Exploring the meaning of value-based occupational therapy services from the perspectives of managers, therapists and clients

2021 ◽  
pp. 030802262110300
Author(s):  
Su Ren Wong ◽  
Bi Xia Ngooi ◽  
Fang Yin Kwa ◽  
Xiang Ting Koh ◽  
Rachel J J Chua ◽  
...  

Introduction There is a worldwide trend towards value-based health care, which strives to control healthcare costs while maximising value for clients. The main concept of value has been defined as health outcomes achieved per US dollar spent. This research explored how clients of occupational therapy services, managers and occupational therapists perceived value in occupational therapy services. Method A qualitative design was used to explore the perspectives of clients ( n = 11), occupational therapists ( n = 7) and occupational therapy managers ( n = 7). Appreciative inquiry guided the two phases of semi-structured interviews ( n = 5) and focus groups ( n = 6). Inductive and deductive coding were used to establish themes. Findings Three themes encompassed the participants’ perceived value of occupational therapy services: (1) outcomes which are meaningful to daily life, (2) a constructive client–therapist relationship and (3) affordable, coordinated and understandable therapy. Conclusion Participants attributed value to occupational therapy services when they encountered personalised goal setting, focused on meaningful outcomes, managed personal costs and experienced positive therapeutic relationships. Enhancing services could focus on (1) developing skills in collaborative goal setting, (2) determining suitable outcome measures which are meaningful at personal- and service-level reporting, (3) encouraging self-management strategies, and (4) emphasising therapeutic relationships and supporting therapeutic communication skill development.

2021 ◽  
pp. 153944922110054
Author(s):  
Sharon A. Gutman

Although occupational therapists were once integrally involved in mental health practice, the percentage of therapists presently working in this clinical area is low. In 2017, the American Occupational Therapy Foundation convened a planning grant collective (PGC) to generate research to support populations with serious mental health challenges. The PGC’s primary mission was to identify key research areas in which occupational therapists and colleagues could work collaboratively to demonstrate evidence for occupational therapy services supporting mental health community participation. Participants included 21 members from six professions and three program officers from federal funding establishments. The PGC identified seven overarching research concepts, three broad areas of research inquiry, and eight possible studies addressing occupational therapy’s contribution to research promoting community participation and health outcomes for people with mental illness. This article provides a summary of the PGC proceedings so that researchers can collaboratively implement identified research topics.


2020 ◽  
Vol 91 (10) ◽  
pp. 1037-1045 ◽  
Author(s):  
Clare Nicholson ◽  
Mark J Edwards ◽  
Alan J Carson ◽  
Paula Gardiner ◽  
Dawn Golder ◽  
...  

BackgroundPeople with functional neurological disorder (FND) are commonly seen by occupational therapists; however, there are limited descriptions in the literature about the type of interventions that are likely to be helpful. This document aims to address this issue by providing consensus recommendations for occupational therapy assessment and intervention.MethodsThe recommendations were developed in four stages. Stage 1: an invitation was sent to occupational therapists with expertise in FND in different countries to complete two surveys exploring their opinions regarding best practice for assessment and interventions for FND. Stage 2: a face-to-face meeting of multidisciplinary clinical experts in FND discussed and debated the data from stage 1, aiming to achieve consensus on each issue. Stage 3: recommendations based on the meeting were drafted. Stage 4: successive drafts of recommendations were circulated among the multidisciplinary group until consensus was achieved.ResultsWe recommend that occupational therapy treatment for FND is based on a biopsychosocial aetiological framework. Education, rehabilitation within functional activity and the use of taught self-management strategies are central to occupational therapy intervention for FND. Several aspects of occupational therapy for FND are distinct from therapy for other neurological conditions. Examples to illustrate the recommendations are included within this document.ConclusionsOccupational therapists have an integral role in the multidisciplinary management of people with FND. This document forms a starting point for research aiming to develop evidence-based occupational therapy interventions for people with FND.


