Applying Clinical Reasoning: A Caseload Management System for Community Occupational Therapists

1996 ◽  
Vol 59 (5) ◽  
pp. 207-211 ◽  
Author(s):  
Tracy Fortune ◽  
Susan Ryan
Keyword(s):  
Occupational Therapy ◽  
Clinical Reasoning ◽  
Occupational Therapists ◽  
Occupational Therapist ◽  
Therapy Assessment ◽  
Therapy Services ◽  
Subjective Phenomenon ◽  
Experienced Therapist ◽  
Perceived Complexity ◽  
Complex Cases

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.

Promoting Occupational Therapy Mental Health Research: Proceedings From the 2017 AOTF Mental Health Planning Grant Collective

2021 ◽  
pp. 153944922110054
Author(s):  
Sharon A. Gutman
Keyword(s):  
Mental Health ◽  
Occupational Therapy ◽  
Community Participation ◽  
Health Planning ◽  
Occupational Therapists ◽  
Mental Health Research ◽  
Research Areas ◽  
People With Mental Illness ◽  
Health Community ◽  
Therapy Services

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.

scholarly journals Patient functional independence and occupational therapist time-use in inpatient services: Patient demographic and clinical correlates

2021 ◽  
pp. 156918612110187
Author(s):  
Bianca E Summers ◽  
Kate E Laver ◽  
Rebecca J Nicks ◽  
Nadine E Andrew ◽  
Christopher J Barr ◽  
...  
Keyword(s):  
Occupational Therapy ◽  
Time Use ◽  
Health Care Expenditure ◽  
Functional Independence ◽  
Occupational Therapist ◽  
Sociodemographic Characteristics ◽  
Cross Sectional ◽  
Patient Demographics ◽  
Therapy Services ◽  
Multivariable Modelling

Introduction Health care expenditure has rapidly increased in Australia. Effective management of occupational therapy services is required to meet clinical demand. Improving our understanding of factors which influence occupational therapy service delivery is a vital step to manage workload distribution and optimise service efficiency. This study aims to examine the influence of patient sociodemographic characteristics, diagnosis and functional independence on the utilisation of occupational therapy resources in hospital inpatients over 18 years old. Methods Prospective, cross-sectional, observational cohort study of 4549 inpatients from three hospital sites in Melbourne, Australia. Data extracted from organisational databases and included in this study were: patient demographics, diagnosis, functional level assessed using the SMAF (Functional Autonomy Measurement System) and occupational therapy time-use. Data were analysed using univariable and multivariable modelling. Results Occupational therapy time-use was significantly associated with all variables included in analysis ( p < 0.05). For each variable the amount and direction of effect differed between hospital sites. The SMAF was the only variable consistently associated with occupational therapy time-use. Higher occupational therapy time-use was associated with lower functional independence (leading to a 3.5 min increase in median occupational therapy time for every unit decrease in SMAF score). Conclusions Management of resources within busy hospitals require knowledge of factors associated with occupational therapist time-use. This study identified that time-use could in part be predicted by functional independence, diagnosis and sociodemographic characteristics. Occupational therapy managers can use this information to support decision making while acknowledging other patient and therapist level factors also influence time-use.

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 ◽  
...  
Keyword(s):  
Occupational Therapy ◽  
Goal Setting ◽  
Management Strategies ◽  
Perceived Value ◽  
Occupational Therapists ◽  
Therapeutic Relationships ◽  
Structured Interviews ◽  
Therapeutic Communication ◽  
Main Concept ◽  
Therapy Services

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.

scholarly journals Atuação do terapeuta ocupacional no NASF: reflexões sobre a prática/Occupational therapist at the NASF: reflections on practice

2019 ◽  
Vol 3 (4) ◽  
pp. 569-583
Author(s):  
Míriam De França Chagas ◽  
Magda Fernanda Lopes de Oliveira Andrade
Keyword(s):  
Health Care ◽  
Occupational Therapy ◽  
Family Health ◽  
Occupational Therapists ◽  
Structured Interview ◽  
Physical Structure ◽  
Occupational Therapist ◽  
Health Networks ◽  
Unified Health System ◽  
The Family

