1. Transfer of Individuals with Motor Impairments and Tech Transfer Steve Bauer, Director RERC on Technology Transfer ICDR/IST Technologies and Strategies for Physical Transfer of Individuals with Motor Impairments State of the Art Conference Washington DC September 10-11, 2007

2. Acknowledgement NIDRR ICDR

3. Introduction Nursing Homes (e.g.) Olmstead Decision Independent Living “Transfer Industry” Recommendations

4. Caregiver Injuries Nursing Homes (e.g.) –1.37M professional caregivers (2002) –Plus 25% by 2012 –211,000 injuries (2003) –Back, shoulders, upper extremities… –Well studied Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health; Safe Lifting and Movement of Nursing Home Residents; http://www.cdc.gov/niosh/docs/2006-117/ http://www.cdc.gov/niosh/docs/2006-117/

5. Public Health Model A. Identify and prioritize problems B. Quantify and prioritize risk factors C. Identify existing or develop new, prevention strategies D. Implement most effective measures E. Monitor results National Institute for Occupational Health and Safety; National Occupational Research Agenda: Traumatic Occupational Injury Research Needs and Priorities; http://www.cdc.gov/niosh/pdfs/tramadoc.pdfhttp://www.cdc.gov/niosh/pdfs/tramadoc.pdf Health and safety of professional caregivers

6. Guidelines, best practices, training materials –NIOSH, OSHA… Transfer technology available & effective Public Policy –TX, WA, MN, OH, RI, HA, NY; Safe “Handling;” Caregiver Protection 1992-2005 –70% reduction in rate of “injuries” –52% reduction in rate of “lost workday injuries” Consequence Total Recordable Occupational Injury Cases in Nursing and Residential Care Facilities. URL: http://www.bls.gov/data/home.htmhttp://www.bls.gov/data/home.htm

7. Case Study U.S. Department of Commerce: Occupational Health and Safety Administration; Ergonomics: Guidelines for Nursing Homes http://www.osha.gov/ergonomics/guidelines/nursinghome/final_nh_guidelines.html http://www.osha.gov/ergonomics/guidelines/nursinghome/final_nh_guidelines.html Wyandot County Nursing Home Assisted transfers w mechanical lifts; electric adjustable beds No back injuries over five years Reduced workers' compensation +$136,000 Reduced absenteeism and overtime +$55,000 Reduced staff turnover +$125,000 Total = $316,000 Annually

8. Why Not Universal? Perceptions –Equipment cost & installation –Training not technology –Assisted manual transfer is faster –Need transfer technology when & where needed –Real savings are not accounted for Lost Days, Overtime, Turnover, Workman’s Compensation

9. Olmstead Decision Supreme Court “Olmstead Decision” (1999) –Title II of ADA; prohibits unnecessary institutionalization of PWD Demographics Microsoft, Intel, Black & Decker, Whirlpool… Migration Hospitals Nursing Homes / Long Term Care Assisted Living Independent Living

10. Transfer & functional independence w / w o AT & EI & CG Return on investment w / w o AT & EI & CG Needed research on AT & EI New business opportunities Needed public policy changes (1999) Mann WC +, Effectiveness of Assistive Technology and Environmental Intervention in Maintaining Independence and Reducing Home Care Costs for the Frail Elderly, Arch Family Medicine, Vol. 8, May/June 1999

11. Transfer “Industry” About 100 companies producing transfer products? Transfer devices for bed, bath, commode, car… Floor lifts (~40), ceiling lifts (~30)… Primarily small businesses Limited capacity to carry out research and development Little “user” input on product design Little “user” input on product needs Limited capacity to understand and use basic research (2003) Technology Assessment of the U.S. Assistive Technology Industry, Department of Commerce

12. SBIR + STTR Awards NIH, NSF, USDE, USDA, DOT 1996-2005 ~14,500 Phase I awards ~750 awards for AT development (5% of total) No awards related to transfer technology… About 10% of small AT businesses use SBIR programs… Small businesses not seeing a market opportunities? Small businesses not seeing a technical hurdles?

13. USPTO 1993-2007 WC + Lift/Transfer + Car~30 WC + Lift/Transfer + Bath/Shower/Commode~15 WC + Lifts/Transfer + Bed~33 Patents Very Low Rate of Patentable Invention! Automatic Locking Brake for Institutional WC

14. Recommendations Primary market research. Industry profiles. What do users & caregivers want and need? Business opportunities. Translate “hard” research (anthropometrics, biomechanics) into product design requirements. Migrate mature transfer research. Foster R&D between researchers and small businesses (RERC) Focused SBIR & STTR grant solicitations (NIH, NSF, DOT, USDE). NRC study. Focused research grant solicitations (RERC, NSF RAPD) Product Development Cycle: 17 years? 8/9 years? 2 or less!!

15. Questions

16. Thank You! Stephen Bauer –Email smbauer@buffalo.edusmbauer@buffalo.edu –Phone (716) 829-3141 x 117 –URL http://cosmos.buffalo.edu/t2rerchttp://cosmos.buffalo.edu/t2rerc