2014 ◽  
Vol 6 (1) ◽  
pp. 37-40 ◽  
Author(s):  
World Federation Of Occupational Therapists

The purpose of this document is to state the World Federation of Occupational Therapists’ (WFOT) position on the use of telehealth for the delivery of occupational therapy services. Telehealth is the use of information and communication technologies (ICT) to deliver health-related services when the provider and client are in different physical locations. Additional terms used to describe this service delivery model include: tele-occupational therapy, telerehabilitation, teletherapy, telecare, telemedicine, and telepractice, among other terms. Telehealth may be used by occupational therapy practitioners for evaluation, intervention, monitoring, supervision, and consultation (between remote therapist, client, and/or local health-care provider) as permitted by jurisdictional, institutional, and professional regulations and policies governing the practice of occupational therapy.Occupational therapy services via telehealth should be appropriate to the individuals, groups and cultures served,and contextualized to the occupations and interests of clients. Important considerations related to licensure/registration, collaboration with local occupational therapists, client selection, consent to treat, professional liability insurance, confidentiality, personal and cultural attributes, provider competence/standards of care, reimbursement/payer guidelines, and authentic occupational therapy practice are discussed.


1988 ◽  
Vol 51 (12) ◽  
pp. 425-428 ◽  
Author(s):  
Nina Buchanan

This article describes a preliminary study into the implications of management budgeting for occupational therapy services. † In the Derby Unit of Psychiatry, occupational therapists used a database provided by the hospital to determine measurable clinical treatment time, to examine patient contact hours for differing grades of occupational therapy staff, and to determine possible links between time spent in clinical contacts and staff job satisfaction. Although the sample size is small (N= 43 investigated working days), results and discussion give rise to important budgeting implications and suggestions for further study.


2005 ◽  
Vol 68 (12) ◽  
pp. 545-552 ◽  
Author(s):  
Alan Simpson ◽  
Len Bowers ◽  
Jane Alexander ◽  
Caroline Ridley ◽  
Jonathan Warren

There is limited research into occupational therapy and interprofessional working on acute psychiatric wards. This study aimed to explore relations between occupational therapists and other members of the multidisciplinary team through structured interviews with 47 staff on 14 acute psychiatric wards. The study found that occupational therapists provided assessments, group activities and individual therapeutic work, with the assessment and development of activities of daily living being central. Linking patients with community resources in preparation for discharge was also important. Severity of illness among patients and speed of discharge were barriers to effective input. Nurses and psychiatrists appreciated occupational therapy input but rarely the breadth of the role. Multidisciplinary relations were generally positive, although some ward teams were disinclined to include occupational therapists in communications and decision making. The occupational therapists appreciated their professional knowledge and opinion being respected and considered. The study concluded that occupational therapists play an important if often misunderstood role on acute psychiatric wards, but that their involvement could be significantly increased through the employment of more experienced occupational therapists and the provision of interprofessional education. Further research is required to explore the facilities, resources and support required to maximise occupational therapy input and identify areas for increased interprofessional working.


1996 ◽  
Vol 59 (5) ◽  
pp. 207-211 ◽  
Author(s):  
Tracy Fortune ◽  
Susan Ryan

This article presents a system of caseload management for community occupational therapists. Using the clinical reasoning work of Mattingly and Fleming as a framework, the perceived complexity of each case for a community occupational therapist was analysed and then paralleled with the type and amount of clinical reasoning required. Following an initial occupational therapy assessment, each case is given a numerical weighting, graded at 3 for complex cases and from 1 for non-complex or simple cases. The degree of complexity or weighting is recognised to be a subjective phenomenon dependent on the experience, knowledge and skills of the therapist. The cases held by an occupational therapist are able to be mixed so that the experienced therapist holds a varied caseload of complex and simple work. Beginning therapists can follow the same measured approach thus augmenting their background experience. This method promotes continuing education, assists experiential learning and provides variety. Using this system, it is proposed that occupational therapy services are enhanced by reducing unnecessary casework from therapists' active caseloads, allowing increased time to work on complex cases and using expertise more efficiently.


2005 ◽  
Vol 68 (4) ◽  
pp. 177-180 ◽  
Author(s):  
Marion Hoyland ◽  
Christine Mayers

The profession's present interest in the topic of spirituality initiated the decision to undertake this study, which aimed to investigate the extent to which occupational therapists consider clients' spiritual needs as part of their domain. The objectives of the study were to ascertain whether this was part of the occupational therapist's role and to identify the ways in which occupational therapists addressed the spiritual needs of their clients. Six senior II occupational therapists participated in semi-structured interviews. The participants felt that all individuals have spiritual needs, although not all would recognise or acknowledge them as such. All the participants considered spiritual care to be part of their role, but there was some uncertainty regarding the relationship of spiritual care to occupational therapy in general. Spiritual needs were addressed by a listening and holistic approach.


