OT Practice Essentials

Question 1

The official document of AOTA that describes the requirements for OTs and OTAs for delivery of OT services.

This document includes specific requirements regarding education, examination, and licensure.

Answer 1

Standards of Practice for OT

Question 2

An official document of AOTA that defines the scope of practice in OT ad provides a model definition of OT to promote uniform standards of professional mobility across state OT statutes and regulations.

Answer 2

Occupational Therapy Scope of Practice

Question 3

True or false: The Occupational Therapy Scope of Practice describes the domain and process of OT (Occupational Therapy Practice Framework) and the educational and certification requirements to become an OT or an OTA (Standards of Practice for Occupational Therapy).

Answer 3

True!

Scope of Practice: Governs what OTs are allowed to do during practice both administratively and with clients.
—OTPF: Governs how OTs are allowed to practice with clients.
— Standards of Practice: Governs how OTs are allowed to practice administratively.

Question 4

“The professions purview and the areas in which its members have an established body of knowledge and expertise,” is called…

A. Process
B. Client
C. Domain
D. Occupational Therapy Practicioner
E. Evaluation
F. Intervention
G. Cornerstones
H. Outcomes

Answer 4

C. Domains

There are 5 domains of practice:
1. Occupations
2. Contexts
3. Performance Patterns
4. Performance Skills
5. Client Factors

Question 5

“The client-centered delivery of occupational therapy services,” is called…

A. Process
B. Client
C. Domain
D. Occupational Therapy Practicioner
E. Evaluation
F. Intervention
G. Cornerstones
H. Outcomes

Answer 5

A. Process

The process has 3 parts:
1. Evaluation
2. Intervention
3. Outcomes

Question 6

“Developing an occupational profile and analyzing a client’s performance of occupations,” is called…

A. Process
B. Client
C. Domain
D. Occupational Therapy Practicioner
E. Evaluation
F. Intervention
G. Cornerstones
H. Outcomes

Answer 6

E. Evaluation

Question 7

“Developing a treatment plan, implementing the treatment, and reevaluating and reviewing it,” is called…

A. Process
B. Client
C. Domain
D. Occupational Therapy Practicioner
E. Evaluation
F. Intervention
G. Cornerstones
H. Outcomes

Answer 7

F. Intervention

Question 8

“What emerges from the occupational therapy process and describes the results clients can achieve through occupational therapy intervention,” is called…

A. Process
B. Client
C. Domain
D. Occupational Therapy Practicioner
E. Evaluation
F. Intervention
G. Cornerstones
H. Outcomes

Answer 8

H. Outcomes

Question 9

“Typically classified as persons, groups, or populations with common attributes such as contexts, characteristics, or have a common shared purpose,” is called…

A. Process
B. Client
C. Domain
D. Occupational Therapy Practicioner
E. Evaluation
F. Intervention
G. Cornerstones
H. Outcomes

Answer 9

B. Client

Question 10

“Occupational therapy practitioners have distinct knowledge, skills, and qualities that contribute to the success of the OT process,” is called…

A. Process
B. Client
C. Domain
D. Occupational Therapy Practicioner
E. Evaluation
F. Intervention
G. Cornerstones
H. Outcomes

Answer 10

G. Cornerstones

Question 11

An official AOTA document that describes the purpose, types, and content of professional documentation used in OT.

Answer 11

Guidelines for Documentation of OT

Question 12

“Services under accepted standards of medical treatment, also considered to be specific and effective treatment for the patient’s condition” are known as ______________ services.

Answer 12

Medically necessary

Question 13

“The medical record must support that the expertise and knowledge of a qualified clinician was necessary” are known as ______________ services.

Answer 13

Skilled

Question 14

What are 4 purposes/reasons it is important to document?

Answer 14

1. To communicate information about the client’s occupational history and experiences, interests, values, and needs
2. To articulate rationale for the provision of occupational therapy services and the relationship of those services to client outcomes
3. To provide a clear chronological record of client status, the nature of OT services provided, client response to OT intervention, and client outcomes
4. To provide an accurate justification for skilled OT service necessary and reimbursement

Question 15

True or false: Client’s full name, date of birth, gender, and case number are required to be on each page of documentation.

