Final Flashcards
What are the occupational outcomes mentioned in the OTPF
Occupational performance, adaptation, health and wellness, participation, prevention, Quality of life, role competence, self-advocacy, and occupational justice
What are outcomes?
Indicators that OTs use to show where skilled OT services have made a difference; Important dimensions of health that are attributed to interventions, including: functional ability, health perceptions, and satisfaction
What is the difference between and outcome and a goal?
Goals are set to meet outcomes; outcomes are less tangible, broader; more objective in measure; goal always has subject and task, is objective and measurable
What are the qualities of outcome measures?
Must be valid, reliable, and sensitive; many outcome measures are first used as assessment (pre), then used later to show progress (post).; It is the comparison that makes it an outcome measure; COPM is one of our best outcome measures
How is the COPM used as an outcome measure?
Produces individualized outcoem measure to detect changes inthe self-perception of teh client’s performance and satisfaction over time; remember, it does not measure actual performance; Difference between initial and subsequent scores (change scores) indicates an outcome; A change score of tow or more is considered clinically significant (not statistically significant)
If using the PEO model to measure outcomes what interventions could you use to measure in the person?
ROM, amount of assistance, endurance, propel w/c, self-care skills
If using the PEO model to measure outcomes what interventions could you use to measure in the environment?
modification -> measure client mobility, current functional adaptive equipment, finding client - environment match, reduce clutter and hazards
If using the PEO model to measure outcomes what interventions could you use to measure in the occupation?
adapted occupation (task simplification)
What role do outcome measure play in reimbursement?
If the client does not show progress, and you did not revise their intervention plan, you will be denied reimbursement
Document: “Client unable to obtain goals as anticipated. Goals changed to meet client needs.”
If you can show you are making changes to accommodate the client, you will be reimbursed
When do you discontinue OT?
If the client is not making reasonable progress
If the client refuses OT for a period of time (no set number); try really hard to engage client before you decide to discontinue, but keep in mind that every client has the right to refuse
Carefully document circumstances for your decision
What is the role of the OT in discontinuation?
Make recommendations for when and to where client care will be discontinued
Prepare, implement and document the discontinuation plan
When do you discharge?
Met all initial goals, or revised/new goals
Potential for gain has plateaued
Return to home environment would have a positive effect on performance
Don’t discontinue just because other therapies have stopped. Be assertive in communicating when client is ready to be discharged
What needs to be considering in the planning ahead of a discontinuation?
Short LOS demands discharge planning begin on day of admission
Continue gains made in occupational performance by extending the program ot other care providers/family
Educate client, family, caregivers to carry out discontinuation plan via a home program (HEP) (document this education!)
OTs must have knowledge of community resources to create a quality discontinuation plan
Listen to family needs/concerns
What are the discontinuation considerations?
Patient’s function and level of disability: prior vs. current level of functioning, prognosis for recovery, acute or chronic nature of deficits, level of motivation
Level of support/care needed after discharge
Continuity of care: referral
Disposition site: health care regulation/institutional requirements
Training and education: patient and caregivers
Client’s/family’s needs and concerns
Equipment: needs and training
Available community resources
Resource availability and accessibility (reimbursement)
What must be included in your discontinuation note?
identifying information summary of the OT services provided response of client to intervention starting and ending dates of service frequency/number of sessions summary of interventions provided summary of client's progress from initial to discharge, and goals met evidence of home program instruction client status at time of discharge schedule and specific plan for follow-up
