Organization of TR/RT Flashcards
Program Design Relative to the Population Served
As programs are designed the cl’s needs need to be of concern. TRS is accountable for cl’s outcomes so the programs must meet the needs of them, and for that to happen, the TRS must have knowledge of the cl and have skills to pick an appropriate intervention.
Protocols are the cornerstone of evidence based practices bc they describe that best practice or standardization of the intervention with the cl.
Service Delivery Systems
Health Care is included here bc a lot of TR is found in health care, so the TRS should know if the service delivery is health care, if the TR process (APIE) is being used, and or what programs and interventions should be brought out.
Leisure Services are found here and are usually community based either inclusive or not.
Education Services are a kind of delivery sx too and because of the Education Act, TR can be found in schools. IEP’s can come into play here, special ed, transitioning with a cl., etc. The TRS might help with goals and objs here too.
Understanding the Roles and Functions of Other Health and Human Service Professionals and of Interdisciplinary Approaches
The tx team members all probably have different roles, especially in health care settings. The TRS should understand everybody’s play and role in the agency and in the bigger picture of a cl’s treatment. This may involve a TR co-treating a cl involving other professionals.
Documentation Procedures for Program Accountability
Accurate and complete documentation is necessary! This ensures quality service delivery, professional accountability, compliance with any administrative requirements, and provides data for quality improvements and efficacy research. TR’s are always accountable for services rendered and outcomes achieved! Agencies can dictate type of documentation needed.
Joint Commission and CARF can imply documenting standards. CMS (Centers for Medicare and Medicaid Services) requires using a MDS - Minimum Data Set for Resident Assessment and Care Screening.
RAPS - Resident Assessment Protocol Summary may also be completed.
Third Party payers may also be interested in documentations.
Payment for Services
Agency specific, or third parties. Type of setting specific. Reimbursements may come into play. May also look to documentations for thoroughness.
Methods for Interpretation of Progress Notes, Observations, and Assessment Results of Cl
The TRS needs to be able to interpret and/or read a medical chart!, need to understand doctor’s orders and read notes, to go further in tx.
Sometimes the TRS may not need to investigate a cl for areas of subject that may have already been on file, but sometimes the TRS may need to understand what has been done already.
Methods for Evaluating Agency andor TR Service Programs
There is a variety of evaluation methods. Determining what is important here is key, then you know what to evaluate. Evaluating can show program effectiveness and how or where to make improvements.
Formative is ongoing and occurs while program is in process.
Summative is conducted at end of program and can be used to compare or provide info for next time.
Collecting evaluation data can involve observations, questionnaires, or record documentations.
Methods for Quality Improvement andor Performance Improvement
This is a common method of evaluating TR services and is mandated by external accreditation agencies. Quality improvement involves a variety of activities and gathering useful data to improve quality of care.
Comprehensive service evals should focus on seeking out problematic areas that lower quality, correcting those problems, and then evaluating how well those corrections are solving the problems.
The TRS needs to understand and evaluate the effective plan that can focus on aspects of care, client assessment and tx, intervention techniques, cl safety and management, and staff trainings and ceu’s.
Performance improvements focus on the quality of the process used in delivering services to the quality of the outcomes produced. May include utilization review, risk management, and outcome monitoring.
Components of an Agency of TR Service Plan of Operation
This is how the plan of operation or the agency operates. Could be a policy and procedures manual. TRS needs to know the agency’s plan of operation andor the TR departments plan of operation. Agency’s plan includes pt’s management functions like APIE. Program management functions could include quality improvements, reviews, or discharge summaries.
Personnel, Intern, and Volunteer Supervision and Management
Focuses on supervision of staff, volunteers and student interns. Clinical supervision refers to supervising other TR staff, that is used to either improve practice skills, or to ensure the TR program intents are being met. TRS is responsible for development of program, responsible for goals being met, etc.
3 roles in clinical: teacher, counselor, consultant.
Tasks for Intern supervisor: communication with and observation of intern, documentation of intern activities and experiences, and provision of training and education opportunities.
Payment Systems
Could be managed care, preferred provider options or PPO, private contract, Medicare, Medicaid, etc.
Managed Care is now predominant.
Payment systems can be price based or set in advance or inclusive of all services that are provided or there could be no additional payments or current yr’s costs could affect prices.
Medicare has ppl who have access to care and is beneficiary centered as a federal health insurance program.
Medicaid is combined of state and federal and may pay the difference between income and cost of care.
Area and Facility Management
This is how areas or facilities are going to be used. TRS needs to know accessibility, requirement of the area and or the program in that area, and rule around the area. TRS should develop a risk management plan for this, to evaluate amounts of risk that something may present and it helps to establish policies for staff to follow.
Budgeting and Fiscal Responsibilities for Service Delivery
TRS should have understanding of fiscal matters. Revenue sources could include tax base appropriations from federal, state, or local governments, or grants and contracts, or contributions and donations, or fees, or charges and reimbursements, or any combination of these. Most programs in community are tax-based. Most consumers may be charged directly.
TR services could be Ancillary (prescribed by physician to meet a need) or Routine (basic service for overhead cost).
Budges could be:
revenue and expense-operating budget (delineates the day to day expenses and revenues for a year)
capital expenditure (long range planning typically 3-5 yrs)
program (focused on meeting goals and objs)
zero based budget (requires manager to re-evaluate programs in departments)
flexible (manager can adjust budget if unexpected stuff comes up)
