Service Delivery Flashcards

1
Q

Medical Model

A

Views pt as a pt who has incurred a physiological insult that has resulted in reduced fx’al capacity. Focus on ID disease or dysfun, tx addresses what is affectig fx’al skills, OT FORs address pathological process of disease/dysfun

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2
Q

Edu Model

A

Views pt as lacking knowledge or skills. Focus is placed on learning/making behavioral changes needed to interact successfully in environment. OT FORs based on learning theories to facilitate environmental adaptation

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3
Q

Community Model

A

Views pt as lacking skills, resources and supports for comm participation. Focus is placed on ID & developing skills needed for one’s expected environment & if skills cannot be developed comm resources/supports are ID’ed and developed to enable fx’ing w/in ones chosen enviornment. OT FOR promo development of performance skills and/or areas of occ w/in performance context

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4
Q

Telehealth Model

A

Service delivery model which can include features of above models by providing med/rehab/edu services to person via telecom techs

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5
Q

Acute Care

A

Admis for medical/psych dx that cannot be tx outpt. Initial onset of illness/major health prob, acute exacerbation, or invol admin w psych if danger to self or others. LOS can be lim 1-7days, ongoing care freq results in d/c to diff setting. OT eval: focus on quick/accurate screening on major diffs impeding fx. OT tx: stabilization of status, engagement in meaningful acts/occs, d/c plan & after referrals & pt/fam edu. OT role can be general or specialized

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6
Q

Subacute/Intermediate Care Facilities (ICFs)

A

Admis for medical/psych dx has progressed from acute but not ready for outpt. LOS: 5-30days. OT eval: more in depth assessments/observations. OT tx: fx’al improvements in performance skills/areas of occ & active engagement of pt in tx planning, implementation & re-eval & d/c process. Can be housed in hospitals or SNFs

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7
Q

Long-term Acute Care (LTAC) Hospitals

A

Admis is for chronic/catastrophic illness or disability that req extensive medical care and/or dependency of life support/vents (often multiple dx/complications). LOS: 25days+ to maintain Medicare cert. OT eval/tx: often lim by severe & complex medical needs - concerned w palliative care and prevention of complications

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8
Q

Rehabs

A

Admis for disability thats medically stable but which has residual fx’al deficits req skilled rehab services. LOS can range from 1wk-months. LOS ends when coverage expended & then pt is d/c’ed to appropriate setting. OT eval: can be extensive/focus on all performance skills & patterns, ares of occ and occ roles req. OT tx: fx’al improvement in performance, dev of compensatory strategies, provision of AE, environmental mod, pt/fam edu.

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9
Q

LT Hospitals

A

Admin for chronic med/psych dx with symptoms present tht cannot be tx outpt. LOS: month-yrs. OT eval: extensive; OT tx: fx’al improvement in performance, dev of compensatory techs, maintenance of Q of L, development of skills for d/c

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10
Q

SNF/Extended Care Facilities (ECFs)

A

Admis for med/psych dx that is chonic and req skilled care but not acute symptoms. LOS: 1mo-lifetime. OT eval/tx is guided by medicare standards.

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11
Q

Forensic Settings

A

Admis d/t engagement in criminal activity: jail, prison or forensic psych hospital/unit. LOS: court-ordered. Services vary greatly from none in most jails to extensive in FPU. OT eval/tx focus: determine pt competency/restoration to stand trial, developing skills needed for community.

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12
Q

Outpt/Ambulatory Care

A

Does not req hosp but has fx’al deficits req eval/tx: private clinics, med offices & hosp satellite centers

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13
Q

Acceptance criteria for EI Eval

A

Based on “at risk” status of u3y/o. Birth comps, suspected delays in development, failure to thrive, maternal sub abuse, birth to adolescent mom, est disability/dx

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14
Q

Acceptance Criteria for EI Tx

A

Extend of develop delay (33% delay in 1 area and 25% in 2), est disability/dx

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15
Q

EI length of services

A

infant/child quals for services, an IFSP is completed by service coordinator after review of all assessments in collab w fam & EI team. 6mo revs are submitted by all professionals to determine if cont services are needed

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16
Q

EI OT Eval

A

Assessment of 5 dev areas: cog, phsy, comm, soc-emo & adaptive. Determination of effects of current dev level on occ areas of play & ADLs. Evals written in strengths oriented manner. Fx’al goals must be written in fam friendly terms & inc levels of fx’ing, unique needs & recommended services

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17
Q

EI OT Tx

A

Dev of cog/process, psychosoc/comm/interaction & sensorimotor skills. Dev of play/ADLs skills. Fam edu/advocacy & training & transition to school planning

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18
Q

School Setting OT Acceptance Criteria & LOS

A

Child req sped services & OT will enable child to benefit, OT will facilitate childs participation in edu acts & enhance fx’al performance, referrals received from EI agency, teach or school study team, school reviews referral and recomm OT eval - LOS is dependent on impact of services on childs abilities & prevention of loss of abilities (& make gains on IEP)

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19
Q

School Setting OT Eval

A

Assess pt factors, performance skills/patterns & areas of occ that impact edu/fx’al performance (findings contrib to IEP) & assess fx’al/dev level to contrib to fx’al behavioral analysis

20
Q

School Setting OT Tx

A

Edu model, addresses fx’al performance & academic, acts used to address goals/objectives doc’ed by IEP w corrective/compensatory methods, AT, increase participation w edu acts, increase ADL performance & play, & skills for post-school life

21
Q

Behavioral Intervention Plan

A

May be inc in school-based OT service provision. Inc: Response to Intervention (RtI), EI Services (EIS) & Pos Behavioral Supports (PBS)

22
Q

Prevoc Programs

A

Participant criteria: adolescents/adults who req tx to develop skills to get job- may have never developed or may have lost. LOS: is determined by agency funding/goal attainment. OT eval: focused on current skills & Tx: improve/development of skills and exploration of work interests

23
Q

Voc Programs

A

Dev of specific voc skills. Person has good pre-req skills but req training for specific job & has ability to further develop work capacities. LOS: determined by agency funds: Rehab workshops, Trans Employment Programs (TEP): 3-6mo, Employee Assist Progs (EAPs).