Answer 15

True!

In addition, identification of the type of documentation, date of service, clear rationale for services, and professional services.

Question 16

True or false: If you make an error in documentation, you can erase it or white it out.

Answer 16

FALSE!

You must put one line through it, make the correction, and sign and initial the error.

Question 17

“Also known as a referral, often written by a physician (but not always required), which includes the date, source of referral, services requested, and reason for referral,” describes which type of documentation?

A. Evaluation report
B. Intervention plan
C. Order
D. Screening

Answer 17

C. Order

Question 18

“The purpose of this document type is to identify whether a person may benefit from OT services and whether evaluation is necessary,” describes which type of documentation?

A. Evaluation report
B. Intervention plan
C. Order
D. Screening

Answer 18

D. Screening

Question 19

“A document that states the referral source, and data gathered through the OT evaluation process,” describes which type of documentation?

A. Evaluation report
B. Intervention plan
C. Order
D. Screening

Answer 19

A. Evaluation Report

Question 20

“A document of goals and interventions to be used along with client’s goals,” describes which type of documentation?

A. Evaluation report
B. Intervention plan
C. Order
D. Screening

Answer 20

B. Intervention Plan

Question 21

“Steps to reach an overarching goal of occupational services,” are also known as…

Answer 21

Short-term goals

Question 22

“Goals the client is expected to achieve by discharge,” are also known as…

Answer 22

Long-term goals

Question 23

True or false: No attendance or missing an occupational therapy appointment is typically documented with a progress note.

Answer 23

FALSE!

This is typically documented with a contact note .

These notes can also document the OTs contact with the client including interventions used, client’s response to intervention, any instruction, education, or training given, and any phone calls or meetings relating to the client.

Question 24

What are the typical contents of a progress note (or progress report)?

Answer 24

—Identifying data (e.g., client’s name, date of birth, gender)
—Intervention provided during session (e.g., environmental modifications, ADL retraining, orthotics fitting)
—Length of session; where session occurred (e.g., home)
—Precautions followed during intervention session
—Contraindications or reasons why particular interventions were not completed
—New assessments completed or information obtained
—Client’s current functional level and progress made toward goals
—Intervention plan modifications
—Whether occupational therapy services should continue and rationale for continuing intervention or for discharging client
—Referrals to other services
—Recommendations with rationale; plan for next session

Question 25

What is a SOAP note?

Answer 25

A type of format for a progress note:

S: Subjective information from client, paraphrased or quoted (e.g., client reported he was able to undress himself before bed last night; “I didn’t sleep well last night”)

O: Objective information from intervention session, such as measurements, observable data, and any quantifiable data such as goniometric or strength measurements

A: Assessment; includes the occupational therapy clinician’s interpretation or analysis of the information in the previous sections of the note, therapist’s judgment

P: Plan; includes the estimated duration and frequency of occupational therapy services, anticipated intervention strategies to be used. Should relate to previous sections of the note.

Question 26

What is a DAP note?

Answer 26

DAP stands for Description, Assessment, and Plan.

This type of note is similar to SOAP except that the “S” and “O” sections of the note (Subjective and Objective) are collapsed together in the “D” section.

Question 27

True or false: A narrative formatted progressive note must follow SOAP format.

Answer 27

FALSE!

These notes may include pertinent information in a logical order of the writer’s choosing but not in a specific format of SOAP or DAP notes.

Question 28

What are BIRP, PIRP, and SIRP notes?

Answer 28

BIRP: Stands for Behavior, Intervention, Response, Plan.

PIRP: Stands for Purpose, Intervention, Response, Plan.

SIRP: Stands for Situation, Intervention, Response, Plan.

Question 29

When is a reevaluation or reassessment report written/conducted?

