Manual Wheelchairs - World Health Organization

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• Wheelchairs are sourced from a range of suppliers, including local and international, depending
on their appropriateness and affordability.
• Services carry out quality control to ensure that every wheelchair is assessed for safety before the
user tries it and for safety and correct fit before each user leaves the workshop or rehabilitation
centre with the wheelchair.
• Repair services are available to provide continuing support to users.
• Services identify local needs and measure their effectiveness in meeting these needs through
regular monitoring and evaluation (see Section 3.5).
• Services promote teamwork between clinical and technical personnel in providing service to
users.
3.3.2 Referrals and appointments
Objective
The objective of good practice in referrals and appointments is to ensure that users have equitable
access to wheelchair service delivery, to increase the efficiency and productivity of the service, and
to minimize waiting lists.
Referral system
This pertains to the way in which users access the service. This may be through “self-referral”,
whereby users contact the service directly, or through a “referral network”, whereby users are
referred by another organization.
Appointment system
This refers to the method of establishing appointment times with users for assessment and
prescription, fitting, basic user training and follow-up. The most common method is to list
appointment times in a service diary, which are then filled as users are referred. The benefits of an
appointment system include reduced waiting times and increased work efficiency.
Waiting lists
Where there is high demand for the wheelchair service, a waiting list will need to be established.
Users on the waiting list can be offered an appointment as the service works through the list. The
administration of appointments will depend on the context.
Box 3.4. Good practice in appointment and referral systems
n When a user is referred to the service, a file is established and an appointment is made or the user is put on the
waiting list.
n Services provide training for referral network personnel to increase their awareness of wheelchair service delivery
and to show them how to refer users to the service.
n Services develop and distribute a form for referral network agencies to complete when referring users.
n Services use clear guidelines to prioritize appointments. This is particularly important where there are waiting lists.
examples of high-priority users include those with a terminal illness and those at risk of developing life-threatening
secondary complications such as a pressure sores.
n Services set targets and measure their performance in relation to the number of referrals, the length of time between
referral and appointment, and reduction of waiting lists.
n Services have a screening procedure to minimize the scheduling of inappropriate referrals.
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