Em 2008, foi criado, pelo Ministério da Saúde, o Núcleo de Apoio à Saúde da Família (NASF), com o intuito de apoiar as equipes da Estratégia de Saúde da Família (ESF) nas redes de saúde e ampliar a ação da Atenção Básica da Saúde. O NASF é composto por uma equipe multidisciplinar e o terapeuta ocupacional é um dos integrantes desta equipe. O objetivo deste trabalho é o de conhecer a atuação dos terapeutas ocupacionais nos NASFs do município de Maceió, Alagoas, e suas reflexões sobre o trabalho desempenhado. Trata-se de uma pesquisa qualitativa, sendo a coleta de dados realizada por meio de entrevista semiestruturada. Como resultados, foram elencadas três categorias temáticas: A atuação do terapeuta ocupacional no NASF: ações e atividades efetuadas; Os principais obstáculos encontrados pelo terapeuta ocupacional no NASF e As ferramentas tecnológicas utilizadas para a realização do trabalho no NASF. A Terapia Ocupacional ainda é uma profissão que busca seu reconhecimento no NASF. Visitas domiciliares, salas de espera e atividades em grupo foram identificadas como ações desempenhadas pelos profissionais, apesar das dificuldades como falta de recursos materiais e de uma estrutura física melhor. Este estudo serviu para enfatizar a importância do trabalho do terapeuta ocupacional no serviço, bem como as dificuldades encontradas por eles, citando assim a falta de reconhecimento/conhecimento da profissão, recursos e espaço. Apesar das dificuldades mencionadas, os mesmos sempre buscam realizar um atendimento humanizado, preocupando-se com os usuários, minimizando os riscos e promovendo a saúde. AbstractIn 2008, the Family Health Support Center (NASF) was created by the Ministry of Health to support the Family Health Strategy (ESF) teams in health networks and expand the action of Primary Care of health. The NASF is composed of a multidisciplinary team and the occupational therapist is one of the members of this team. The objective of this work is to know the performance of occupational therapists in the NASFs of the city of Maceió-AL, and their reflections on the work performed. This is qualitative research, and the data collection is done through a semi-structured interview with occupational therapists of the NASFs in the municipality of Maceió-AL. As a result, three thematic categories were listed: The work of the occupational therapist in the NASF: actions and activities carried out; the main obstacles encountered by the occupational therapist in NASF; at technological tools used to perform work in the NASF. Occupational Therapy is still a profession that seeks recognition in the NASF. Home visits, waiting rooms and group activities were identified as actions performed by professionals, despite difficulties such as lack of material resources and a better physical structure. This study contributed to emphasize the practice of the work of the occupational therapist in the service, as well as the difficulties encountered to know: citing the lack of recognition/knowledge of the profession, resources and space. Despite the mentioned difficulties, they seek to perform a humanized care, reaffirming principles and guidelines of the Unified Health System - SUS, to minimize risks and promote health care. Keywords: Occupational Therapy, Primary Health Care, Family Health. Resumen En 2008, fue creado por el Ministerio de Salud, el Núcleo de Apoyo a la Salud de la Familia (NASF), con el propósito de apoyar a los equipos de la Estrategia de Salud de la Familia (ESF) en las redes de salud y ampliar la acción de la Atención Básica de la Salud. El NASF está compuesto por un equipo multidisciplinario y el terapeuta ocupacional es uno de los integrantes de este equipo. El objetivo de este trabajo es el de conocer la actuación de los terapeutas ocupacionales en los NASF del municipio de Maceió-AL, y sus reflexiones sobre el trabajo desempeñado. Se trata de una investigación cualitativa, siendo la recolección de datos realizada por medio de una entrevista semiestructurada con terapeutas ocupacionales de NASF en el municipio de Maceió-AL. Como resultados, se enumeraron tres categorías temáticas: La actuación del terapeuta ocupacional en el NASF: acciones y actividades efectuadas; los principales obstáculos encontrados por el terapeuta ocupacional en el NASF; las herramientas tecnológicas utilizadas para la realización del trabajo en el NASF. La Terapia Ocupacional sigue siendo una profesión que busca su reconocimiento en el NASF. Las visitas domiciliarias, salas de espera y actividades en grupo fueron identificadas como acciones realizadas por los profesionales, a pesar de las dificultades como falta de recursos materiales y de una estructura física mejor. Este estudio contribuido para enfatizar la práctica del terapeuta ocupacional en el servicio, así como las dificultades a saber:la falta de reconocimiento / conocimiento de la profesión, recursos y espacio. A pesar de las dificultades mencionadas, buscan realizar una atención humanizada, reafirmando los principios y lineamientos del Sistema Único de Salud - SUS, para minimizar los riesgos y promover la atención médica.Palabras clave: Terapia Ocupacional, Atención Primaria de Salud, Salud Familiar. 