Answer 29

Formal reevaluation is conducted when, in the professional judgment of the occupational therapist, new clinical findings emerge, a significant change in the patient’s condition requiring further tests and measures is observed, the client demonstrates a lack of response as expected in the plan of care, or additional information is required for discharge or when required by practice guidelines and payer, facility, and state and federal guidelines and requirements.

Question 30

This report “documents the formal transition plan to support the client’s transition from one service to another within a service delivery system.”

Answer 30

Transition Plan

Question 31

This report “documents the discharge plan to support the client’s discharge from OT services.”

Answer 31

Discharge or discontinuation report and summary

Question 32

What are the 3 different types of goal writing methods?

Answer 32

RUMBA: Relevant, understandable, measurable, behavioral, and achievable

COAST: Client, Occupation, Assistance level, Specific conditions, Timeline

SMART: Specific, Measurable, Achievable, Related, Time limited

Question 33

This written document details a student’s academic needs and functional goals within the school setting.

Answer 33

Individualized Education Plan (IEP)

Question 34

This document is generally written in lay terms and document the types of needs and goals for children to meet specific milestones; not always in a school setting.

Answer 34

Individualized Family Services Plan (IFSP)

In early intervention settings

Question 35

Section GG outcome measures are typically used in which 3 settings?

Answer 35

—Skilled nursing facilities
—Inpatient rehab
—Long-term care settings

Question 36

Clients who have Medicare or Medicaid in home health settings must complete what type of assessment?

Answer 36

Outcome and Assessment Information Set (OASIS)

This assessment helps to provide guidance for the services the client requires and helps determine the client’s eligibility to receive home health.

NOTE: OT documentation in home health typically revolves around the client’s ability to perform functional tasks as well as safety or environmental concerns.

Question 37

What is the Health Insurance Portability and Accountability Act (HIPAA)?

Answer 37

A federal legislation giving patients certain rights over their medical information, including:
—Ensuring a record remains private
—Providing rules and regulations around sharing medical information discarding documents with Protected Health Information (PHI); more below.

The HIPAA Privacy Rule defines and limits the use and disclosure of individuals’ protected health information (PHI; see Kornblau, 2019). The law sets forth 18 identifiers that, if associated with medical information or billing, render that information PHI (e.g., a client’s name, medical record number, or social security number). Failure to eliminate any of the 18 identifiers would allow someone to locate or identify the patient and thus violate HIPAA. Occupational therapy practitioners and other health care providers can de-identify the PHI by removing the 18 identifiers.

Under the rules, a covered entity cannot use or disclose PHI unless the Privacy Rule allows or requires the disclosure or the individual or his or her personal representative authorizes the release in writing

Question 38

What is the Family Education Right and Privacy Act of 1974 (FERPA)?

Answer 38

This act protects the confidentiality of student information, including a student’s educational record (Estes & Bennett, 2019), including occupational therapy documentation completed on students.

Question 39

In regard to confidentiality, what is the Individuals with Disabilities Education Improvement Act of 2004?

Answer 39

Similar to FERPA, this act protects the confidentiality of student information, ages 0-21.

Question 40

What is the AOTA Code of Ethics?

Answer 40

The Code of Ethics stresses the principle of autonomy and states that “occupational therapy personnel shall respect the right of the individual to self-determination, privacy, confidentiality, and consent.” (AOTA, 2020a, p. 3).

Question 41

True or false: Third party payers may request, review, and audit OT’s documentation to determine whether it meets their specific guidelines for reimbursement and whether OT services should be paid for by the payer.

Answer 41

TRUE!

Question 42

What is the largest third-party payer in the United States?

Answer 42

Centers for Medicare and Medicaid Services (CMS)

CMS administers programs such as Medicare and Medicaid.

Question 43

What are the eligibility requirements for Medicare?

Answer 43

—65 years or older
—Some people with disabilities younger than 65 years old
—People who have end-stage renal disease

Question 44

Payment for Occupational Therapy services falls under what part/s of Medicare?

