Supporting person-centred decision making: Application for service provision and resource allocation

Date & Time

Nov 11th at 2:35 PM until 2:50 PM


Working beyond the normal expectations - Allied Health 


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Chairs: Kathleen Philip and Peter Nuttman

Dr Rachel Schmidt

The clinical decision making process of providing appropriate specialised wheelchair-seating systems for complex mobility and postural needs is an acknowledged complex, multi-variant process. The findings from an in-depth case study exposes the decision making processes and service pathways evident in Australian wheelchair and seating procurement.

Sixty participants were purposively recruited from 2011-12 via the ARATA network. Their service experiences were explored in an in-depth interview process from
differing stakeholder perspectives including: eleven consumers, five care providers, 28 prescribing clinicians and 16 vendors with recent specialised wheelchair-seating procurement experience (≥ 3 years). All participant interviews were recorded, transcribed, and member-checked and subjected to a multi-data analytical process.

The first, a peer reviewed thematic analysis scrutinised common themes emerging within each stakeholder group. These were compared with similar themes common across all four stakeholder groups to better understand the seating service experiences. A second
analysis explored the data from a decision-making perspective and a third, from a social justice perspective to enhance data trustworthiness.

The study exposes decision making occurs at a service level, at a clinical level and at consumer level. This presentation presents the findings at a consumer level. There are three types of decision makers: the independent, supported and advocate decision makers.
Each type of decision maker describes the consumer's capacity to make decisions and identifies the degree of service and clinical support required. Identifying the degree of consumer support required by the type of their decision making capacity helps to allocate the
service resources and expertise appropriately.

Within a National Disability Insurance Scheme environment, this evidence-based data identifies necessary supports, resources and time to optimise the
consumer's inclusion in wheelchair procurement. Its application is transferrable to consumer's decision making capacity for specialised assistive technology procurement as it helps to highlight necessary services and resources required for effective service outcomes
and satisfied consumers.