Women’s health clinic: Here’s how it was done
First step: Ask women what they want
After the decision was made to provide preventive care for women with spinal cord injuries, multiple sclerosis, and other disabilities, the real work began. Here’s what went into establishing SSM Rehab of St. Louis women’s health center:
• A survey was an essential first step.
Through a survey that went out to more than 1,000 wheelchair-bound women, SSM Rehab learned what women needed and where they needed it to be located.
"We asked women what they wanted to see in this clinic, and we found that transportation and parking were issues," says Angela Allen, PT, manager of women’s services.
Women also said they needed educational programs about menopause and information about family planning, psychological counseling, and social services available in their areas. SSM Rehab provides foreign language and sign language interpreters for any patient who needs assistance, so this need, which also was mentioned, could easily be met.
Based on the ZIP codes of the survey responders, SSM Rehab marketing professionals selected two locations for the women’s clinics, with the pilot clinic located in St. Mary’s Health Center on the sixth floor as part of the rehab program. The pilot clinic opened in July 2002. Even before it opened, the St. Mary’s site had patient appointments scheduled for well into November 2002, says Melinda Clark, president of SSM Rehab. Though no date for opening the second clinic has been set, it will be located in another SSM Healthcare hospital, called St. Joseph’s Medical Center in St. Charles, MO, Allen says.
Right equipment critical
• The hospital provides specialized equipment to meet the needs of disabled women.
Allen did research on the Internet to learn about primary care services offered to disabled people, and she contacted people who had worked in this specialized field, including a disabled women’s health physician, Sandra Welner, MD. Welner, who died last October, had been the clinical director of primary care for Programs for Women with Special Needs in Washington, DC.
"Dr. Welner helped Hausmann Industries Inc. of Northvale, NJ, create a universally accessible exam table that would make the pelvic exam easier for women in wheelchairs," Allen says. "Women can be transferred from their wheelchair to the table, which lowers to 19 inches from the floor."
The chair also has special stirrups that give the women whole leg support from the mid-thigh down, and they can strap their legs into them so the physician can move their legs around as needed.
"If a woman has spasticity in her legs or if her legs are too weak to be held up, she no longer has to rely on the physician to hold up her legs," Allen notes. The women’s clinic has two of these exam tables, she says.
Allen also discovered that mammography chairs are available for disabled women, so she consulted with the radiology department in St. Mary’s and figured out which chair on the market would be appropriate for their use.
"We chose the video imaging chair from STERIS Corp. of Mentor, OH," Allen says. "The patient transfers into the chair and it lowers and rotates, so the patient doesn’t have to be disturbed at all."
With two of these chairs, the clinic will be able to provide mammograms to women who might otherwise never be screened. "We’re trying to devise ways for this experience to provide total support and comfort for patients, and the mother-in-law doesn’t have to be standing there holding the woman’s breast in place," Allen remarks.
Adequate staff, sensitive marketing
• Staff included a wide range of health care providers.
At present the women’s clinic will use two SSM Rehab medical offices one day a week, but this time allotment will be changed as the demand grows. The staff providing care include a physiatrist; a women’s health nurse practitioner, who will conduct most of the well-woman exams; and an obstetrician/gynecologist, who will see any patient who needs advanced care.
As a physical therapist, Allen will both manage the clinic and provide treatment as needed.
• A brochure was created.
At least during the start-up phase, SSM Rehab did next to no marketing of the new clinic because the patient appointments came easily from women who had heard about it after responding to the survey and from referrals from ParaQuad Inc. of St. Louis, which is a nonprofit advocacy group for disabled people.
"I went ahead and wrote up a brochure and we printed it and faxed it over to ParaQuad, where a dozen women looked at it and wrote down suggestions," Allen says.
Their comments came back with notes of "This sounds patronizing" and "We don’t know what you’re trying to say here."
Taking their advice, Allen rewrote the brochure until it met the volunteer consultants’ approval.
"They were very helpful, because they have a totally different perspective than I do," Allen says. "It took us from being very centered on the barriers that these women face, and once it was reworded, it comes across as we’re totally accessible with a well-trained staff."
In essence, the brochure’s focus was changed from being written about the disabled population the clinic hopes to recruit to being focused on the services the clinic provides, Allen adds.
Need More Information?- Angela Allen, PT, Manager of Women’s Services, SSM Rehab, 6420 Clayton Road, St. Louis, MO 63117. Telephone: (314) 908-5527.
- Melinda Clark, President, SSM Rehab, 6420 Clayton Road, St. Louis, MO 63117. Telephone: (314) 768-5362.
- Thy Huskey, MD, Medical Director of General Rehabilitation, SSM Rehab, 6420 Clayton Road, St. Louis, MO 63117. Telephone: (314) 768-5200.
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