SCI Clincally Speaking
A Balanced Look at Seating & Positioning
Providers and clinicians share the same ultimate goal
of ensuring that a client’s needs are fully met in
the most complete and efficient means possible.
When it comes to a client’s seating & positioning needs,
it is necessary that all parties involved have a clear
understanding of how this is best accomplished.
Understanding the Need
A complete wheelchair evaluation is necessary to address
what an individual requires from his or her seating system,
which may include cushions, backrests, headrests and
trunk, arm and leg supports. Only through a thorough
seating evaluation can the client’s needs be understood.
While the evaluation is the clinician’s key area of focus,
providers, as product experts, should take an active role
on the evaluation team.
A stable and comfortable position in an appropriate
wheelchair is critical to the patient’s comfort, health,
productivity and independence. Individualized seating and
positioning systems can enhance breathing capacities,
prevent skin breakdown, minimize pain and greatly
improve overall functional abilities of an individual.
The factors that determine what seating components
are going to work best for the client are numerous,
but on a general level, are similar to those of other
rehab equipment. The patient’s level of injury, his or her
capability, body type and activities of daily living must all
be factored in, so this information should be gathered
during the initial evaluation process.
Know What Is Available
Seating requirements vary from a simple out-of-the-box
solution to a highly complex, custom-built power
positioning system. Staying up to date on the latest
equipment available and the reimbursement rules that
govern its provision is a full-time job in itself.
Providers must work diligently to educate themselves
and their referral sources on the ever-growing number
of seating solutions available. Numerous educational
opportunities can be found within the industry. By
investing in education, providers can serve as a valuable
resource to the clinician.
Clinicians should therefore make time to meet with
providers by scheduling in-services. Providers are an
excellent source of information on the options available
to meet the client’s needs. Listen to what they have to say
regarding the products they carry and why they are best
suited to meeting your patient’s needs.
Providers should engage clinicians for feedback when
reviewing the benefits of a product they would like to
provide. Chances are the clinician has experience working
with the product or a similar item and can offer an
informed opinion. Clinicians will also be able to estimate
how many of their patients use the product, giving
providers an idea of its demand and potential applications.
Clinicians should remain realistic in their expectations.
Understand the reimbursement and economic reality for
each client. If you are recommending equipment that
cannot be funded, then the patients’ needs are not going
to be met. Providers should create a system that takes the
guesswork out of the reimbursement process. Develop
an easy tool for your staff and referral sources to match
International Statistical Classification of Diseases, Ninth
Revision codes (ICD-9 codes) with the local coverage
determinations (LCD) and match the demo equipment
available to this tool.
When providers and clinicians work together to stay up
to date, they are capable of giving the client access to the
broadest range of equipment available.
Efficiency Is Essential
Patients and clinicians depend on providers to deliver
seating solutions accurately and quickly. To stay
competitive, providers must take steps to ensure that efficiency is a paramount part of their business
To ensure efficiency, providers should evaluate their
purchasing history and identify trends regarding the
seating products they provide. A clear picture of the most
commonly supplied products should emerge. Efficiency
can be improved by purchasing your most popular
products in quantity.
Providers should partner with a high-quality
manufacturer that can provide many solutions to diminish
the need to order from multiple vendors. Again, this can
dramatically reduce overhead, reduce product lead time
and shrink the margin of error.
Product reliability is an essential ingredient to ensuring
the satisfaction of the patient, clinician and provider.
Replacing or repairing a seating system leads to downtime
for the patient, frustration for the clinician and quickly
drives up provider costs. If you select a manufacturer who
produces and stands behind high-quality products, there
will be fewer service calls.
Providers must work with clinicians to keep the patient’s
future needs in mind. Will the back you provided easily
integrate with the positioning components they may need
in the future? A commitment should be made to carry
products and parts your customers may eventually need
or that will serve their changing needs. Choose products
that can be easily modified to prevent having to purchase
additional items. Identify which products work best with
the other equipment you are providing. Compatibility is
key. Offer cushions and other seating products that work
with all of the chairs you provide. This keeps both patient
and provider costs and down and makes future adjustment
fast and easy.
Ensure customizations are provided in a timely and
cost-effective manner. It is important to consumers that
their customizations are performed accurately and as
quickly as possible. Partner with a manufacturer that can
quickly and reliably deliver custom seating sizes, and
if necessary, can help fabricate unique components to
reduce time and cost.
Clinicians should educate providers on the progression
of a client’s need. If a patient’s ability is likely to improve or
decline, a plan that encompasses these changes should be
discussed with the provider.
When providers and clinicians work closely together to
meet seating and positioning needs, a great outcome is
easily attainable. The needs and goals of each simply need
to be understood and addressed.
This article originally appeared in the SCI Handbook October 2010 issue of Mobility Management.
Julie Pello is the general manager of Quantum sales for Pride Mobility Products Corp., Exeter, Pa. Julie can be reached via e-mail at firstname.lastname@example.org or by calling (800) 800-8586.
Mike McCarthy, ATP, is the Quantum Rehab national sales manager/manual wheelchairs & Synergy Seating products for Pride Mobility Products Corp., Exeter, Pa. Mike can be reached via e-mail at email@example.com or by calling (800) 800-8586.