers to take the lead, says Weesie Walker, executive director of NRRTS.

Walker, who has 30 years of experience as a rehab provider, recently hosted a NRRTS webinar about the importance of building consensus during a wheelchair evaluation.

“I once worked with a seating therapist who had never done switch access for power driving and she wasn't knowledgeable about the equipment,” she said. “I didn't get us all on the same page and it became very frustrating for the parents (of the wheelchair user).”

The key to a successful evaluation, says Walker, is managing expectations from the start.

“One of the big issues in that case was, the parents wanted me to bring in, 'one of these' and 'one of those' to try and that wasn't realistic,” she said. “All the manufacturers are very generous with loaning equipment to providers, but that's a huge process and families need to know that upfront.”

Walker also recommends that providers develop clear, attainable goals.

“For this particular child, our goal was for her to be able to drive her chair,” she said. “We had accomplished that goal, but then dad said, 'Well I want her to be able to access her communications device,' but they hadn't even determined what communication device she was going to use.”

When all parties aren't on the same page, Walker says, the biggest consequence is abandonment of equipment, which ends up wasting a lot of time and money.

“With healthcare dollars shrinking every day, no one wants to see them being wasted,” she said. “Another consequence is that the provider will have to spend a lot of extra time, effort and resources redoing the consultation.”