Thesis abstract
- 1. An in-depth case study of the Australian seating service experiences: stakeholders’ perspectives Thesis Abstract The in-depth case study explores the Australian seating service experience from four stakeholders’ perspectives. To capture essential case study data, a qualitative approach collected the seating service experiences of eleven consumers, five care providers, 28 prescribing clinicians and 16 vendors. Sixty participants shared their experiences via an in- depth interview process of procuring specialised wheelchair-seating technology within the Australian seating service sector. The in-depth interviews were recorded, transcribed, and member-checked. The interview data builds on scant evidence of the seating service as experienced in Australia. The data underwent a multi-phased analytical process to delve into their seating service experience. The first data analysis explored for emergent themes, initially for each of the four stakeholder groups, and again for common themes overall. There are six themes common across all the groups. A second analytical phase explored the data from two different perspectives. Two different analytical lens delved the data deeply from the perspective of decision-making informed by the Eggers et al. Wheelchair Service Delivery Model and again from a social justice perspective, informed by Rawls Principles of Equality, of Equity and of Opportunity Equality. The data analysis exposes a fragmented seating service sector dominated by a restrictive funding system, on the cusp of impending change brought on by the National Disability Insurance Scheme. The case study expose eight major findings pertaining to the Australian seating service sector, its stakeholder’s experiences and the factors of influence specialised wheelchair procurements. The following eight major findings provide service structure and benchmarking needed to boost existing seating service capacity.
- 2. The first major finding exposes the importance of forming trustworthy one-to-one partnerships and these collaborative partnerships are intentionally enhanced using a person- centred service approach to manage case complexity. The second finding describes an Australian Seating Service Landscape dominated by an overarching system of governance, that influences funding at a seating service level and upon wheelchair procurement. The third finding classifies the consumer’s bio-functional postural capacity as the Four Domains of Postural Complexity. Aligned with the third finding, the fourth finding proposes a Seating Service Selection Guide based on seating approach according to postural capacity. The fifth finding describes three Decision-Making types, according to who has decision making control and where support is required, to specific resource needs. Informed by the third, fourth and fifth findings, the sixth finding establishes a holistic guide: the Determinants of Case Complexity that clarifies the direction of the seating approach and allocation of specific seating expertise in specialised wheelchair procurement according to consumer capacity. The seventh finding defines Six Seating Service Steps as a non-linear, dynamic service and procurement process operating with the Australia service sector. The eighth and final major finding establishes an Australian Seating Service Benchmark and for the first time, provides structure to build a sustainable seating service sector. A coordinated seating service plan urgently requires a national education program, aligned with industry-based career planning and universal quality assurance program. This case study provides baseline data, much needed to shape and develop the Australian seating service capacity to adapt to a rapidly changing market place. Keywords: wheelchair procurement, seating service, decision making, social justice. Email: rachael@olexports.com.au