107 - Guidelines and Recommendations for Providing Disability-Competent Care for Individuals with Physical Disabilities: A Narrative Review

Thursday, February 22, 2024

5:00 PM – 6:30 PM EDT

Presenting Author(s)

GB

Gurasees Bajaj, BA

Medical Student
Feinberg School of Medicine, Northwestern University
Chicago, Illinois, United States

Co-Author(s)

Leslie Rydberg, MD

Physician
Shirley Ryan AbilityLab
Chicago, Illinois, United States
CH

Carol Haywood, PhD

Research Assistant Professor
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States
TL

Tara Lagu, MD, MPH

Professor/Director
Northwestern Feinberg School of Medicine
Chicago, Illinois, United States
MM

Megan Morris, PhD, MPH, CCC-SLP

Associate Professor
University of Colorado School of Medicine
Denver, Colorado, United States
SS

Samantha Schroth, BS

MD PhD Student
Northwestern University Feinberg School of Medicine
Chicago, Illinois, United States

Objectives:

To understand the full scope of guidelines and recommendations for providing disability-competent care (DCC) and create a resource for healthcare systems and clinicians alike to better advocate for lawful and proper care for people with disabilities (PWD). We also aim to identify areas of the DCC model that are missing corresponding recommendations in hopes to encourage further guideline development that addresses essential care gaps.

Design:

A literature search and content analysis of key grey/white literature, research reports, as well as consumer and clinician perspectives were performed. 131 articles related to disability-competent care were identified from which 23 articles met the inclusion criteria of being guideline- driven and focused on physical disability.

We characterized the literature according to a published framework of axes of healthcare access, focusing primarily on physical and policy/procedural constructs relevant to physical disability. We then examined the literature against the DCC model as defined by Resources for Integrated Care, a coordination office for Medicare/Medicaid recipients.

Results:

The Axes of Access and DCC models yield complementary constructs and recommendations for caring for people with physical disabilities. Guidelines for providing physical access to care are widely published with great detail, but with limited support for implementation in practice. For policy/procedural access, ensuring proper care coordination within a healthcare system, addressing lifestyle and behavioral health concerns, and establishing long term support for PWD are key areas in need of greater development. Disability etiquette, while not explicitly discussed in current policy, was a central component of clinician and consumer perspectives to ensure care delivered is patient-centered and understanding of one’s unique disability experience.

Conclusions:

Greater implementation of existing physical access guidelines, as well as guideline development to ensure procedural access and proper disability etiquette, are essential to address persistent disparities in care for people with physical disabilities.