Answer 44

Part A: Services in the hospital, skilled nursing facilities, hospice services, and some home health

Part B: Outpatient care, some medical supplies, and preventative services

Part C: (Also known as “Medicare Advantage”) An alternative way to receive Medicare benefits, run by private companies and approved by the federal government

Only Part D is NOT covered—that is for prescriptive drug coverage.

Question 45

What are the 5 requirements for Occupational Therapy reimbursement under Medicare?

Answer 45

1. Client must be/must have been recently under care of a physician; OT must be medically necessary.
2. Services are providing following a written care plan approved by the physician.
3. Services are performed by qualified Occupational Therapy providers (including OTAs under appropriate supervision)
4. Services must be skilled and require the knowledge and expertise of OT.
5. The amount, duration and intensity of services must be ”reasonable and necessary” for the client’s condition.

Question 46

In the hospital setting, how are hospital services paid for under Medicare?

Answer 46

Paid through Prospective Payment Systems (PPS) in which patients are classified into Diagnosis-Related Groups (DRGs)

Covered under Medicare Part A

Question 47

In the inpatient rehab setting, how are rehab services paid for under Medicare?

Answer 47

This type of facility treats clients who require rehabilitation services. IRFs admit specific percentages of clients with certain rehabilitation conditions.

Medicare IRF services are paid through a PPS. Medically necessary occupational therapy is covered based on the rate for a patient’s DRG.

Covered under Medicare Part A

Question 48

In a skilled nursing facility (SNF) setting, how are services paid for under Medicare?

Answer 48

Medicare Part A covers up to 100 days of the SNF stay, including skilled nursing and therapy services in a SNF if the person meets certain criteria, such as requiring skilled services a minimum of 5 days a week. Occupational therapy services are paid as part of the per diem PPS.

In October 2019, a new case-mix model titled the Patient-Driven Payment Model (PDPM) went into effect. PDPM focuses on clinically relevant factors rather than codes and other patient characteristics as the basis for patient classification.

Covered under Medicare Part A

Question 49

In a psychiatric hospital setting, how are services paid for under Medicare?

Answer 49

Psychiatric hospitals are paid by Medicare under an Inpatient Psychiatric Facility PPS, including a per diem rate using a client classification system.

Covered under Medicare Part A

Question 50

In a home health setting, how are services paid for under Medicare?

Answer 50

A client must be considered homebound and require skilled services (nursing, physical therapy, or speech–language pathology) to qualify for home health.

The Outcome and Assessment Information Set (OASIS) helps classify clients’ needs for the home health agency and helps determine payment for services.

Covered under Medicare Part A

Question 51

In a hospice setting, how are services paid for under Medicare?

Answer 51

A person qualifies for Medicare Part A coverage for hospice when he or she meets the criteria of being terminally ill and has a prognosis of fewer than 6 months as determined by a physician.

If occupational therapy services are required, they are focused on helping clients maintain their functioning or reducing symptoms (e.g., pain control) to participate in valued occupations to enhance quality of life.

Covered under Medicare Part A

Question 52

True or False: Medicare Part B is free for everyone over 65.

Answer 52

Generally, most people must pay a premium each month to cover the cost of Medicare Part B.

Question 53

In regard to outpatient services, how much does Medicare Part B cover (percentage)?

Is there a deductible?

Answer 53

Medicare Part B covers 80% of the cost for medically necessary outpatient physical therapy, occupational therapy, and speech–language pathology.

The client pays any deductible not met and 20% of the Medicare-approved costs

Question 54

For outpatient occupational therapy, how does Medicare Part B receive payment?

Answer 54

Payment is based on the Medicare Physician Fee Schedule, which takes into account Current Procedural Terminology (CPT®) codes used during the provision of services.

Question 55

Is there a Medicare Part B cap?

Answer 55

No, The Medicare Part B Therapy Cap was repealed in 2018, but a threshold amount of $2,080 per year for occupational therapy remains.

Claims above that yearly threshold need to be billed with a KX modifier and must be medically necessary. Claims exceeding $3,000 in a year are subject to a targeted review.

