Unit 8: Intervention Process and Outcomes Flashcards

1
Q

The intervention phase of the OT Process

A
  • Where a lot of the action happens.
  • The OT practitioner takes information gathered during the evaluation phase, collaborates with the client, and delivers the occupation-centered intervention to allow the client to reach their goals.
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2
Q

Components of the Intervention Process include…

A
  1. Intervention Plan (aka the treatment plan or plan of care (POC)
  2. Intervention Implementation
  3. Intervention Review
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3
Q

The Intervention Plan

A

(aka the treatment plan or plan of care (POC)

  • Developed collaboratively and balances the clients needs and goals, client well-being, the context of service delivery, evidence-based practices, activity demands, and performance abilities of the client.
  • The intervention plan guides actions taken and is based on evidence, theory, and frames of reference.
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4
Q

When is the intervention plan developed?

A

After the evaluation plan to help direct the occupational therapy approach and determine what type of intervention might assist the client in meeting their desired outcomes.

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5
Q

The steps of the intervention plan include

A
  • Developing a plan based on measurable goals
  • Using a variety of intervention approaches and types of interventions
  • Considering the discharge needs of the client
  • Making recommendations for outside professionals to participate in the client’s care.
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6
Q

The intervention plan is a client-centered process and takes into account many factors, including the client’s…

A

-Goals
-Values
-Health
-Performance skills and patterns
-Surrounding context and environment
(This is where you can see how the domain portion of the OT interacts with the process of OT.)

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7
Q

Consult the Literature (intervention plan)

A

Important for the therapist to consult the literature and ensure that the intervention being provided is evidence based and a best practice.

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8
Q

Make Goals and Determine an Intervention Time Frame (intervention plan)

A
  • Goals are made in conjunction with determining a relevant time frame for intervention.
  • At this time, outcome measures may also be selected to help measure progress toward goals.
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9
Q

Define Intervention Approaches and Service Delivery Models (intervention plan)

A

During this time, intervention approaches are defined and service delivery models, including who is to deliver the services, are also determined.

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10
Q

Synthesize Information into Plan and Determine Discharge Needs (intervention plan)

A
  • All of this information is synthesized into the plan, while also attending to the discharge needs and forecast.
  • No matter what the time frame is, an OT is always thinking about what the end goal and discharge plan are for the client.
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11
Q

Make Recommendations/Referrals to Other Professionals (intervention plan)

A

It is also in this time frame that an OT might make recommendations to other professionals, such as a physical therapist, speech therapist, social worker, or others, to meet the client’s needs.

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12
Q

To examine the approaches for intervention more carefully, please review Table 13, Approaches to Intervention, of the OTPF-4. (1 of 2)

A

These approaches are specific strategies that direct the process of OT and help inform practice models, frames of reference, and/or treatment theories.

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13
Q

To examine the approaches for intervention more carefully, please review Table 13, Approaches to Intervention, of the OTPF-4. (2 of 2)

A

These approaches are specific strategies that direct the process of OT and help inform practice models, frames of reference, and/or treatment theories.

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14
Q

Create, Promote, Health Promotion (intervention plan approach)

A
  • Assumed disability will not interfere with performance

- Provides enriched activity experience that enchance performance for all persons

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15
Q

Establish Restore, Remediation (intervention plan approach)

A

Changes client variables to establish a new skill or restore an impaired skill

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16
Q

Maintain (intervention plan approach)

A

Allows a client to preserve performance capacities

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17
Q

Modify, Compensation, Adapting (intervention plan approach)

A

Focuses on revising a context or activity

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18
Q

Prevent, Disability Prevention (intervention plan approach)

A
  • Clients with or without disabiity

- Prevents occurence in cluents that are at risk for performance problems

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19
Q

Intervention implementation

A

Occurs after intervention planning

  • The process of putting the plan into action with the client to address aspects of the domain that limit the clients participation in occupations.
  • Ongoing actions are taken by a therapist to influence and support client performance. Interventions are selected to target identified outcomes.
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20
Q

It is important to remember that even though you are in “Step 2,” you, as the therapist, are…

A

Constantly revising intervention planning as well as evaluating/reevaluating the client as they work toward their intended outcomes.

