Project P2: Assessment and Monitoring of Wheelchair Transportation Activities and Incidents on Public Buses

Task Leader: Gina Bertocci, PhD, PE

Co-investigators: Karen Frost, PhD, MBA

Other Participants: Russ Rakestraw (Director of Safety, TARC), Barry Barker (Executive Director, Transit Authority of River City - TARC), Graduate Student (Mechanical Engineering) and Carol Flannagan, PhD (UMTRI Biostatistician).

Overview

Studies, anecdotal evidence and preliminary data have shown that injuries to wheelchair-seated passengers often occur during normal or emergency driving maneuvers on public transit buses, but a clear and complete understanding of injury causation in the public transportation setting does not exist.  This project will provide an understanding of adverse incidents, injury scenarios and activities (ingress/egress, securement and occupant restraint process, navigating to securement station) on large transit buses involving wheelchair-seated passengers using both a retrospective and innovative prospective approach. This project is possible due to a unique collaboration with the Transit Authority of River City (TARC), which includes unlimited access to their in-bus video surveillance system. Results of this project will provide an objective window into real-world wheelchair-seated passenger experiences on transit buses traveling in a large metropolitan region. 

This project has three interrelated tasks designed to objectively assess and document real-world transportation experiences of wheelchair users, including vehicle ingress/egress, wheelchair securement, occupant restraint, and injury causing scenarios on TARC transit buses.

• Task P2.1: Retrospective Adverse Wheelchair Incident Assessment (task occurs in years 1 & 2)
• Task P2.2: Prospective Monitoring and Assessment of Wheelchair Related Activities (task spans all 5 years)
• Task P2.3: Prospective In-Depth Investigations of Adverse Wheelchair-Related Incidents (task spans all 5 years)

This project contributes to the RERC WTS intermediate outcome to effect changes in attitudes, policies, and procedures of key stakeholders involved in wheelchair transportation safety, as well as the RERC WTS key output to provide accurate and objective knowledge of wheelchair user transportation experiences.

Specifically, project P2 is designed to meet the following objectives for transit on large buses:

• Characterize and assess wheelchair-related activities and procedures used during the transportation process,
• Characterize and assess wheelchair and occupant response during normal and emergency bus driving and during crash events,
• Investigate the circumstances and underlying causes of adverse incidents
• Characterize the extent and frequency of injuries to wheelchair-seated passengers that result from adverse incidents
• Assess the real-world use and performance of wheelchairs, ramps/lifts, and WTORS

Expected Outputs:

• Peer-reviewed publications regarding:
  • adverse incidents involving wheelchair-seated passengers on transit buses
  • causes of injury to wheelchair-seated passengers in public transit buses including identification of operational or equipment problems leading to potentially unsafe conditions
  • prediction of injury risk to wheelchair-seated passengers in public transit buses
• Educational and Training materials - videos describing wheelchair-occupant response during normal driving, emergency driving and crash conditions (if available) under varying wheelchair securement and occupant restraint conditions
• Recommendations for improved safety and usability in wheelchair transportation in transit buses
• Modifications in transit agency policies as warranted to reflect improved wheelchair transportation safety

• Improvements in wheelchair occupant safety on large public buses through a better understanding of real-world transportation procedures, activities, incidents and injury producing scenarios
• Improvements in transit system operational policies involving wheelchair transportation
• Improvements in transit system operator knowledge of wheelchair transportation safety issues through targeted improvements in training

Project Updates

• Project P2.1: July 2007
• Project P2.2: July 2007
• Project P2.3: July 2007
• P2 Annual Report 2007 (1.5 MB pdf)

Task P2.1: Retrospective Adverse Wheelchair Incident Assessment

This component is a retrospective analysis of TARC transit bus incident reports recorded between 1999-2006.

• Retrospectively characterize all types of adverse incidents involving wheelchair-seated passengers on large transit buses to gain an improved understanding of underlying cause, mechanism and resulting injuries.
• Identify vehicle conditions and wheelchair-related activities that are associated with injury to wheelchair-seated passengers on large transit buses.

