Mobility Options for the Aging Population of Manitoba: An Action Plan for Regional Solutions

Report: iv., pp.122; ill., Digital file.Safe mobility for older adults is a multifaceted and complex issue, and no single solution exists to address the needs of a diverse senior population. Solutions to improve transportation for seniors are impeded by a range of obstacles including: (1) increasing demand due to large increases in the elderly population; (2) inadequate funding and the need for clarification in jurisdictional responsibility; (3) the extreme winter conditions experienced in Manitoba; and (4) heavy reliance on the automobile and limited support for alternative forms of transportation. In the province of Manitoba previous research has emphasized that the lack of appropriate mobility resources for seniors in both urban and rural settings hinders the promotion of independence, quality of life and empowerment that are all crucial factors for successful aging.Manitoba Seniors and Healthy Aging Secretariat

Development and Application of 3D Kinematic Methodologies for Biomechanical Modelling in Adaptive Sports and Rehabilitation

Biomechanical analysis is widely used to assess human movement sciences, specifically using three-dimensional motion capture modelling. There are unprecedented opportunities to increase quantitative knowledge of rehabilitation and recreation for disadvantaged population groups. Specifically, 3D models and movement profiles for human gait analysis were generated with emphasis on post-stroke patients, with direct model translation to analyze equivalent measurements while horseback riding in use of the alternative form of rehabilitation, equine assisted activities and therapies (EAAT) or hippotherapy (HPOT). Significant improvements in gait symmetry and velocity were found within an inpatient rehabilitation setting for patients following a stroke, and the developed movement profiles for patients have the potential to address patient recovery timelines. For population groups, such as those following a cerebral incident, alternative forms of rehabilitation like EAAT and HPOT are largely unexplored. Within these studies, relevant muscular activations were found between healthy human gait and horseback riding, supporting the belief that horseback riding can stimulate similar movements within the rider. Even more, there was a strong correlation between the horse’s pelvic rotations, and the responsive joint moments and rotations of the rider. These findings could have greater implications in choosing horses, depending on the desired physical outcome, for EAAT and HPOT purposes. Similar approaches were also used to address another biomechanically disadvantage population, adaptive sport athletes. Utilizing similar methodologies, a novel 3D wheelchair tennis athlete model was created to analyze match-simulation assessments. Significant findings were present in the energy expenditure between two drill assessments. Overall, the quantitative results, coupled with the qualitative assessment chapter, provide a robust assessment of the effects of 3D movement analysis on rehabilitation and adaptive activities

Patient flow analysis at Magee-Womens Hospital of UPMC

As the number of hospital visits increases, patients across the U.S. are experiencing longer wait times before being transferred to an inpatient unit. Hold hours in emergency rooms (ED) and post-operative care units (PACU) are defined as the period of time where patients are prepared to be transferred but cannot because the receiving unit is at capacity. Magee-Womens Hospital of UPMC has seen an increase in hold hours in both their PACU and ED because inpatient units are usually at 95% of capacity. Total hold hours over a two-week period typically range from 70 to 130 hours, with the all-time high reaching 250 hours. Accrediting agencies, such as the Joint Commission and the Institute of Medicine have identified hold hours as a public health problem, because hold hours lead to poorer patient outcomes as well as lower patient satisfaction scores. After consideration, Magee executives and staff identified ineffective discharge processes, with patient transportation being a primary factor, as the cause of the bottlenecks being created in both the PACU and ED. This report analyzes ways to increase transport efficiencies so that wait times that patients are currently experiencing once they have been cleared for discharge can be reduced. Observations and data were collected to review the discharge process and understand where problems may be occurring. The use of patient transport communication system (Teletracking) reports were used to analyze the discharge process and proved vital in determining where processes were broken. Data logged by transporters into Teletracking was used to create a Pareto chart that shows categories of delays that include delays broken down into nursing, patient, equipment, physician and paperwork as well as miscellaneous delays. Results of the study indicate that an inefficient discharge process is causing the hold hours. Recommendations are made based on the problems noted in the analysis with an emphasis on increasing efficiency in the transport department to make the discharge process more efficient. These recommendations include increased communication between departments, implementation of a discharge unit, so patients have a place to wait after they have been discharged, and an inventory analysis to reduce time spent looking for equipment

