How could the service delivery process of dynamic arm supports be optimized?

Abstract

Background:The service delivery process of dynamic arm support (DAS) is complex. Obtaining an optimal match between user and DAS depends on a variety of interrelated factors, different professionals are involved, and the market of available solutions is evolving.Objective: To determine how the service delivery process of DAS could be optimized. Methods:Interviews with DAS users that retrospectively focused on the experienced service delivery process D 'a focus group session to seven DAS consultants, and subsequently verified by a member-check. Results:Sixteen people who considered the Gowing (a DAS new on the market) as a solution and seven DAS consultants participated. Aspects that can be optimized in the current service delivery process included an improved cooperation between clients, professionals and consultants, increased knowledge of DAS in professionals, an embedded user evaluation, and timely delivery. Conclusions:It is recommended that the service delivery process is optimized by developing a DAS specific prescription framework. The issues identified in this study should be addressed in this framework. For this additional knowledge on how to optimally match persons and DAS is needed.

Effectiveness and cost-effectiveness of an optimized process of providing assistive technology for impaired upper extremity function: Protocol of a prospective, quasi-experimental non-randomized study (OMARM)

“…The process of providing AT for impaired upper extremity function within care as usual is described in van der Heide et al [50], based on data of 16 persons who were retrospectively interviewed on their service delivery process and participated in a focus group session with advisors of a supplier. Important aspects are summarized below; a comprehensive overview of all steps with more detailed information is presented in van der Heide et al [13,50].…”

“…This is necessary, since not every healthcare professional is well informed about the potential of dynamic arm supports and robotic arms. Conversely, once it has been decided that clients can benefit from such a device, other available options, such as eating devices, are only considered to a limited extent [13,50].…”

“…2. Summary of aspects that could be optimized in the provision process of dynamic arm supports (based on van der Heide et al [50]).…”

The neuromechanical and behavioural adaptations to dynamic arm supports in neuromuscular disorders

“…Similar bias was also present in studies evaluating the functional improvement where a patient's perceived gain was higher than the gain detectable through clinical scales [57]. The low level of specificity and the bias in self-reports makes it difficult to distil the most important aspects of DAS usage [118]. Therefore, we need to move beyond self-reporting if we want to understand the benefits and limitations of a dynamic arm support for specific user groups.…”

“…Currently, monitoring methods in the field mainly rely on (subjective) self-reports, which are recommended to identify the reasons for DAS use [118]. Such methods are valuable to assess subjective factors, such as the perceived activity, benefits, and limitations, and possibly specific causes for discontinuation of use.…”