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Archive Diversity in Surgery 2019

Is Your Facility Disability Friendly?

Take steps to ensure disabled patients and staff have comfortable access to every room.

Outpatient Surgery Editors


Months after enrolling in Harvard Medical School in the 1980s, Lisa Iezzoni, MD, MSc, received a diagnosis of multiple sclerosis. Although she completed her degree, medical educators discouraged her from seeking an internship, arguing her disability was incompatible with medical practice. In the absence of any support to go into practice, Dr. Iezzoni was forced to pursue health policy research. For the last 23 years she has investigated health policy issues related to people with disabilities. Today, she's arguably one of the world's leading experts on the topic. She is the author of the book When Walking Fails, has authored or co-authored more than 250 papers on health policy and served as professor of medicine at Harvard Medical School. We talked with Dr. Iezzoni to discuss what you can do to improve the care and comfort of patients with disability.

Q Many surgery managers may feel that if their facilities are compliant with the Americans With Disabilities Act (ADA), they have done enough for patients with disability. Are they right?

A No, they aren't. ADA is a minimal standard. It does not mean that a place is easy or comfortable to get around. Bathrooms are a good example. ADA requires enough space for a wheelchair to turn around. A standard manual wheelchair has a small turning radius, but many electric scooters do not. Sometimes, if I'm using one of my scooters, I have to pull straight into the bathroom, then back out. There is no room to turn around. I have to reach behind me to open the door. That's neither easy nor dignified.

The same thing is true for elevators. Frequently in retrofitted buildings, an elevator is big enough for a standard manual wheelchair to turn around, but not a scooter.

Also, when older facilities retrofit for ADA, they sometimes take improper shortcuts. In one older hospital, they ended up being cited for, among other things, inadequate wheelchair maneuvering space, improper arrangement of grab bars, and toilets and hand sanitizers in the bathrooms and drinking fountains that were too high.

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