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Improving Access, Care For People With Disabilities

Ruzanna Harutyunyan's picture

In collaboration with Boston's disability community and the Boston Center for Independent Living (BCIL), Brigham and Women's Hospital (BWH) and Massachusetts General Hospital (MGH) have begun a comprehensive and landmark effort to improve access and care for people with disabilities. The initiative was announced this morning at MGH where the presidents of both institutions -- the founding hospitals of Partners HealthCare - joined individuals with disabilities to present the new collaboration.

The initiative is comprehensive in scope. It includes an ongoing assessment by the MGH and BWH and the BCIL of the degree to which the hospitals are addressing the needs of people with disabilities, and what steps need to be taken to further improve care. These are likely to include:

o removing architectural barriers in hospitals, off hospital campus physicians' offices and health centers (including exam rooms, patient rooms, treatment rooms, waiting areas, gift shops and parking areas);

o purchasing additional medical equipment and devices that are accessible for people with disabilities (including wheelchair scales, power adjustable exam tables, power door openers, mammography);

o modifying hospital policies and procedures that address issues related to the care of people with disabilities;

o developing a training program for all staff including physicians, nurses and support staff who interact with patients and visitors.

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In announcing the collaboration, Brigham and Women's Hospital President Gary L. Gottlieb, MD, MBA said "This initiative is intended to go well beyond providing ramps and eliminating architectural barriers. It is designed to build a stronger partnership between health care providers and patients with disabilities, and help to fundamentally change the culture of access and care for people with disabilities."

MGH President Peter L. Slavin, MD, commended members of the disability community for their "courage, tenacity and willingness" to work with the hospitals to address this challenging problem. "This collaboration is about developing a deeper understanding of the needs of people with disabilities and reaffirming our commitment to provide the best care to all of our patients," said Dr. Slavin.

"We hope this process can be a catalyst for improving access and health care for people with disabilities in Massachusetts and throughout the country," said Bill Henning, director of BCIL. Greater Boston Legal Services (GBLS), which worked collaboratively with BCIL, BWH, and MGH to develop the wide-ranging plan to better address the needs of patients with disabilities at the hospitals, called the initiative a "model for hospitals in Massachusetts and nationwide."

In April 2008, the BCIL and GBLS made BWH and MGH aware that patients with disabilities felt they were not consistently getting the care and services they needed. Patients with disabilities cited a number of concerns including: not being weighed because they use a wheelchair, but being worried because certain medicines are dosed by weight; being examined in a wheelchair instead of on an adjustable exam table; a lack of sensitivity to their disability by some caregivers.

The patients' statements were taken very seriously by the hospitals, and during the past year, representatives from the hospitals, Partners HealthCare, BCIL and GBLS met frequently to develop a comprehensive plan to address the problems. In the meantime, the hospitals continued implementing a number of previously planned patient improvements.

Both BWH and MGH have large disability awareness councils composed of representatives from a full range of hospital departments, including patient care and nursing, human resources, facilities, support services and senior management. The goal of the councils is to support the hospitals' efforts to be first-rate providers of choice for people with disabilities.

Some of the issues identified by the BCIL had already been raised by the disability awareness councils in the hospitals. The councils have used the discussions with the BCIL to reassess their priorities. The hospital disability awareness councils understand, and it is clear in the initiative, that the definition of disabilities goes beyond mobility issues and patients who are deaf and blind, to include the elderly and other patients with partial hearing loss and/or other visual impairments, the frail, and those with non-visible disabilities.