‘It’s An Accessible World After All’: Evaluation of Amusement Park Accessibility and Accommodations for Guests with Disabilities

The word “disability” is defined as, “A physical or mental impairment that substantially limits one or more major life activities” (Brennan, p. 1, 2013). In order to provide more inclusive environments for individuals with various disabilities, the Americans with Disabilities Act was signed and passed by George H. Bush in 1990 which supported their natural human rights and prevented discrimination. However, any architectural structures built before the passing of this act may be inaccessible and cause segregation due to the lack of Universal Design (UD) for people requiring special needs, which includes a handful of long-standing amusement parks. Therefore, it was hypothesized that a majority of U.S. amusement parks will be inaccessible and lack diverse accommodating services to create an inclusive environments for persons with disabilities. The hope of this particular study is to spread awareness and further inspire future research related to the prevalence of accessibility features of public spaces and how they impact individual daily occupations and basic human functions. Semi-structured qualitative interviews were conducted with three (3) participants in order to collect personal responses and feedback regarding accessibility features of various amusement parks. The theme parks discussed during the interviews included Coney Island, Holiday World, attractions at the Indianapolis Zoo, and Walt Disney World. After the completion of semi-structured interviews, participant responses were coded using Qualitative Description Analysis that revealed four underlying themes

Transportation for an Aging Population: Promoting Mobility and Equity for Low-Income Seniors

This study explores the travel patterns, needs, and mobility problems faced by diverse low-income, inner-city older adults in Los Angeles in order to identify solutions to their mobility challenges. The study draws information from: (1) a systematic literature review of the travel patterns of older adults; (2) a review of municipal policies and services geared toward older adult mobility in six cities; (3) a quantitative analysis of the mobility patterns of older adults in California using the California Household Travel Survey; and (4) empirical work with 81 older adults residing in and around Los Angeles’ inner-city Westlake neighborhood, who participated in focus groups, interviews, and walkabouts around their neighborhood

Spartan Daily, October 1, 2014

Volume 143, Issue 15https://scholarworks.sjsu.edu/spartandaily/1514/thumbnail.jp

Addressing Non-Emergency Medical Transportation Needs in Androscoggin County

Public health and social equity hinge upon the accessibility of medical services to all. Lack of access to transportation for routine and non-emergency medical appointments poses a significant barrier to appointment attendance, a barrier that disproportionately impact low income people and other marginalized groups. Healthcare providers also suffer major financial losses when patients are unable to attend their appointments. Prior research and community forums in Androscoggin County, Maine have identified several shortcomings to existing local non-emergency medical transportation (NEMT) services, illuminating the need for transportation options that better address the specific needs of the local population. In this report, we identify unmet transportation needs in Androscoggin County, detail the findings of our research on alternative models of NEMT across the United States, and propose a pilot program for a NEMT system tailored to the local needs and resources in Androscoggin County. This project is conducted in collaboration with Community Concepts Inc. (CCI). We build on the work of a previous Environmental Studies Capstone group from Bates College that identified the specific shortcomings of the current NEMT ride brokerage system from the perspective of the New Mainer community. Through consultations and scholarly research, we found a number of elevated transportation barriers faced by New Mainer users, rural users, users with disabilities, and non-MaineCare users. Our comparative study of different NEMT programs in Maine, New York, Minnesota, and Oregon allowed us to identify the range of different vehicles, transport styles, scheduling services and payment options that exist in NEMT services on a national scale. We synthesize the findings of this research into a proposal for a six month NEMT pilot program to be implemented in Androscoggin County. The pilot program we propose would be operated by CCI as a means of testing out the viability of an alternative to the current LogistiCare system. The program would operate two vans, one as a demand responsive, taxi-style service, and one on a fixed route with pick-up points in the downtown Lewiston-Auburn area and drop-off points at major healthcare providers. In order to address local and cultural needs present in Androscoggin County, our proposal recommends a multilingual ride-scheduling service, driver trainings on implicit bias and mental health first aid, and a representative community board to receive feedback and implement changes in the program moving forward. Fare options and potential funding options are also discussed. We conclude with a set of recommendations for next steps for working towards more accessible, culturally appropriate NEMT services in Androscoggin County