Question 56

Is Durable Medical Equipment (DME) covered under Medicare Part B?

Answer 56

Most adaptive equipment—such as reachers or dressing sticks, bathtub seats, and grab bars—is not covered or reimbursed by Medicare.

​DME is defined as “reusable medical equipment like walkers, wheelchairs, or hospital beds”. Medicare generally covers about 80% of the approved cost of DME, and the client generally pays the remaining 20% of the cost.

Question 57

Is there one standard Medicare Part C plan?

Answer 57

No. A Medicare Advantage plan is a Medicare-approved plan from a private company that offers an alternative to original Medicare for health and drug coverage. These “bundled” plans include Part A, Part B and, usually, Part D.

A variety of Medicare Advantage plans are available, and each has different guidelines and coverage requirements.

Question 58

Does Medicare Part C always cover occupational therapy?

Answer 58

Occupational therapy practitioners will need to check specific policy requirements to determine coverage for their services.

Question 59

What is the Federal Employees Health Benefits Program?

Answer 59

This health insurance covers many retired and active federal workers.

Coverage of specific types of services; requirements for the settings in which those services may be provided; out-of-pocket expenses; and limitations on coverage are determined by each private plan with which the government contracts to administer health care services.

Question 60

What is Tricare?

Answer 60

TRICARE is part of the Military Health System and provides coverage for active-duty service members, retirees, their families, survivors, and certain former spouses.

Nonmilitary and military providers may provide services under TRICARE.

Coverage for occupational therapy services may vary, depending on the specific regional plans.

Question 61

What are the eligibility requirements for Medicaid?

Answer 61

People with disabilities are eligible in every state.

In some states, people with disabilities qualify automatically if they get Supplemental Security Income benefits.

In other states, a person may qualify depending on income level and financial resources.

Medicaid covers screening, diagnosis, and treatment for eligible people younger than age 21. This eligibility includes access to occupational therapy.

Medicaid covers services provided in nursing facilities, including occupational therapy for people age 21 and older.

Some, but not all, states cover occupational therapy for adults.

Question 62

What is the Children’s Health Insurance Program (CHIP)?

Answer 62

CHIP is funded by both the federal and state governments but is administered by each state.

CHIP provides health care to approximately 7 million children in low-income families with incomes too high to qualify for Medicaid.

Occupational therapy coverage under CHIP may vary from state to state.

Question 63

The IDEA governs how states and public agencies provide early intervention, special education and related services to eligible infants, toddlers, children and youth with disabilities.

What do Part B and Part C cover specifically?

Answer 63

IDEA Part B covers children and young adults with disabilities ages 3–21. Occupational therapy is a “related service” under IDEA Part B.

IDEA Part C provides early intervention services to infants and toddlers ages 0–36 months. Occupational therapy is an “early intervention service” under Part C.

Question 64

Workers’ compensation programs provide money and medical benefits to workers who are injured at work or acquire an occupation-related disease.

How are occupational therapists covered under Worker’s Comp?

Answer 64

Occupational therapy practitioners may work with clients who have been injured on the job and are covered by workers’ compensation insurance.

Guidelines for reimbursement for occupational therapy services for people who are covered under workers’ compensation may vary from employer to employer.

Question 65

Does all private insurance cover occupational therapy?

Answer 65

Each plan has its own requirements for coverage and reimbursement of occupational therapy services.

Question 66

Do occupational therapists use diagnosis codes? For example ICD-9/ICD-10 codes.

Answer 66

ICD-9/ICD-10 codes serve as medical diagnosis codes, as well as treatment diagnosis codes.

Therapists must use their clinical judgment to select treatment diagnosis codes that correspond to the client’s condition and the intervention.

Question 67

Do all payers accept CPT codes?

Answer 67

Occupational therapy providers in certain settings may use the CPT codes to denote services they provided for billing.

However, not all payers accept all CPT codes.

Occupational therapy practitioners are encouraged to check with reimbursement sources to learn each one’s specific regulations and procedures for reimbursement.

