Developing product quality standards for wheelchairs used in less-resourced environments.

BACKGROUND: Premature failures of wheelchairs in less-resourced environments (LREs) may be because of shortcomings in product regulation and quality standards. The standards published by the International Organization for Standardization (ISO) specify wheelchair tests for durability, safety and performance, but their applicability to products used in the rugged conditions of LREs is unclear. Because of this, wheelchair-related guidelines published by the World Health Organization recommended developing more rigorous durability tests for wheelchairs. OBJECTIVES: This study was performed to identify the additional tests needed for LREs. METHODS: First, a literature review of the development of ISO test standards, wheelchair standards testing studies and wheelchair evaluations in LREs was performed. Second, expert advice from members of the Standards Working Group of the International Society of Wheelchair Professionals (ISWP) was compiled and reviewed. RESULTS: A total of 35 articles were included in the literature review. Participation from LREs was not observed in the ISO standards development. As per wheelchair testing study evidence, wheelchair models delivered in LREs did not meet the minimum standards requirement. Multiple part failures and repairs were observed with reviewed field evaluation studies. ISWP experts noted that several testing factors responsible for premature failures with wheelchair parts are not included in the standards and accordingly provided advice for additional test development. CONCLUSION: The study findings indicate the need to develop a wide range of tests, with specific tests for measuring corrosion resistance of the entire wheelchair, rolling resistance of castors and rear wheels, and durability of whole wheelchair and castor assemblies.

A working lexicon for the tele-intensive care unit: we need to define tele-intensive care unit to grow and understand it.

Telemedicine in the intensive care unit (Tele-ICU) has grown exponentially since the first formalized program in 2000. Initially, there was limited product choice, and certain capabilities have been engineered into the process with the implication of necessity. New technology is evolving, and new vendors are entering the market place, which should yield a multitude of technologies from which to select. To date, there has been no organized lexicon designed to facilitate communication, comparison, or evaluation. This article is designed as a starting point to develop a lexicon applicable to all technologies for the Tele-ICU with the goal of facilitating clinical comparisons and administrative choices.