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“Filling in the Gaps” of Dialysis Transportation Services in Rural County

by Todd Robinson, Mobility Coordinator, WSOS Community Action Agency, Ohio

Team (SCORE) Successfully Coordinating and Organizing to Revitalize and Enhance dialysis transportation has had an incredible learning experience as a grantee from the National Center for Mobility Management Grant. In focusing on our challenge area—getting dialysis patients living in mostly rural Wood County to treatment—we followed the design thinking process.

The SCORE team has devoted its time and efforts to assist the following challenged populations in Wood County, Ohio: older adults, low income individuals, and persons with developmental disabilities. Wood County is home to 15,389 people who are 65 years or older, just over 12 percent of the population.  The elderly population in Wood County is anticipated to generate significant demand for transportation as they discontinue driving on their own due to the physical effects of aging on response times, physical exertion, and driver visibility impairment.

Our NCMM project specifically focused on dialysis patients. Listed below are real life examples of barriers for current dialysis patients getting to and from treatment:

  • No county wide transportation
  • Driving in bad weather
  • Clot time ranging from 10-45 minutes (no exact end time)
  • Strain on caregivers
  • Excessive Waiting and Indirect Route
  • Cost/Affordability
  • 3rd Shift Worker gets limited amount of sleep taking his mother to and from treatment 3 days a week

Accessing care for rural patients receiving dialysis treatment is particularly difficult due to two main reasons: the amount of treatment days required (3 days a week, every week) and the scarcity of treatment centers. According to a previous study of health care access in rural states, “patients typically have to travel 1.5 times farther for dialysis than for a typical doctor's office visit, and up to 2 times farther for dialysis than for other highly specialized care such as chemotherapy.” In our project we also learned that there are two main times associated with dialysis treatment that can impact transportation: arrival time and the 15-minutes-later chair time. We learned that transportation needs to be scheduled for the arrival time, not the chair tiem.

In 2013, there was only one dialysis center located in Wood County, just north of the Wood County Hospital in Bowling Green, Ohio.  In 2016, there are 3 dialysis centers located in Wood County.  This is a realistic example confirming there is an increased demand for dialysis treatment.

During our design thinking project, we identified the What Is, What If, What Wows, and What Works for dialysis transportation in Wood County. Survey and research work was incorporated into the project to learn more about the needs of the patients, the clinics, and the caregivers. The SCORE team identified barriers and solutions by testing our assumptions about what would work best. Assumption tests were completed by interviewing dialysis patients, caregivers, and treatment centers. During the project, we had the opportunity to build relationships with dialysis patients, caregivers, and dialysis centers. We believe the best solution is piloting a Volunteer Driver Program in Wood County, serving all individuals in Wood County, especially focusing on the rural parts that do not have other public transportation services provided to them. The program will provide an alternative option for dialysis patients. This project allowed us to find compassion for the dialysis patients and inspired us to help them improve dialysis transportation. You can view more about our project here.

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This post was written by on March 25, 2016 6:32 am

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