Handles with care
With around 1.4 million patients per year visiting Mayo Clinic, you can imagine how many wheelchairs there are, and how many miles they're pushed.
In fact, you don't have to imagine — Mayo is attentive to such things, and estimates that, taken together, its service staff of 130 pushes patients about 14 miles per day, over all kinds of surfaces, in all kinds of weather.
Little surprise, then, that staffers have reported a variety of long-term health concerns, including wrist, elbow, shoulder and back injuries.
The traditional wheelchair design, with its flat handles at a height ideal for somebody about 5-foot-7, was ripe for a change.
Mayo began testing chairs with upright handles at its Rochester facilities in March 2015. Those chairs proved so popular and effective that every wheelchair was converted to the new style early this year.
From there, other medical facilities across the country have either adopted the new style or are exploring the option — including Mayo's facilities in Florida and Arizona, and Johns Hopkins in Maryland.
Those new-style handles let you put your weight into your push, increasing the maximum push force by about 11 percent, while also reducing stress on the rest of the body. That becomes a critical improvement for staffers who sometimes push large patients up to a quarter-mile through downtown Rochester.
"It's actually a lot easier," said Mayo's Patient Services Manager Ralph Marquez, who was involved in the decision to convert to the new chair handles — and he didn't do so lightly.
"I asked the tough questions," he said. "I wanted to make sure we weren't doing this on a whim. I wanted to make sure we were justified in this. This is a patient and staff concern, so it was a very easy sell."
'A testing kitchen'
Sandra Wooley, Mayo Clinic's ergonomist and expert in occupational safety, spearheaded the push in coordination with Centicare Corporation President Jim Haigh, Mayo's longtime wheelchair vendor. The initial prototype was tweaked to elongate the handles and include more rubber grip on them to accommodate people's different heights.
The wheelchair attachments got plenty of odd looks at first, Marquez said, but Wooley's research suggests that 20 percent of back injuries are due to pushing or pulling. Mayo has only got anecdotal evidence thus far about injury prevention, but the new chairs are drawing rave reviews.
"I have not seen this implemented elsewhere," Wooley said. "I think we were sort of a testing kitchen for this manufacturer. General service management deserves a lot of kudos because they were willing to listen to me and move forward with a very big change."
How big? There are about 400 of the new-look wheelchairs stationed at the Gonda building door each morning, and hundreds more positioned around the city.
Haigh, who has four patents on his new design, called the conversion a no-brainer.
"The typical wheelchair forces you to be in a very unusual position," he said. "You can't push very hard when your palms are down, and it was starting to cause health problems. Have you tried to push a patient who is 400 pounds? It's absurd, but it was happening all the time."
Mayo's new wheelchair handles were aimed at addressing health concerns, but that turned out to be just one of the benefits.
Clinic officials were surprised to see that many of the old-style wheelchairs, taken from the Clinic under Mayo's lenient check-out policy and never returned, began coming back.
Before now, Mayo spent about $90,000 per year to replace about 150 lost wheelchairs, Marquez said. It was viewed as "the cost of doing business," he said.
But this year, Mayo has not had to order a single new wheelchair. Marquez suspects the new handles make it difficult, or even impossible, for patients to pack wheelchairs into their vehicles after their medical care is completed.
"That's the secondary benefit," he said. "We're not losing wheelchairs anymore. I haven't ordered wheelchairs yet this year. Normally I order 120 to 150 each year (at $600 apiece)."
What's more, Mayo has actually added to its wheelchair collection, due to the returns. Mayo's wheelchair count rose to 1,700, from 1,000, without buying a single chair. At $600 per chair, that's a $400,000 benefit.
The chairs that have returned are being outfitted with new handles, too.
"I'm just looking at it from a flow process," Marquez said. "It's flowing back to me and then flowing back out. That's what we want."
Mayo's wheelchairs, by the numbers
— 120-150: Number of new wheelchairs ordered in a typical year to replace missing chairs
— $600: Amount per chair
— 1,000: Size of wheelchair fleet in 2015
— 1,700: Size of fleet today, despite no new purchases