Pediatric Occupational Therapy within a Medical Model Flashcards
Characterists and structures of children hospitals - insurance driven
■ Health care cost controlled by managed care organizations which can result in shorter hospital stays, provision of fewer services, or limited reimbursement for services provided
Characterists and structures of children hospitals - Governed by external private accrediting agencies and insurance providers
□ Governed by external private accrediting agencies and insurance providers
■ CMS, JCAHO, CARF, and OSHA set standards regarding hospital operations such as providing professional services, documenting progress, employee safety, and quality improvement
Hospital based services
□ Provide medical care to children with acute or chronic illness, traumatic injury, or special needs
□ Continuum of services
■ Intensive care
■ Acute care
■ Rehab units/pediatric rehabilitation
■ Outpatient care
NICU
OT in NICU setting- high risk & specialized practice
Appropriate for OTs with advanced knowledge & skills in neonatal care
Activity Analysis (Physical, social, sensory, biological, and psychosocial aspects).
Adaptation (modifications/compensatory strategies)
Family centered care
Preventative care
Co-occupation
Feeding
Positioning
Stretching/ROM
Environmental modification
Sensory Integration
Infant Massage
Parent Education/Consult
Medical model and setting
Medical team (ie doctor) recommends and prescribes focus, frequency, and duration of therapy. Third party (insurance carrier) may be the ultimate decision maker.
Therapy focuses on treatment to alleviate or cure specific underlying medical pathologies.
Assessments and outcomes take the child’s performance of all areas into consideration
Treatment settings usually include hospital, rehab center, outpatient clinic and home.
Education Model
Educational team uses educational, psychological and therapeutic evaluations, to determine focus frequency and duration of therapy based on the educationally-related needs of the student
Therapy focuses on intervention to improve the student’s ability to learn and function in the school environment.
Assessments and Outcomes must have a direct link to educational performance
Services are provided primarily on school grounds
what is the difference between medical model and educational model when it comes to ages
Medical model is all ages
education is up to 21y/o
What is the payment like for medical model?
Payment is on a fee-for-service basis, covered by private insurance, government assistance, or family.
What is payment like for educational model
Services are covered by the school district and provided at no cost to parents.
What is the documentation like in medical model?
Documentation of intervention is dictated by guidelines of the setting (JCAHO) and insurance requirements. Emphasis on medical terminology
What is the documentation like in educational model?
Documentation of intervention is based on IEP. Emphasis is placed on educational terminology
How does medical model see intereventions for mobility
Functional mobility crutch training for acute temporary sports injury
Fabrication of splints to maintain range of motion
Providing seating alternatives/durable medical equipment for the home environment (bath chair, shower chair, etc)
how does education model see mobility intervention
Gait training to decrease time student walks from classroom to bus
Fabrication of splints to enable students to participate in educational setting (ex writing, eating lunch etc)
Modifying seating or positioning on the bus and at school
Treatment team involved in medical model
MD
OT
PT
SLP
Parent/Caregiver
Child Life Specialist
Music Therapist
Art Therapist
Teacher
Neuro-psychologist
Psychologist
Social Worker
Case Manager
Provide services in a relatively brief period of time
Insurance driven managed care results in shortened hospital stays, and limited reimbursement for services provided
OTs need to be
highly efficient:
Thorough and streamlined evaluation process
Prioritize treatment goals
Consider discharge plans as part of the initial eval
