OT Practice Essentials Flashcards
1
Q
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.
A
Standards of Practice for OT
2
Q
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.
A
Occupational Therapy Scope of Practice
3
Q
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).
A
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.
4
Q
“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
A
C. Domains
There are 5 domains of practice:
1. Occupations
2. Contexts
3. Performance Patterns
4. Performance Skills
5. Client Factors
5
Q
“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
A
A. Process
The process has 3 parts:
1. Evaluation
2. Intervention
3. Outcomes
6
Q
“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
A
E. Evaluation
7
Q
“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
A
F. Intervention
8
Q
“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
A
H. Outcomes
9
Q
“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
A
B. Client
10
Q
“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
A
G. Cornerstones
11
Q
An official AOTA document that describes the purpose, types, and content of professional documentation used in OT.
A
Guidelines for Documentation of OT
12
Q
“Services under accepted standards of medical treatment, also considered to be specific and effective treatment for the patient’s condition” are known as ______________ services.
A
Medically necessary
13
Q
“The medical record must support that the expertise and knowledge of a qualified clinician was necessary” are known as ______________ services.
A
Skilled
14
Q
What are 4 purposes/reasons it is important to document?
A
- To communicate information about the client’s occupational history and experiences, interests, values, and needs
- To articulate rationale for the provision of occupational therapy services and the relationship of those services to client outcomes
- To provide a clear chronological record of client status, the nature of OT services provided, client response to OT intervention, and client outcomes
- To provide an accurate justification for skilled OT service necessary and reimbursement
15
Q
True or false: Client’s full name, date of birth, gender, and case number are required to be on each page of documentation.
A
True!
In addition, identification of the type of documentation, date of service, clear rationale for services, and professional services.
16
Q
True or false: If you make an error in documentation, you can erase it or white it out.
A
FALSE!
You must put one line through it, make the correction, and sign and initial the error.
17
Q
“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
A
C. Order
18
Q
“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
A
D. Screening
19
Q
“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
A
A. Evaluation Report
20
Q
“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
A
B. Intervention Plan
21
Q
“Steps to reach an overarching goal of occupational services,” are also known as…
A
Short-term goals
22
Q
“Goals the client is expected to achieve by discharge,” are also known as…
A
Long-term goals
23
Q
True or false: No attendance or missing an occupational therapy appointment is typically documented with a progress note.
A
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.
24
Q
What are the typical contents of a progress note (or progress report)?
A
—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
25
What is a SOAP note?
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.
26
What is a DAP note?
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.
27
True or false: A narrative formatted progressive note must follow SOAP format.
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.
28
What are BIRP, PIRP, and SIRP notes?
**BIRP**: Stands for *Behavior, Intervention, Response, Plan*.
**PIRP**: Stands for *Purpose, Intervention, Response, Plan*.
**SIRP**: Stands for *Situation, Intervention, Response, Plan*.
29
When is a reevaluation or reassessment report written/conducted?
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.
30
This report “documents the formal transition plan to support the client’s transition from one service to another within a service delivery system.”
Transition Plan
31
This report “documents the discharge plan to support the client’s discharge from OT services.”
Discharge or discontinuation report and summary
32
What are the 3 different types of goal writing methods?
**RUMBA**: Relevant, understandable, measurable, behavioral, and achievable
**COAST**: Client, Occupation, Assistance level, Specific conditions, Timeline
**SMART**: Specific, Measurable, Achievable, Related, Time limited
33
This written document details a student’s academic needs and functional goals within the school setting.
Individualized Education Plan (IEP)
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.
Individualized Family Services Plan (IFSP)
*In early intervention settings*
35
Section GG outcome measures are typically used in which 3 settings?
—Skilled nursing facilities
—Inpatient rehab
—Long-term care settings
36
Clients who have Medicare or Medicaid in home health settings must complete what type of assessment?
**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.
37
What is the Health Insurance Portability and Accountability Act (HIPAA)?
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
38
What is the Family Education Right and Privacy Act of 1974 (FERPA)?
This act protects the **confidentiality of student information**, including a student’s educational record (Estes & Bennett, 2019), including occupational therapy documentation completed on students.
39
In regard to confidentiality, what is the Individuals with Disabilities Education Improvement Act of 2004?
Similar to FERPA, this act protects the confidentiality of student information, ages 0-21.
40
What is the AOTA Code of Ethics?
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).
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.
TRUE!
42
What is the largest third-party payer in the United States?
**Centers for Medicare and Medicaid Services (CMS)**
CMS administers programs such as Medicare and Medicaid.
43
What are the eligibility requirements for Medicare?
—65 years or older
—Some people with disabilities younger than 65 years old
—People who have end-stage renal disease
44
Payment for Occupational Therapy services falls under what part/s of Medicare?
**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.
45
What are the 5 requirements for Occupational Therapy reimbursement under Medicare?
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.
46
In the hospital setting, how are hospital services paid for under Medicare?
Paid through **Prospective Payment Systems (PPS)** in which patients are classified into **Diagnosis-Related Groups (DRGs)**
Covered under **Medicare Part A**
47
In the inpatient rehab setting, how are rehab services paid for under Medicare?
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**
48
In a skilled nursing facility (SNF) setting, how are services paid for under Medicare?
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**
49
In a psychiatric hospital setting, how are services paid for under Medicare?
