Veteran Centre Residents' Use of Power Mobility Devices

Policy Statement

Sunnybrook Health Sciences Centre (Sunnybrook) Veterans Centre Residents' Use of Power Mobility Devices policy is consistent with Accessibility for Ontarians with Disabilities Act, 2005 (AODA) and the Accessibility Standards for Customer Service, Ontario Regulation 429/07.

The Power Mobility Devices policy is consistent with the principles of customer service i.e. dignity, independence, integration and equal opportunity. (See: Accessibility ADM-100).

Sunnybrook encourages the use of personal assistive devices whenever possible to improve access to hospital services.

Mobility contributes to quality of life; therefore independent mobility will be promoted and maintained where possible. It is every resident's responsibility to operate his/her power-mobility device in a safe and respectful manner. Residents requesting or needing a power-mobility device for traveling within Sunnybrook will be assessed by Occupational Therapy. The assessment includes physical and cognitive abilities and successful completion of the Power Mobility Indoor Driving Assessment (PIDA).
In the event of an accident, or with a significant change in medical condition, the resident's continuing ability to use the power-mobility device will be monitored and reviewed by the team. When issues related to safety and unsafe operations are identified and documented, a discussion will take place with the resident/family, and the team. This may involve re-evaluation of the resident's ability to operate a power-mobility device and possibly re-training.

Sunnybrook holds the right to revoke driving privileges at all times.

Definition(s)

Power-Mobility Device (PMD): Power wheelchair or scooter

Procedure

1. A referral is initiated following a request from a resident/family or a member of the team for a power-mobility device.
2. The Occupational Therapist will complete an initial assessment to determine the most appropriate power- mobility device
3. The Occupational Therapist and/or Occupational Therapy Assistant will provide the training in the use of a power-mobility device. The training will be tailored to the resident's skill and ability and to the environment where they will be driving.
4. Throughout the assessment and training, there will be discussion and documentation about the resident's progress.
5. On successful completion of the Power-Mobility Indoor Driving Assessment (PIDA) driving test:
   
   • A driver's licence will be issued to the resident and attached to the power-mobility device.
   • The resident and the Occupational Therapist will sign the Resident Power-Mobility Letter of Agreement [Appendix I]. A copy will be given to the resident and the original will be placed on the resident's health record.
   • The Occupational Therapist will review the safety guidelines and policies, provide the resident with a copy and document the discussion on the resident's health record.
6. When a resident does not successfully complete the power-mobility driving test:
   
   • The reasons for this will be discussed with the resident/family/team and alternative means of transportation will be discussed.
   • The discussion and plan will be documented on the resident's health record.
   • Opportunities for further re-training and re-assessment will be discussed when possible.
   • Throughout the assessment there will be ongoing discussion with the resident/family/team. The process will be documented on the resident's health record.

Actions/Incidents That Will Revoke Driving Privileges

Incidents related to safety and/or the unsafe operation of a power-mobility device may lead to a revocation of driving privileges.
Examples of some safety violations are:

• Driving at unsafe speeds (driving above normal walk speed).
• Reckless driving causing accidents.
• Undue damage to the mobility device and the environment.
• Behaving in a harmful, threatening or offensive manner.
• Reacting inappropriately to obstructions and hazards by striking, hitting or ramming with the power mobility device.

All incidents related to unsafe driving must be reported and documented. When incidents are witnessed by residents/families/visitors, they are to inform a staff member as soon as possible of the incident. They should provide an account of the incident, describe the individual/PMD if identity unknown. The staff member will then initiate documentation and an investigation.

All accidents and all incidents of unsafe driving involving the operation of a power mobility device will require:

• An investigation into the circumstances of the accident or incident by the Team.
• Documentation of the accident or incident including the completion of an online Safety Report.
• Discussion and documentation of the incident with the resident/family and team in a timely fashion.
• A plan developed to address the circumstances that contributed to the accident. The plan is then documented and communicated to the resident/family and team members.

Consequences of Driving Incidents

1. FIRST DOCUMENTED INCIDENT: A representative of the team will discuss the occurrence with the resident. A written letter from the team, outlining the occurrence and strategies to prevent re-occurrence will be given to the resident within 3 working days of the incident.
2. SECOND DOCUMENTED INCIDENT: A representative of the team will discuss the occurrence with the resident. The team will review all aspects of the incident. The power mobility device could be removed for 4 consecutive days. A written letter from the team outlining the occurrence and the consequence will be given to the resident within 3 working days of the incident.
3. THIRD DOCUMENTED INCIDENT: A representative of the team will discuss the occurrence with the resident. The team will review all aspects of the incident. The power mobility device could be removed for a period of 8 consecutive days. A written letter from the team outlining the occurrence and the consequence will be given to the resident within 3 working days of the incident. During this time the team will identify further strategies to be implemented to ensure the safety of the resident and the community.

Sunnybrook holds the right to revoke driving privileges at all times.

Appendices & References

Appendix I: Resident Power-Mobility Letter of Agreement