OT Process Flashcards
What makes up the OT Process?
- Evaluation
- Intervention
- Outcome
Clients who receive OT services
- Individual Persons
- Caregivers
- Groups
- Population
Individual
Evaluation Process
- Consultation/Screening
- Occupational Profile
- Analysis of Occupational Performance
- Synthesis of Eval Process
Individual Eval
Consultation/Screening
- Review client hx
- Consult with interprofessional team
- Administer Standardized screening tools
Individual Eval
Occupational Profile
Interview Client/cargeiver
Individual Eval
Analysis of Occupational Performance
- Assess occupational performance
- Conduct occupational and activity analysis
- Assess context
- Assess perofrmance skills and patterns
- Assess client factors
Individual Eval
Synthesis of Eval Process
Review and consolidate info to select occupational outcomes and determine impact of performance patterns and client factors on occupation
Group
Eval Process
- Consultation & Screening, Environment Scan
- Occupational Profile
- Analysis of Occupational Performance
- Synthesis of Eval Process
Group Eval
Consult & Screening, Environmental Scan
- Identify collective need from available data
- For each person in group (review hx, admin screening tool, consult interprofessional team)
Group Eval
Occupational Profile
Interview individuals that make up group engage with persons in the group to determine their needs, interests, and priorities
Group Eval
Analysis of Occupational Performance
- Conduct occupational and activity analysis
- Assess group context
- for each individual (assess occupational performance, performance skills and patterns, client factors)
- Analyze impact of individual performance on the group
Group Eval
Synthesis of Eval Process
- Review and consolidate info to select collective occupational outcomes
- Review and consolidate info for each memeber perforamnce and its impact on the group and the groups occupational performance as a whole
Population
Eval Process
- Environmental Scan, Trand Analysis, Preplanning
- Needs Assessment, Community Profile
- Needs Assessment, Review of Secondary Data
- Data Analysis & Interpretation
Population Eval
Environmental Scan, Trend Analysis, Preplanning
- Collect data to inform design of intervention program by identifying info needs
- Identify health trends in targeted population and potential positive and negative impacts on occupational performance
Population Eval
Needs Assessment, Community Profile
- Engage with persons within the population to determin their interests and needs and opportunities for collab
- Identify priorities through surverys, interviews, and group discussion or forums
Populaiton Eval
Needs Assessment, Review of Secondary Data
Evaluate existing quantitative data (public health record, prevalence of disease or disability, demographic data, economic data)
Individual
Intervention Process
- Development of Intervention Plan
- Intervention Implementation
- Intervention Review
Group
Intervention Process
- Development of Intervention Plan/Program
- Intervention/Program Implementation
- Intervention Review/Program Eval
Population
Intervention Process
- Program Planning
- Program Implementation
- Program Eval
Individual/Group Outcome Process
- Outcomes
- Transition
- Discontinuation
Population Outcome Process
- Outcomes
- Sustainability Plan
- Dissemination Plan
Overview
Evaluation
- Process of gathering and interpreting data to understand the person, system or situation.
- Requires synthesis of all data gathered, analytic interpretation, reflective clinical reasoning, and consideration of occupational performance and contextual factors
What is the general process of an evaluation?
- Occupational Profile
- Analysis of occupational performance
What is the difference between using “top-down” approach vs “bottom-up” approach when using assessments during an evaluation?
- Top-down: considers the clients occupations first
- Bottom-up: focuses on clients factors and performance skills
Evaluation Assessments
Considerations for determining which assessment tool will be the most effective
- PLOF & major concerns and pressing needs
- Environmental context the eval is completed
- Environmental context of the client current and expected environment
- Temporal contexts of the client and their condition/disability
- Eval tool compatibility within the FOR to help guide intervetnion planning
Ethical Considerations for the Selection and Use of OT Assessments
OTR Competencies
- Determine assessment focus based on the needs and goals of the client
- select, admin, and interpret results using established eval guideline
- complete standardized assessments according to protocols
- supervise other OT personnel in their collections of assessment data
- ensure all delegated assessment tasks are completed in a competent manner
- document the assessment in a manner that accurately describes its procedures and outcomes
Ethical Considerations for the Selection and Use of OT Assessments
OTA Competencies
- Complete the assessment data collection that they are responsible to perform
- Determine that their training and supervision is adequate to carry out assigned assessment procedures
- Report the assessment data in an accurate manner
- Contribute to the eval process
Ethical Considerations for the Selection and Use of OT Assessments
Client/Consumer & caregiver/guardian vested interests
OTR must ensure that the person being assessed & their caregiver/guardian:
* Have provided input about their needs and goals to inform the assessment process
* have been fully informed about the purposes and administrative procedures of an assessment
* understand how the assessment results will be used to inform intervention
* have been provided the opportunity to decide if the assessment shoul dbe administered
* Know the assessment wil be billed
Who can request an OTR referral?