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21
Q

Parts of the intervention implementation include…

A

Selecting appropriate interventions and monitoring the client’s response to interventions.

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22
Q

During implementation, the therapist is determining what Type of Intervention they want to deliver. Table 12, Types of Occupational Therapy Interventions, of the OTPF-4 details a fairly inclusive list of interventions that fall under our scope of practice. (1 of 4)

A
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23
Q

During implementation, the therapist is determining what Type of Intervention they want to deliver. Table 12, Types of Occupational Therapy Interventions, of the OTPF-4 details a fairly inclusive list of interventions that fall under our scope of practice. (2 of 4)

A
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24
Q

During implementation, the therapist is determining what Type of Intervention they want to deliver. Table 12, Types of Occupational Therapy Interventions, of the OTPF-4 details a fairly inclusive list of interventions that fall under our scope of practice. (3 of 4)

A
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25
Q

During implementation, the therapist is determining what Type of Intervention they want to deliver. Table 12, Types of Occupational Therapy Interventions, of the OTPF-4 details a fairly inclusive list of interventions that fall under our scope of practice. (4 of 4)

A
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26
Q

The six main types of OT intervention are:

A
  1. Occupations and Activities
  2. Interventions to Support Occupations
  3. Education and Training
  4. Advocacy
  5. Group Interventions
  6. Virtual Interventions
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27
Q

Client makes a meal using adaptive device (intervention)

A

Occupation and Activities

28
Q

OT applies a heat pack to decrease pain and joint stiffness (intervention)

A

Interventions to Support Occupations

29
Q

OT provides instruction to a caregiver on how to protect their back during transfers (intervention)

A

Education

30
Q

OT advocates to and collaborates with local school board to get a handicap accessible playground swing for their students (intervention)

A

Advocacy

31
Q

A communication skills group on an adolescent psychiatric unit (intervention)

A

Group Interventions

32
Q

OT provides a telehealth session with a child and parent who is unable to travel to outpatient clinic (intervention)

A

Virtual Interventions

33
Q

Intervention Review

A
  • Necessary to ensure the intervention plan is consistent and appropriate for the client’s dynamic and changing needs.
  • The therapist reviews the intervention plan as well as any progress being made toward the identified outcomes.
  • This is part of the continuous re-evaluation process that occurs throughout therapy.
34
Q

Determine Need for Continuation/ Discontinuation of Services (intervention review)

A
  • It is important for an OT to be able to modify their plan and intervention in a quick and efficient manner in order to meet the ongoing needs of the client.
  • The therapist also needs to determine if there is continued need for skilled OT intervention.
  • It can often be difficult to determine if it is time for discharge from services. This can be made easier by ensuring the therapist is choosing relevant outcome measures and writing strong, efficient, client-centered goals.
  • It is also at this stage that a therapist can reassess whether there is a need for referral to another professional or set of services.
35
Q

The Outcomes phase of the OT Process

A

Involves establishing outcomes and measures that directly relate to the clients needs and interventions provided.

  • They are selected early in the process and should align with the clients goals.
  • Outcomes assessment is not left for just the discharge phase of therapy but should occur continuously throughout the OT process.
36
Q

Outcomes

A

The end result of the OT process. The outcome is the description of what a client is expected to achieve through a skilled OT intervention.

37
Q

Steps in the Outcome Process

A

Implementation of the outcome process has two definitive steps.

  1. Select the Outcome Measures Needed for Client’s Goals
  2. Determine Progress, Adjust Goals and Interventions, and Modify Discharge Plans
38
Q
  1. Select the Outcome Measures Needed for Client’s Goals (outcome process steps)
A

The clinician selects the outcome measures in terms of what is needed for the client’s goals—targeted outcomes as well as what measure might be sensitive and valid for the situation in which it is being used.

39
Q
  1. Determine Progress, Adjust Goals and Interventions, and Modify Discharge Plans (outcome process steps)
A

The therapist uses those outcome measures to look at progress, to adjust goals and interventions, and to modify any plans for discharge.