24
Q

Residential Programs

A

Admis for dev, medical, psych condition resulting in fx deficits that impede I living but are not acute enough to req hosp. On continuum from 24/7 supervision to bi-wkly check in. OT eval: focused on assessment of skills for living in community & determination of soc/environmental resources/supports. Tx: consultation/supervision of residential staff, remed of underlying skills/compensation, ADL training/adaption training, referrals & edu on ADA, fair housing and Sec 8.

25
Q

Partial Hosp/Day Hosp

A

Admis for med/psych condition that has been sufficiently stabilized w some symptoms that still req active tx. Tx can be up to 5x/wk w multiple tx scheduled during the day. LOS: 1wk-6mo. Eval: assess current skills/deficits & determine whats req for expected environments. Tx: fx’al improvement, remediation of underlying skills, development of skills

26
Q

Clubhouse Programs

A

Membership open to adults/elders w current MI or hx. All members have equal access to club fxs/opportunities regardless of dx. Only exclusion: sig/direct safety risk. Services provided by staff/mems. Staff main role is to engage/provide support. Individual sched to meet unique needs: open 5-7days/wk & daily sched is org-ed around “work-ordered” day w weekend/evenings for a-voc interests. LOS: indef & members can exit/re-enter at will. Eval/tx not formal.

27
Q

Adult Day Care

A

Admis for adults/elders w chronic phys/psych impairments and/or frail but semi-I. Services in group. Flex sched of attendance. LOS: indef. Eval: fx’al skills/deficits affecting home/care environment. Tx: maintain healthy, fx’al aspects of pt, engage in purposeful act, caregiver edu/support groups & environmental mods

28
Q

Outpt/Ambulatory care

A

Admis for med/psych condition that is not serious enough for hosp or stable w some symptoms. Tx usually provided short 30-60min/day up to 5x/wk. Eval: focused on fx’al assets/deficits/ Tx: active engage, remediation of underlying performance skills , fx’al improvements, compensatory strategies & pt/fam edu

29
Q

HHC

A

Acceptance Criteria: Presence of med/psych condition that is not serious enough to warrent hosp or stable but some symptoms present, reimburses can be very strict. Tx usually 60min/day up to 5x/wk. Eval: skills/defs across all environments. Tx: active engage of pt/fam, fx’al improvement, remediation, edu, environmental mods, increase ability to resume roles outside, prevention

30
Q

Hospice

A

Accept Criteria: term ill w life expect of 6mo or less. Services most often provided in home w type/quantity of services determined by pt/fam but can be hosp/SNF, LOS: determined by terminal outcome; eval: occ fx’ing for most important; tx: maintenance of control over life, engage in meaningful acts, reduction of pain, environmental/act mod & caregiver/fam edu.

31
Q

Case Mngt Programs (2 Focuses)

A

Clinical: provided individualized support/tx to pt w serious ill that sig affects fx’ing in community. Admin: connects person w serious ill to appropriate/needed comm services. Can be provided in office/home/comm. Tx can be purely referral based or encompass full range of tx

32
Q

Wellness/Prevention Program

A

Pt self-referallt to meet personal needs or institutional provision. LOS determined by individual - but influenced by program duration

33
Q

MBO

A

Mngt by Objective: complete system if mngt based upon core set of goals to be accomplished by program: mission/goals estab, measurable objectives quantified, specific time frames for accomplishments observed, staff training needs ID-ed & program eval instituted

34
Q

4 Basic Steps of Program Development

A

Needs assessment, program planning, program implementation & program development.

35
Q

Q’s that Violate ADA/Civil Rights Legislation when Interviewing

A

Age, sexual orientation, martial status, fam composition, race/national origin/religion/political views, disabilities of any kind

36
Q

Criteria for fair disciplinary action

A

Written doc of prob behaviors/expectations for improvement, referral to counseling and/or other services, clear/doc’d warnings, consequences that are impersonal, immediate and consistent & cont doc monitoring of employee behavior until reaches satisfactory performance

37
Q

Program Eval: Quality Improvement (QI)

A

system-oriented approach that views limits /probs proactively as opps to increase quality: prevention is emp and no blame attributed

38
Q

Total Quality Mngt (TQM)

A

Creation of org culture that enables all employees to contribute to an environment of cont improvement to meet/exceed consumer needs

39
Q

Performance Assessment and Improvement (PSI)

A

Systemic method to eval the appropriateness & quality of services. Interdis system/pt centered focus

40
Q

Goal Attainment Scaling (GAS)

A

Eval tool to attain pt goals for tx & measures goal attainment over specific time period.

41
Q

Utilization review

A

Rev use of resources in facility: determination of medical necessity/cost efficiency & often component of QI/ PAI

42
Q

Stat Utilization Review

A

reimbursment claims data analyzed to determine most most efficient/cost effective care.

43
Q

Professional Rev Org (PRO)

A

groups of peers who eval appropriateness of services & qual of care under reimbursement and/or state licensures.

44
Q

Prospective Rev

A

Eval of proposed tx plan that specifies how/why for care, used by 3rd party payers to approve proposed OT plans.

45
Q

Concurrent Rev

A

Eval of ongoing tx program during hosp/outpt/HHC - ensure appropriate care is being provided often component of QI/PAI

46
Q

Retrospective Rev

A

Audits of med records after tx were rendered - ensu. e appropriate care is being provided