Question 68

What happens when a client’s occupational therapy services are denied reimbursement by the payer source?

Answer 68

The occupational therapy clinician, facility, or both may go through the payer’s appeals process to see whether any technical errors can be corrected or to provide justification for payment of the services.

Question 69

What are some causes of denial of occuaptional therapy services?

Answer 69

–Using an experimental intervention
–Writing documentation that does not demonstrate that the skills of an OT or an OTA under the supervision of an OT were needed
–Exceeding the number of visits allowable

Question 70

True or false: Knowingly soliciting, receiving, offering, or paying remuneration (e.g., kickbacks, bribes, or rebates) to induce or reward referrals for items or services reimbursed by Federal health care programs is considered fraud.

Answer 70

TRUE! This is called the anti-kickback statute.

In addition:
1. Knowingly submitting, or causing to be submitted, false claims or making misrepresentations of fact to obtain a Federal health care payment

2. Making prohibited referrals for certain designated health services.

Question 71

What is the False Claims Act?

Answer 71

Protects the Government from being overcharged or sold substandard goods or services

Question 72

What is the Anti-kickback statute?

Answer 72

This statute makes it a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration directly or indirectly to induce or reward patient referrals or the generation of business involving any item or service reimbursable by a Federal health care program.

Question 73

“Practices that may directly or indirectly result in unnecessary costs to the Medicare Program” is known as…

Answer 73

Abuse

Question 74

True or false: Occupational Therapy Assistants are not licensed.

Answer 74

FALSE

They must undergo COTA certification and examination to become licensed.

Question 75

State regulatory boards require occupational therapy practitioners to renew their license, certification, or registration at specific intervals. What is the most common condition of these renewals?

Answer 75

Continuing competency (e.g., continuing education)

Question 76

True or false: Occupational therapy practitioners are required to recertify through NBCOT.

Answer 76

FALSE

Occupational therapy practitioners are not required by NBCOT to recertify.

Question 77

True or false: State regulatory boards are responsible for ensuring the safety of consumers and disciplining practitioners for ethical or practice issues.

Answer 77

True

Question 78

Each health care provider and practitioner who bills for services must obtain a/an _____________.

Answer 78

National Provider Identifier (NPI) number

Question 79

What is the purpose of the Joint Commission?

Answer 79

To continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value

Question 80

What is CARF International?

Answer 80

An independent, nonprofit organization focused on advancing the quality of services you use to meet your needs for the best possible outcomes

Question 81

What is the Americans With Disabilities Act (ADA) Amendments of 2008?

Answer 81

This act is important for occupational therapy practitioners to understand; it does not just apply to clients.

The ADA prohibits discrimination on the basis of disability in employment, State and local government, public accommodations, commercial facilities, transportation, and telecommunications.

Under the ADA, businesses with 15 or more employees are required to provide reasonable accommodations.

Question 82

_____________ can occur in occupational therapy if occupational therapy practitioners do not provide at least the typical standard of care for a client, resulting in injury to a client.

Answer 82

Malpractice

Ways to prevent malpractice include:
–Ensuring that adequate supervision of practitioners is provided
–Educating employees and staff in methods to keep their clients safe from harm and encouraging continuing education related to safety
–Having employees perform a peer review of others’ occupational therapy treatment sessions
–Documenting occupational therapy sessions accurately and in a timely manner
–Clearly and respectfully communicating with clients

Question 83

What is service competency?

Answer 83

The process of teaching, training, and evaluating in which the occupational therapist determines that [the OT or OTA] performs tasks in the same way that the supervising occupational therapist would and achieves the same outcomes.

After initial service competency is established, the therapist supervisor will need to periodically recheck service competency to ensure that it is maintained

Question 84

To ensure safe and effective occupational therapy services, it is the responsibility of the _________________ to recognize when an occupational therapist requires peer supervision or mentoring that supports current and advancing levels of competence and professional development.

Answer 84

The occupational therapist themselves

Question 85

What are the types of supervision?

