Call 734-936-7021 or email [email protected] to arrange for an ASL interpreter upon appointment scheduling as soon as possible.

Communication Access Realtime Translation (CART)

Communication Access Realtime Translation (CART) or real-time captioning is the instant translation of spoken English into text using a stenotype machine, notebook computer and software. The text can be displayed on an individual's computer monitor or tablet, projected onto a screen, or combined with a video presentation as captions. This helps people with hearing loss access information in a wide variety of settings.
To arrange for CART service, page 31019 or email [email protected] upon appointment scheduling as soon as possible.

Zoom Video Visit CC/Live Captioning

Live captioning is an auto transcribe feature available on Zoom video and can be used during virtual visits with patients. The text can be displayed once this feature can be enabled at the bottom of the screen. To enable CC/Live Captioning during virtual visits with patients, follow the steps below:

Step 1: See bottom bar for Live Transcript button. Select this.

Step 2: Select enable under Live Transcription. This will activate the live transcription feature.

Educational, instructional or any critical information should be written or given in print form in advance of discussion whenever possible. When sharing any patient education videos, check that the correct version of the video with the subtitles enabled is shared with the patient.

Ask patient what type of device they use/need and how best to work with them. Pocket talkers are available upon request - email [email protected] or page 31019

Pocket talker - A Pocketalker is a personal amplifier.  It is a headset with an amplifying system.  It looks like what a Walkman ® used to look like; a little box with a microphone on it wired to a headset.  It provides some amplification for sound.  It can be useful particularly in an in-patient setting where you need some amplification, and there may not be an opportunity for the person to go to an audiologist to be fitted with hearing aids.  This is a solution for "in the moment."

Minimize any environmental noise that might effect communication (e.g., fans, alarms, hallway noises).

Clear masks can be ordered from supply chain 82295.  FDA approved clear masks currently include:

• Safe N’Clear
• ClearMask

• Consider utilizing whiteboards
• Laminated cards with written instructions can be helpful during the check-in process

Any patient education videos should have the audio descriptors turned on. When sharing any patient education videos, check that the correct link with the enabled audio descriptors is shared with the patient. If text or an image appears on the screen, it needs to be read aloud or described.

For patients with a refreshable braille reader, digital format braille can be produced in a couple of different formats. Please contact Jane Berliss-Vincent at [email protected] or Knox Center staff at [email protected] or call (734) 936-3794 to arrange for this service.

Dimmer switches may alleviate eye strain for the patient. We recommend that your clinic/floor identifies rooms with dimmable switches prior to rooming the patients. If dimmers are not available, consider a room with a window and adjust the blinds.

In a room without a dimmer light, check with the patient if they prefer the overhead lights off. Clip-on lights with dimmable and hue switches can also be utilized instead of the overhead lights.  We are currently building the Disability Cart that includes clip-on lights. This page will be updated with more information on how request one.

A large-font AVS is now available under the Snapshot reports.  Search “AMB AVS – large font” in the search bar on the top left. This will increase the font size for the report along with the After Visit Summary sheets for the patients.

Consider using a highlight to emphasize the important sections in the AVS.

General Diet: Large print and pictorial menus are available in PFANS internal website. Patients can also request a large print or picture menu by calling the meal order line (3-8080).

Therapeutic Diet: Therapeutic menu is currently not available in large-print. For patient who needs assistance with diet restrictions, the call center staff will assist with meal selections when they call to order. Medical staff can order “Room Service Assistant” for low vision/blind patients, and the call center staff will visit the patient at the bedside to assist with meal ordering.

Screen readers are software programs that allow blind or visually impaired users to hear/magnify the text that is displayed on the computer screen. Patients may also use this technology to fill out forms.

In partnership with Michigan Medicine’s Office of Patient Experience and multiple community organizations, CDHW has developed a training to help Michigan Medicine affiliates serve as human guides to patients who are blind.

To learn more about Michigan Medicine’s policy on service animals, please watch this video. It has been designed to provide real life examples on how to handle patients with service animals and describes the rights of patients with service animals. You may also download a FAQ sheet to share with colleagues.

Call Light/TV Controller Adaptation

Standard call lights can be adapted by using protective bump dots. We are currently in the process of building ADA Cart Kit, which will include protective dots. In the interim, protective dots like the one shown in the picture can be used. We are currently in the process of building ADA Cart Kit, which will include protective dots. In the interim, protective dots like the one shown in the picture can be used.

Follow the steps below to make the call light more accessible:

• Place the clear dot over the nursing symbol and the light symbol. Using the clear dot ensures that the symbols are visible to patient attendants.