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**
50
In a home health setting, how are services paid for under Medicare?
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**
51
In a hospice setting, how are services paid for under Medicare?
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**
52
True or False: Medicare Part B is free for everyone over 65.
Generally, most people must **pay a premium each month** to cover the cost of Medicare Part B.
53
In regard to outpatient services, how much does Medicare Part B cover (percentage)?
Is there a deductible?
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**
54
For outpatient occupational therapy, how does Medicare Part B receive payment?
Payment is based on the **Medicare Physician Fee Schedule**, which takes into account **Current Procedural Terminology (CPT®) codes** used during the provision of services.
55
Is there a Medicare Part B cap?
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*.
56
Is Durable Medical Equipment (DME) covered under Medicare Part B?
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.*
57
Is there one standard Medicare Part C plan?
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.
58
Does Medicare Part C always cover occupational therapy?
Occupational therapy practitioners will **need to check specific policy requirements** to determine coverage for their services.
59
What is the Federal Employees Health Benefits Program?
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.
60
What is Tricare?
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.
61
What are the eligibility requirements for Medicaid?
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.
62
What is the Children's Health Insurance Program (CHIP)?
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.
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?
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.
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?
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.**
65
Does all private insurance cover occupational therapy?
Each plan has its own requirements for coverage and reimbursement of occupational therapy services.
66
Do occupational therapists use diagnosis codes? For example ICD-9/ICD-10 codes.
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**.
67
Do all payers accept CPT codes?
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.
68
What happens when a client's occupational therapy services are denied reimbursement by the payer source?
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.
69
What are some causes of denial of occuaptional therapy services?
--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
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.
**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.
71
What is the False Claims Act?
Protects the Government from being overcharged or sold substandard goods or services
72
What is the Anti-kickback statute?
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.
73
"Practices that may directly or indirectly result in unnecessary costs to the Medicare Program” is known as...
Abuse
74
True or false: Occupational Therapy Assistants are not licensed.
FALSE
They must undergo COTA certification and examination to become licensed.
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?
Continuing competency (e.g., continuing education)
76
True or false: Occupational therapy practitioners are required to recertify through NBCOT.
FALSE
Occupational therapy practitioners are not required by NBCOT to recertify.
77
True or false: State regulatory boards are responsible for ensuring the safety of consumers and disciplining practitioners for ethical or practice issues.
True
78
Each health care provider and practitioner who bills for services must obtain a/an _____________.
National Provider Identifier (NPI) number
79
What is the purpose of the Joint Commission?
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
80
What is CARF International?
An independent, nonprofit organization focused on **advancing the quality of services you use** to meet your needs for the best possible outcomes
81
What is the Americans With Disabilities Act (ADA) Amendments of 2008?
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**.
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.
**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
83
What is service competency?
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
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.
The occupational therapist themselves
85
What are the types of supervision?
**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.
86
Does supervision have to be documented?
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
87
Describe the role of OT versus the role of OTA during the Evaluation process.
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.
88
Describe the role of OT versus the role of OTA during the Intervention Planning process.
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.
89
Describe the role of OT versus the role of OTA during the Intervention Implementation process.
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.
90
Describe the role of OT versus the role of OTA during the Intervention Review process.
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.
91
True or false: OT students in Level 1 fieldwork can be supervised by other health professionals aside from OTs.
True!
92
True or false: OT students in Level 2 fieldwork can be supervised by other health professionals aside from OTs.
**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
93
What is the difference in supervision for Level 2 OT students versus Level 2 OTA students?
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
94
Can Level 2 fieldwork OT and OTA students bill for services?
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**.
95
Practice improvement involves the use of principles, evidence-based practice (EBP), and ________ to improve practice.
Knowledge translation
96
The most common Continuous Quality Improvement method is...
**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.
97
The National Strategy for Quality Improvement in Health Care established 3 overarching aims, including...
1. Better Care
2. Healthy People/Healthy Communities
3. Affordable Care
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...
1. the patient experience
2. improve the health of populations
3. reduce the cost of health care concurrently
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?
1. Measurement of **compliance with standards** (quality assurance)
2. **Continuous improvement of processes** to meet standards (performance improvement)
100
What is evidence-based practice?
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**.
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.*
Systemic review
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.*
Meta-analysis
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.*
Randomized controlled trial (RCT)
104
What type of study is described below?
*__________ studies with controls are quasi-experimental designs. This design is like an RCT, without the randomization.*
Two-group / nonrandomized studies
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.*
Ecological
106
What type of study is described below?
*________ studies and _________ studies are two types of observational studies that aid in evaluating associations between variables.*
Cohort, Case Control
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.*
Pretest/posttest
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.*
Case series
109
What is the "research-practice gap"?
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
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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...
Standard 1: Knowledge
Standard 2: Professional reasoning
Standard 3: Interpersonal skills
Standard 4: Performance skills
Standard 5: Ethical practice
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What are NBCOT's continuing education requirements?
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.
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True or false: Occupational therapy practitioners can assess their skills and develop a professional development plan.
**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.
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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.
**FALSE!**
It can occur in daily practice, professional, and/or systems levels.
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What did the Balanced Budget Act of 1997 do?
Resulted in **changes to the reimbursement of occupational therapy** and related services under **Medicare**