Answer 85

Direct, face-to-face: observation, modeling, demonstration with a client, discussion, teaching, and instruction.

Indirect: phone and virtual interactions, telehealth, written correspondence, and other forms of secure electronic exchanges.

Question 86

Does supervision have to be documented?

Answer 86

Site specific; Supervision documentation should include frequency, method and type, content reviewed, evidence that supports competency, and names and credentials of the OTA and OT

Question 87

Describe the role of OT versus the role of OTA during the Evaluation process.

Answer 87

The OT performs the evaluation and directs all parts of the evaluation process.

The OT interprets the gathered data and creates an intervention plan.

The OTA may contribute to the evaluation process by performing delegated assessments and delivering reports of observations and client capacities to the OT.

The OT analyzes the feedback from the OTA and incorporates that information into the evaluation process.

Question 88

Describe the role of OT versus the role of OTA during the Intervention Planning process.

Answer 88

The OT is responsible for creating the intervention plan, but the OT and OTA partner with the client to develop this plan.

NOTE: The OTA must understand the evaluation results and be able to offer client-centered input into the intervention plan.

Question 89

Describe the role of OT versus the role of OTA during the Intervention Implementation process.

Answer 89

The OT is responsible for implementation but may delegate components to the OTA while offering adequate supervision.

The OTA must be knowledgeable about the client’s goals and will choose appropriate therapeutic activities and interventions and modify them as needed, adhering to client goals and demands of the practice setting.

Question 90

Describe the role of OT versus the role of OTA during the Intervention Review process.

Answer 90

The OT selects, measures, and analyzes outcomes as they pertain to a client’s occupational engagement.

The OTA must understand the client’s specific outcomes and then document and provide information related to progress.

The OTA may measure outcomes and offer clients discharge resources.

The OT determines a client’s need to continue, modify, or stop occupational therapy services on the basis of information and documentation from the OTA about the client’s feedback and performance during the intervention process.

Question 91

True or false: OT students in Level 1 fieldwork can be supervised by other health professionals aside from OTs.

Answer 91

True!

Question 92

True or false: OT students in Level 2 fieldwork can be supervised by other health professionals aside from OTs.

Answer 92

FALSE

OT Students must be supervised by a currently licensed or credentialed occupational therapy practitioner who has a minimum of 1 year of practice experience subsequent to initial certification and is adequately prepared to serve as a fieldwork educator

Question 93

What is the difference in supervision for Level 2 OT students versus Level 2 OTA students?

Answer 93

Level II occupational therapy students have an OT as a supervisor.

Level II occupational therapy assistant students have an OT or an OTA (in conjunction with the supervising OT) as a supervisor

Question 94

Can Level 2 fieldwork OT and OTA students bill for services?

Answer 94

Level II OT fieldwork students may provide occupational therapy services under the supervision of a qualified occupational therapist in compliance with state and federal regulations.

Level II OTA fieldwork students may provide occupational therapy services under the supervision of a qualified occupational therapist OR an occupational therapy assistant who is under the supervision of an occupational therapist in compliance with state and federal regulations.

In terms of billing, Occupational therapy services provided by students under the supervision of a qualified practitioner will be billed as services provided by the supervising licensed occupational therapy practitioner.

Question 95

Practice improvement involves the use of principles, evidence-based practice (EBP), and ________ to improve practice.

Answer 95

Knowledge translation

Question 96

The most common Continuous Quality Improvement method is…

Answer 96

Plan - Do - Study - Act (PDSA)

Plan: The change to be tested or implemented

Do: Carry out the test or change

Study: Examine the data before and after the change and reflect on what was learned

Act: Plan the next change cycle or full implementation.

Question 97

The National Strategy for Quality Improvement in Health Care established 3 overarching aims, including…

Answer 97

1. Better Care
2. Healthy People/Healthy Communities
3. Affordable Care

Question 98

The Institute for Healthcare Improvement has developed the Triple Aim to use as a foundation in achieving the National Quality Strategy.