2003 ◽  
Vol 70 (1) ◽  
pp. 42-50 ◽  
Author(s):  
Kym Sloggett ◽  
Nancy Kim ◽  
Debra Cameron

Background. Occupational therapists are entering private practice in ever increasing numbers. In order to gain the skills to practice in this area, students should have the opportunity to experience private practice fieldwork placements. However, the number offered in private practice settings continues to be limited. The purpose of this exploratory qualitative study was to identify the benefits, the barriers, and the strategies associated with providing fieldwork opportunities in private practice. Methods. Data were obtained through semi-structured interviews with six occupational therapists in private practice. Results. Results indicated that participating in fieldwork education affords benefits to the profession of occupational therapy, to the clinician, and to the facility. Potential barriers included student characteristics, cost, time, travel and legalities. Involvement from the university and the private setting were considered necessary for providing and implementing strategies. Clinical Implications. The findings have implications for increasing private practice placements for future students in occupational therapy and other health care professions offering clinical placements as a component of their formal education.


1992 ◽  
Vol 55 (2) ◽  
pp. 49-52 ◽  
Author(s):  
Gail Crawford ◽  
Sybil Johnson ◽  
Shelagh Morris ◽  
Sheila Steeples

Occupational therapy managers have relied on the College's document entitled Recommended Minimum Standards for Occupational Therapy Staff: Patient Ratios for more than a decade. Trent Region District Occupational Therapists' Group reviewed this document and agreed to formulate proposals for its update. This article describes the work of a project team who collaborated with regional manpower colleagues and the region's mental health occupational therapy services staff in an endeavour to establish norms, formulae or other means of manpower planning.


Author(s):  
Thayane de Cácia Brito Prudente ◽  
Rayssa Béder César Paiva ◽  
Daniela Tavares Gontijo

Introdução: A população em situação de rua caracteriza-se predominantemente pela falta de moradia regular, condição de pobreza extrema e vínculos rompidos ou fragilizados. No entanto, a vida na rua e o acesso aos serviços socioassistenciais tendem a não se configurar da mesma forma para homens e mulheres. Considerando a perspectiva do desempenho ocupacional, os terapeutas ocupacionais se preocupam com os fatores que influenciam o envolvimento dos sujeitos em ocupações. Objetivo: compreender o desempenho ocupacional de mulheres em situação de rua. Métodos: Estudo de abordagem qualitativa, com base na História Oral de Vida. A coleta de dados foi realizada em dois serviços socioassistenciais do Recife que atendem pessoas em situação de rua.  Os dados foram coletados através de entrevistas semiestruturadas e submetidos à Análise de Conteúdo Temática. Resultados/discussão: Foram entrevistadas 8 mulheres com idades entre 20 a 39 anos. A análise resultou em três categorias temáticas: Desempenho Ocupacional na infância, Ida para rua e Desempenho Ocupacional na rua. As categorias forma dividias em: Atividades de Vida Diária (AVDs), Atividades Instrumentais de Vida Diária (AIVDs), Trabalho, Lazer e Participação Social. Observou-se que as mulheres em situação de rua vivenciam um processo de privação ocupacional pela situação de desfiliação em que vivem, com repercussão negativa na qualidade de vida. Conclusão: Neste estudo pode-se observar a dificuldade das mulheres em realizar todas as ocupações, justificando a intervenção da Terapia Ocupacional para favorecer o empoderamento pessoal, a ressignificação do cotidiano e exercício da cidadania.  AbstractIntroduction: The population in street situation is predominantly characterized by a lack of regular housing, an extreme poverty and  weakened or broken bonds. However, street living and access to social assistance services tend not to be configured in the same way for men and women. Considering the perspective of occupational performance, occupational therapists are concerned with factors that influence the subjects' engagement in occupations. Objective: To understand the occupational performance of women who are homeless. Method: A qualitative study based on the Oral Story of Life. The data collection was performed in two social assistance services in the city of Recife that receive people who live on streets. Data were collected through semi-structured interviews and submitted to the Thematic Content Analysis. Results/Discussion: Eight women aged 20 to 39 years were interviewed. The analysis resulted in three thematic categories: Occupational Performance in childhood, Going to the streets and Occupational Performance in the streets. The categories were divided into Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), Work, Leisure and Social Participation. It was observed that homeless women experience a process of occupational deprivation with negative repercussions on the quality of life due to the situation of disaffiliation in which they live. Conclusion: In this study it is possible to observe the women's difficulty to perform all the occupations, justifying the intervention of the Occupational Therapy to favor the personal empowerment, the resignification of the daily life and the exercise of the citizenship.Keywords: Homeless persons, Autobiography, Gender identity, Women, social Vulnerability, Occupational therapy.


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