Getting in and out of a vehicle is something most of us take for granted. But if you’ve just had a hip or knee replaced, suddenly ordinary maneuvers seem daunting or even dangerous.
Discharge from the hospital usually means approaching a vehicle for the first time, with limited ability for routine movements like bending at the waist, or rotating and bending a leg. Motivated by the very real risk of patients falling or injuring themselves after surgery, a small team of Virginia Mason health care workers hatched an idea to help prepare patients for entering and exiting a car.
The team, consisting of occupational and physical therapists, a patient transporter, patient care technician and a kaizen (continuous improvement) specialist collaborated to build a prototype “therapy car.” This process included building 3D tabletop mockups – out of things like pipe cleaners and tongue depressors – to create the team’s vision. A Virginia Mason volunteer with an engineering background helped with design based on the staff’s list of functional requirements: it must be adjustable, lightweight and portable.
While the result wasn’t shiny or aerodynamic, the therapy car has a cushioned seat and adjustable height to simulate different sized vehicles. Wheels make it easy to move, though usually it stays “parked” in Virginia Mason’s Orthopedics Unit therapy gym. Before the creation of the therapy car, patients had no realistic way to practice getting in and out of a vehicle.
“When recovering patients are told they can’t bend or lift their leg in a certain way they are left wondering how they can possibly navigate the car safely,” says physical therapist Jennifer McClure. “Using the therapy car they practice with a therapist, usually someone who has been working with them and has insight into how well they are moving with other activities.”
While the therapy car is ideally suited for joint-replacement patients, it can also help patients who’ve suffered a stroke or other neurological problems to “re-learn” the mechanics of getting in a car. Therapy patients are encouraged to share ideas for improvement with the care team as the design is continually refined.
And what do patients think of the therapy car so far? “Patients often look at it with trepidation initially, but after some instruction and practicing the techniques for a safe transfer they consistently report more confidence for managing the car to go home,” says Jennifer. She points out that patients’ family members benefit too, by learning the techniques at discharge to help transport their loved ones safely.