On Clinical Reasoning: Patterns of Reflection on Practice

1996 ◽  
Vol 16 (2) ◽  
pp. 98-110 ◽  
Author(s):  
Anitha Alnervik ◽  
Gunilla Svidén
Keyword(s):  
Occupational Therapy ◽  
Qualitative Analysis ◽  
Clinical Reasoning ◽  
Preliminary Investigation ◽  
Occupational Therapists ◽  
Treatment Session ◽  
Conditional Reasoning ◽  
Narrative Form ◽  
Reasoning Patterns ◽  
Reflection On Practice

Five qualified occupational therapists and their patients were videotaped during a treatment session. The occupational therapists first were asked to describe the session in a narrative form, i.e., “tell the story,” and then they were asked to describe the thoughts and considerations on which they had conducted the treatment session, i.e., “reflection on practice.” A qualitative analysis was performed in accordance with the model for clinical reasoning developed by Fleming (1991). Both quantitative and qualitative analysis showed that procedural reasoning was predominant both in storytelling and reflection on practice, and a very small number of comments was classified as interactive or conditional reasoning. The results of this preliminary investigation suggested that we should examine the role that reflection on practice plays in examining, developing, and teaching the art of occupational therapy.

Values Influencing Clinical Reasoning in Occupational Therapy: An Exploratory Study

1990 ◽  
Vol 10 (1) ◽  
pp. 41-55 ◽  
Author(s):  
Elaine D. Fondiller ◽  
Lois J. Rosage ◽  
Barbara E. Neuhaus
Keyword(s):  
Qualitative Research ◽  
Content Analysis ◽  
Occupational Therapy ◽  
Clinical Reasoning ◽  
Research Methodology ◽  
Exploratory Study ◽  
Occupational Therapists ◽  
Qualitative Research Methodology ◽  
Interview Format

This exploratory study used qualitative research methods to identify values that influence clinical reasoning in occupational therapy. Through an interview format, selected occupational therapists were asked to respond to a predetermined list of questions about a general case study. The interviews were tape-recorded and a content analysis of the tapes yielded 18 distinct value statements. Implications of the findings and recommendations for further studies are presented. Qualitative research methodology is examined for its utility in occupational therapy.

scholarly journals Occupational therapy consensus recommendations for functional neurological disorder

2020 ◽  
Vol 91 (10) ◽  
pp. 1037-1045 ◽  
Author(s):  
Clare Nicholson ◽  
Mark J Edwards ◽  
Alan J Carson ◽  
Paula Gardiner ◽  
Dawn Golder ◽  
...  
Keyword(s):  
Occupational Therapy ◽  
Neurological Disorder ◽  
Best Practice ◽  
Management Strategies ◽  
Occupational Therapists ◽  
Therapy Assessment ◽  
Consensus Recommendations ◽  
Starting Point ◽  
Stage 1 ◽  
Functional Neurological Disorder

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.

scholarly journals World Federation of Occupational Therapists' Position Statement on Telehealth

2014 ◽  
Vol 6 (1) ◽  
pp. 37-40 ◽  
Author(s):  
World Federation Of Occupational Therapists
Keyword(s):  
Occupational Therapy ◽  
Information And Communication Technologies ◽  
Occupational Therapists ◽  
Position Statement ◽  
Standards Of Care ◽  
World Federation ◽  
Local Health ◽  
Related Services ◽  
Local Health Care ◽  
Therapy Services

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.

Management Budgeting for Occupational Therapists?

1988 ◽  
Vol 51 (12) ◽  
pp. 425-428 ◽  
Author(s):  
Nina Buchanan
Keyword(s):  
Job Satisfaction ◽  
Occupational Therapy ◽  
Sample Size ◽  
Treatment Time ◽  
Occupational Therapists ◽  
Clinical Treatment ◽  
Patient Contact ◽  
Contact Hours ◽  
Therapy Services ◽  
Preliminary Study

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.

Sign in / Sign up

Export Citation Format

Share Document