Anyone
OTR Screening
- Determine need for eval
- usually brief
- chart review, checklist, structured observations in BADLs, brief interview
Role of OTA/COTA during Referral & Screening
- Can admin screening tools under the supervision of OTR
- any data collected by be analyzed by OTR
What is the purpose of gathering information in evaluation?
To understand clients’ capabilities and limitations for occupational performance and participation.
What is an occupational profile?
A tool used to gather information about a client’s occupational history and experiences.
What does analysis of occupational performance involve?
Interpreting data related to how clients perform in their daily activities.
What role do assessments play in evaluation?
They are used to understand clients’ capabilities and limitations.
What is intervention planning based on?
Analysis of evaluation results and relevant frame of reference/models & Evidence-Based Practice (EBP).
Why is collaboration important in intervention planning?
Collaboration with individuals, family members, and caregivers is essential to establish a relevant, meaningful plan.
What should an intervention plan be?
An intervention plan should be relevant and meaningful.
Prioritization of concerns to be addressed in intervention
- concrete and specific concerns are more likely to be effectively resolved than abstract global ones
- the values, interests, needs of the individual, family, caregivers
- individuals CLOF and expected roles and environment
- Tx setting characteristics, resources and limitations (LOS)
- likelihood that the person concerns can be addressed by the intervention provided in the given setting
Parts of Intervention planning
- STG/LTG
- Intervention Methods
- Duration, freq, number/type of intervention
- Recs
Intervention methods
- Meaningful occupations
- Purposeful activities
- clearly related to goals
- HEP/Education/training
- AE, AT, orthotics, prosthetics, DME, environmental mods
OT Principle
Occupations and activities act as a therapeutic change agent to remediate/restore
People have the potential to improve performance skills, patterns (habits/rituals/routines), and bod fxn
ex. A homemaker who has impairments and probs in motor skills resulting from a stroke benefits more from working in the actual occupation of preparing meals in conjunction with exercises to increase her ROM, muscle strength, and coordination as opposed to solely using exercise equip. And objects stimulating the motor actions of the activity
Assessments are administered according to their protocols, which are?
- Standard precautions must be observed during all evals
- An interpreter must be used when there is a language barrier
- results are scored/rated according to guidelines/protocols
- info gathered is used to identify strengths and weaknesses in occupational performance and participation
Ethical Considerations for the Selection and Use of OT Assessments
Employer and Inter-disciplinary team members vested interests
The OTR must ensure that:
* Assessment is consistent with the mission of the setting and helps attain desired outcomes
* Assessment findings, interpretation, and recommendations are effectively communicated to team members and meaningfully contribute to an inter-disciplinary intervention plan
Ethical Considerations for the Selection and Use of OT Assessments
Payer Vested Interest
OTR must ensure that:
* Assessment is a necessary and billable servie that is accurately documented for reimbursement
* If there is no 3rd party reimbursement, the perosn being assessed know this and has given consent before the completion of an assessment
* payment is requested only for the services provided
Ethical Considerations for the Selection and Use of OT Assessments
Professional Standards
OTR must ensure that:
* Selected assessments are evidence-based (to the extent possible) and within the OTR SOP
* Specific training and/or specialized credentials required to use an assessment have been completed by the assessments administrator
* Permission to use copyrighted assessments has been obtained, fees to use an assessment have been paid, and assessment use complies with the law regulating their use
* The assessment doesn no hinder the fiar and equitable distribution of OT services to all persons in a setting needing OT services
What does an evaluation identify for the client?
problems that are prioritized to help develop intervention/program planning
Eval findings are documented and communicated to who?
- Client
- Team members
- 3rd party payers