Study Design

This component of project P2 is an observational, descriptive study consisting of a retrospective review of prior incident reports involving wheelchair-seated passengers on TARC buses.

Update July 2007: P2.1 Retrospective Assessment of Adverse Wheelchair Incidents

This task ran smoothly and is nearing completion on schedule. During this reporting period, the IRB was submitted and approved, and all data was collected, recorded and stored in an electronic database. Preliminary analysis was conducted and presented in poster format at RESNA in June 2007. Dr. Frost is currently analyzing data and leading development of a manuscript for submission to a peer reviewed journal. Drs Bertocci and Frost will add author this manuscript. Additionally, the investigators will prepare a report and presentation for TARC in the fall to summarize the research findings.

Members of the research team are scheduled to participate in TARC’s eight hour driver training program in order to observe and better understand TARC policies and training approach. We have been invited to provide feedback to TARC regarding any improvements that might be suggested to insure wheelchair rider safety.

We have met with TARC on many occasions throughout the year in order to build a collaborative work environment. The result is a very positive working relationship with TARC and support and enthusiasm for this project throughout the organization. We will continue to invest in this relationship to insure mutually beneficial outcomes.

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Task P2.2: Prospective Monitoring and Assessment of Wheelchair Related Activities

This component of project P2 consists of prospective monitoring and assessment of wheelchair related activities on TARC public buses equipped with video surveillance systems. Activities of interest include ingress/egress, maneuvering to/from securement stations, wheelchair securement and occupant restraint process, and wheelchair and occupant response during normal and emergency driving. (Adverse incidents will be studied in Task P2.3.)

• Prospectively characterize and assess wheelchair-related activities occurring on large public transit vehicles

This component of the project is a prospective observational descriptive study.

Update July 2007: P2.2 Prospective Monitoring & Assessment of Wheelchair-Related Activities

During the past year, we focused on working closely with TARC to finalize video camera, recording and viewing software and equipment, and establishing protocols for collection and storage of data. We have submitted and obtained IRB approval, hired and trained a graduate student and completed development of database field definitions. Database development is currently in progress and on schedule for completion by the end of July.

We experienced a two-month delay in obtaining critical video recording and viewing equipment due to administrative purchasing issues between the University and vendor. This problem was resolved and all necessary equipment has been received. Because obtaining this equipment was a critical path item, this delay was passed on to the installation and test schedule for the final video surveillance protocol. We used this time to refine database field definitions, data collection and video viewing protocols.

TARC agreed to install the video cameras into existing buses at no charge. This cost savings allowed us to purchase all 17 cameras in year 1, rather than spreading the purchase and installation across 2 years. Installation and testing of the video surveillance protocol is expected to be complete by the end of July. Having all 17 cameras installed in year 1 will allow the research team to observe more data, sooner than expected. This benefit will offset the initial two-month delay.

Data collection for this project is running approximately two months behind schedule

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Task P2.3: Prospective In-Depth Investigations of Adverse Wheelchair-Related Incidents

This component consists of in-depth investigations of wheelchair related adverse incidents occurring on TARC transit buses.

• Prospectively investigate wheelchair related incidents occurring on large public transit buses
• Identify activities, vehicle conditions and factors leading to injuries in wheelchair seated passengers
• Identify deficiencies in operational procedures and/or wheelchair and adaptive equipment designs leading to adverse incidents and injuries

Null Hypothesis: There are no differences in wheelchair-seated passengers injury outcome across various transit bus conditions (non-moving; moving non-crash; crash).

This component of project P2 is a prospective, observational descriptive study.

Update July 2007: P2.3 Prospective In-depth Investigations of Adverse Wheelchair Incidents

The IRB is in process and expected to be submitted the first week of July. IRB approval is anticipated by the end of July, allowing us to begin incident investigations beginning in August. The prospective incident investigation database will build on the video monitoring database, and is scheduled for completion during the 4th quarter of year 1.

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Last updated: December 4, 2007