DC and HEP

Question 1

Things that may follow re-eval

Answer 1

Pt progresses according to current care plan
Decrease in progress:
- slower than expected
- expectations too high
Discharge
Out of scope
- problem is sx
- may need to see specialist

Question 2

Discharge vs. discontinuation

Answer 2

Discharge:
- goals met
- death
- no show/ self DC
- out of scope
> other procedures
- change of location
> OT settings, moving homes
- plateau
> refer them to someone else

Discontinuation: OT can’t provide what pt needs and needs to be referred out

Question 3

When can a discharge occur?

Answer 3

When goals are met
- completely
- at your facility
- within area of expertise
Pt move or leaves facility
Pt refusal
- unsafe
- noncompliant
Pt has reached maximal benefit
- from you or therapy
Pt dies

Question 4

OTR vs COTA in DC

Answer 4

OTR
- Over the process
- Writes the report
- Determines d/c time
- Makes recommendations
- Writes referrals
- Develops home program

COTA
- Assists with the process
- Can recommend d/c (to you)
- Can review home program with client or family

Question 5

Parts of a DC summary

Answer 5

1. ID information
2. Summary of OT services (interventions)
   - Broad, not summary of activities
   > ADL training, perceptual training, strengthening, anger management
3. Clients response to treatment, focus on occupation
   - Met goals
   - Partial goals
   - Refused
   - Struggled
4. Start and end date
5. Frequency/number of sessions
6. Occupational outcomes
   - Initial status
   - Ending status
   **client assessment of efficacy
7. Referral to other sources
   - Referral
   - Home program
8. Sign and Date

Question 6

When are rechecks necesssary?

Answer 6

Splints
Adaptive equipment
If they are having other medical expected changes
- Botox
- Deterioration syndromes
- Wt loss

Question 7

What is the format of a DC?

Answer 7

Anything goes
- Soap
- Dap
- Narrative
- Pre-printed

Question 8

Home Program

Answer 8

Can be simple or complex
- Should meet the needs and abilities of the client
- Think about their resources

Client should have a printed copy
- Some places require a client signature
- Copy goes in chart
- Should be legible to the client
> Pictures
> Avoid professional lingo

Question 9

Home program should include…

Answer 9

ID information
Instructions
Any particular don’t or precaution
- Do not perform exercises if joint swells and becomes painful
Frequency and duration of the program
- Perform 3 x a day 15 x each, spread your time out
Your name and how to reach you