• Place the green felt dots over the TV on/off buttons and on the side under the volume up/down wheel.

• Place the grey felt dots over the channel buttons.

When orienting the patient to the patient controller, compare it to a shoe: “The cord is attached to the heel, which is where the light switch is located. At about where the shoelaces are placed is where the TV on/off buttons can be found. To the left of the TV button is the channel buttons. The nurse call light is located past the shoestring area in the middle of the toe area. It has the biggest dot. Volume controls is on the side and has the same dot as the TV.” Combine this with hand-over-hand tactile learning and have the patient teach locations back to demonstrate recall. 

The bump dots can be scraped off by using detachol. Alternatively, floors can also keep the adapted call lights with the bump dots on the side and swap it out whenever the need arises.

People with mobility disabilities are not all the same - they use mobility devices of different types, sizes, and weight, transfer in different ways, and have varying levels of physical ability. If you are unsure, it is encouraged to ask questions. Understanding what assistance, if any, is needed and how to provide it, ensures safe and accessible health care for people with mobility disabilities.

Wheelchair users and patients with other activity limitations have difficulty may have difficulty getting onto a fixed-height examination table that is typically 32 inches tall. Adjustable height examination tables capable of achieving a low height in the range of 18 inches can remove barriers to access.

In the absence of adjustable exam tables, a therapy table may be used. Wheelchair users and patients with other activity limitations should be lifted or assisted onto the exam table.

Below are some videos on how to use various transfer equipment such as a Hoyer Lift and a transfer board.

Transfers Intro

Here is a quick video on some transfer techniques and steps to remember:

• Make sure that the patient is comfortable before transferring the patient
• Keep straight back in a neutral position and stay low with knees slightly bent
• Stay close to the patient when assisting the patients

Transfer Options

Hoyer Lift Transfer

It is recommended that you watch this video prior to operating a Hoyer Lift even if you had a training before. When operating a Hoyer Lift, please remember to:

• Check that the sling is appropriately sized – the harness should be large enough to wrap around the patient’s torso, but not too large that the patient will slip through
• Check that the brakes are locked
• Check that the bottom crease of the harness is all the way down to the bottom of the patient’s buttocks
• When cross the two-leg straps, ensure that the patient’s bottom does not fall behind in the whole harness
• When lacing the loop in the ring of the Hoyer, ensure that the cross position of the loop is maintained
• Undo any straps or belts the patient may have attached to the wheelchair
• Hold the boom, which is the long-angled bar at the top, while moving the patient to minimize the swing

Transfers Popover

Transfer Popover is used by patients who have good upper body strength but are not able to use their legs. Here is a video on some transfer popover techniques and steps to remember:

• Have the patient lean forward to help put on the gait belt
• Make sure the brakes are on
• The patient will turn their hips and will use upper extremities to push through the arms and pop hips over to the surface
• Stay in front of the patient in case the patient loses balance or needs help

In case the patient cannot perform popover transfers safely, use a sliding board:

• Tuck the board underneath the patient’s thigh
• Have the board at an angle with the endpoint on the surface
• Stay in front of the patient while the patient scoots over to the surface
• Make sure that the patient’s feet have moved along with the body
• Once the patient is balanced, remove the board
• Do not bend at your back when assisting the patient, use your knees

Transfers Sliding Board

Here is a video on how to operate transfers sliding board and some steps to remember:

• Pull the brake on the patient’s chair
• Have the patient lean forward to place the gait belt
• The patient will twist in the chair and place the board under their thigh
• Keep a hand on the patient’s shoulder and hold on to the patient’s leg
• Make sure that the patient is balanced before removing the board or adjusting the patient’s legs onto the table
• When moving the patient back to the chair, have the chair at a slight angle to the patient
• Lift the patient’s leg and place one foot on the pedal
• Ensure that both brakes are on
• Place one end of the board under the patient’s thigh and the other end on the chair
• Stay close to the patient with one hand over the patient’s shoulder and the other hand on the patient’s leg. The patient will scoot over to the chair
• Take the gait belt off

Use the largest patient room with an adjustable exam table and remove extra chairs in the room.

A wheelchair-accessible scale should have a sloped platform large enough to fit a wheelchair with a high weight capacity to weigh a patient while he or she is seated in the wheelchair. There should be enough maneuvering space to pull onto and off the scale.

Please see Michigan Medicine’s Visitor Guidelines During COVID-19, including the Guidelines for Supporting Adult Patients with Disabilities During the COVID-19 Public Health Emergency (PDF). Questions regarding policy modifications should be referred to Patient Relations and Clinical Risk at 734-936-4330.