Occupational therapy for spinal cord–injured clients is based on training in the use of adapted techniques and adapted equipment to optimize functioning. Two factors, the need for equipment to enhance the client’s potential and the demand for cost containment in equipment ordering, spurred a quality assurance study of equipment ordering. Through a follow-up survey of persons who had received equipment while they were patients of the New England Regional Spinal Cord Injury Center, suspected problems were identified and defined. A plan was formulated and implemented to resolve the problems; then the outcomes of this plan were evaluated by a telephone survey 1 year later. This quality assurance study helped establish accountability for cost containment in equipment ordering based on the client’s perceived need, the client’s level of spinal cord injury, equipment durability, and the timeliness of ordering.