Clinical Report: Experiences of a Driver with Vision Impairment when Using a Tesla Car.

SIGNIFICANCE: Assisted and autonomous driving technologies may be a new paradigm shift for the driving rehabilitation field to enable less restricted driving, increase driving confidence, and maintain driving safety for drivers with vision impairment. PURPOSE: This study aimed to document how a driver with vision impairment uses assistance and automation systems in a Tesla car based on real-world experiences of using these technologies. METHODS: A 53-year-old man with Stargardt disease and 20/182 visual acuity self-explored the use of driver assistance technologies, which resulted in purchasing a Tesla Model Y with the full self-driving package in 2020. Two semistructured interviews were administered to quantify the driver's driving habits, adaptive strategies, use of the assisted and semiautonomous driving features in the Tesla car, and use of his bioptic telescope. RESULTS: When driving a Tesla car, the patient developed new driving strategies by codriving with different assisted and semiautonomous functions (e.g., Traffic-Aware Cruise Control, Traffic Light and Stop Sign Control, Autopilot) in different road environments. He shifted his main task from active driving to supervising the car automation systems in most driving situations. He also integrated a new use of his bioptic telescope to support him with monitoring the road environment before granting permission to the automated systems for car maneuver changes. The patient reported that driving confidence greatly increased and that he is able to drive more often and in situations that he would otherwise avoid because of difficulties related to his vision. CONCLUSIONS: This clinical report demonstrates how assisted and semiautonomous driving systems in a Tesla car were used to support daily driving by a driver with vision impairment. Codriving with these systems allows him to confidently drive more often and to avoid less situations than he used to.

Falling less in kansas: development of a fall risk reduction toolkit.

Falls are a serious health risk for older adults. But for those living in rural and frontier areas of the USA, the risks are higher because of limited access to health care providers and resources. This study employed a community-based participatory research approach to develop a fall prevention toolkit to be used by residents of rural and frontier areas without the assistance of health care providers. Qualitative data were gathered from both key informant interviews and focus groups with a broad range of participants. Data analysis revealed that to be effective and accepted, the toolkit should be not only evidence based but also practical, low-cost, self-explanatory, and usable without the assistance of a health care provider. Materials must be engaging, visually interesting, empowering, sensitive to reading level, and appropriate for low-vision users. These findings should be useful to other researchers developing education and awareness materials for older adults in rural areas.

Implementing projects using the rapid-cycle approach.

The Quality Work Out, a rapid-cycle improvement initiative, was put into place to prepare a complex 5-hospital system for The Joint Commission and the concept of the "next patient." The patient care team, a group of 11 change agents, was tasked with developing, leading, and implementing projects using the rapid-cycle approach. The authors outline key strategies that led to a successful The Joint Commission survey and measurable change at the bedside.