The Triple Aim framework is designed to improve…

Answer 98

1. the patient experience
2. improve the health of populations
3. reduce the cost of health care concurrently

Question 99

CMS (Medicare and Medicaid) has established the need for essential services in the hospital systems to have a Quality Assurance and Performance Improvement (QAPI) plan. What does this address?

Answer 99

1. Measurement of compliance with standards (quality assurance)
2. Continuous improvement of processes to meet standards (performance improvement)

Question 100

What is evidence-based practice?

Answer 100

Evidence-based practice (EBP) is a problem-solving approach to the delivery of health care that integrates the best evidence from studies and patient care data with clinician expertise and patient preferences and values.

Question 101

What type of study is described below?

A/an high-quality _________ is considered the most reliable source of evidence to guide clinical practice. The purpose of a these studies is to deliver a meticulous summary of all the available primary research in response to a research question.

Answer 101

Systemic review

Question 102

What type of study is described below?

A/an ____________ is conducted after a systematic review is completed. If the population, intervention, and outcomes are the same in multiple high-quality studies, the findings from those studies can be combined and a statistical analysis conducted.

Answer 102

Meta-analysis

Question 103

What type of study is described below?

A/an _______________ is an experimental design. It is the only research design that can show whether an intervention caused the outcomes of interest.

Answer 103

Randomized controlled trial (RCT)

Question 104

What type of study is described below?

__________ studies with controls are quasi-experimental designs. This design is like an RCT, without the randomization.

Answer 104

Two-group / nonrandomized studies

Question 105

What type of study is described below?

A/an __________ study is an observational study that analyzes data at the population or group level, rather than at the individual level.

Answer 105

Ecological

Question 106

What type of study is described below?

________ studies and _________ studies are two types of observational studies that aid in evaluating associations between variables.

Answer 106

Cohort, Case Control

Question 107

What type of study is described below?

In a/an ____________ study, data is collected on one group of participants before the intervention then again after the intervention.

Answer 107

Pretest/posttest

Question 108

What type of study is described below?

__________ are collections of reports on the treatment and outcomes of individual patients or of reports on a single patient. All patients have the same condition.

Answer 108

Case series

Question 109

What is the “research-practice gap”?

Answer 109

There is a 17-year lag (the “research–practice gap”) in the health care system between significant research discoveries and their adoption into real-world practice.

Barriers include a lack of time, insufficient resources and personnel, limited organizational support, and decreased awareness or competence delivering a particular EBP

Question 110

The Standards for Continuing Competence, an official document from AOTA (2021d), describes the standards for continuing competence for occupational therapy practitioners. It includes the following 5 standards…

Answer 110

Standard 1: Knowledge
Standard 2: Professional reasoning
Standard 3: Interpersonal skills
Standard 4: Performance skills
Standard 5: Ethical practice

Question 111

What are NBCOT’s continuing education requirements?

Answer 111

Must accrue 36 professional development units every 3 years as one component of maintaining certification

NOTE
- State regulatory board regulations: Most occupational therapy state regulatory boards require a certain amount of continuing education to continue to practice in the state).
- Accreditation regulations: Certain accrediting bodies stress the need for staff development and continuing competence.
- Employers: Most employers expect that professionals will remain competent in their field and may assess competency during a performance review.

Question 112

True or false: Occupational therapy practitioners can assess their skills and develop a professional development plan.

Answer 112

TRUE!

1. Use self-assessment to identify areas of weakness.
2. Determine the learning that needs to occur on the basis of the results of the self-assessment.
3. Review current goals and objectives and determine progress toward prior personal professional development goals.
4. Determine available resources for meeting future goals.
5. Change or modify prior goals and objectives or determine new goals and objectives.

Question 113

True or false: Advocacy at all levels is an important component of occupational therapy practice. However, it can only occur at the daily practice level.

Answer 113

FALSE!

It can occur in daily practice, professional, and/or systems levels.

Question 114

What did the Balanced Budget Act of 1997 do?

Answer 114

Resulted in changes to the reimbursement of occupational therapy and related services under Medicare