40
Q

The outcomes of the occupational therapy process are:

A
  1. Occupational Performance
  2. Improvement
  3. Enhancement
  4. Prevention
  5. Health and Wellness
  6. Quality of Life
  7. Participation
  8. Role Competence
  9. Well-being
  10. Occupational Justice
41
Q

Table 14 in the OTPF-4, details the desired treatment outcomes of the occupational therapy process (1 of 4)

A
42
Q

Table 14 in the OTPF-4 details the desired treatment outcomes of the occupational therapy process (2 of 4)

A
43
Q

Table 14 in the OTPF-4 details the desired treatment outcomes of the occupational therapy process (3 of 4)

A
44
Q

Table 14 in the OTPF-4 details the desired treatment outcomes of the occupational therapy process (4 of 4)

A
45
Q

Outcomes can be defined in two different ways:

A
  1. Some outcomes can be measured and directly reflected in attainment of the established, concrete treatment goals.
  2. Other outcomes are more experiential and impact how the client engages in occupation as well as how they engage in their habits, roles, routines, and rituals.
46
Q

Act of doing and accomplishing a selected action, activity, or occupation through improvement or enhancement (outcomes)

A

Occuaptional Performance

47
Q

Increased occupational performance through adaptation when a performance limitation is present (outcomes)

A

Improvement

48
Q

Development of performance skills and performance patterns that augment existing performance of life occupations when a performance limitation is not present (outcomes)

A

Enhancement

49
Q

Efforts designed to identify, reduce, or prevent onset or incidence of unhealthy conditions (outcomes)

A

Prevention

50
Q

A state of physical, mental, and social well-being; providing resources for everyday life (outcomes)

A

Health and Wellness

51
Q

Life satisfaction, hope, self-concept, health and functioning (outcomes)

A

Quality of life

52
Q

Engagement in occupations that are personally satisfying and congruent with cultural expectations (outcomes)

A

Participation

53
Q

Ability to meet demands of roles a client engages in (outcomes)

A

Role Competence

54
Q

Contentment with ones health, self-esteem, and roles; the total universe of human life domains (outcomes)

A

Well-being

55
Q

Access to and participation in the full range of meaningful and enriching occupations that are afforded to others (outcomes)

A

Occupational Justice

56
Q

“Occupation as means and occupation as end”

A

This is how we can think about intervention and the goals that we’re working toward.

57
Q

“Occupation as Means”

A
  • Suggests that we should be using occupation in our interventions to help clients work toward their goals.
  • So if we have a particular goal in mind, what we’re doing is we’re using the things that are meaningful to the clients and the natural full occupations as they might be performing them in day to day life in working toward that particular goal.
58
Q

“Occupation as End”

A
  • Suggests that the goals should be occupation-based, but it doesn’t necessarily tell us how we would get to those goals.
  • So when we think about occupation as end, this is where we might end up using preparatory tasks or activities, preparatory methods, other types of intervention, to reach those particular goals.
59
Q

The goals themselves are always…

A
  • The client’s occupations and what they need and want to be able to do in day-to-day life.
  • One of the ways that we might think about this is to take a look at a particular client’s experiences and what interventions might be involved.
    (ex. ulnar nerve damage and limited supination and pronation. OT, identified the goals of treatment were to be able to do things in day-to-day life that required supination and pronation like playing the piano bc client had been taking lessons for about 10 years and wanted to be able to get back to that)
60
Q

All of our goals should be

A

Occupation-based, and then we want to aim for as much occupation in intervention as possible as well.

  • Keep in mind, intervention is really a process where you’re developing theories along the way and then testing those out.
    (ex. might start with, “Well, let’s use piano as part of treatment.” And then you’re observing, you’re watching, you’re seeing how that works)
61
Q

If there’s any challenges when testing out interventions, the OT should look at…

A

If the client motivated by that, and you’re changing up your intervention depending on that process.

  • So you might always keep the goal in mind, but switch between preparatory tasks, preparatory methods, activities, occupations, with the idea that we’re testing this out or seeing, well, I think that this certain type of intervention will be more effective here, or I think that what’s going on is something biomechanical.
  • So we’re going to use this type of intervention. And if that seems not to be working, maybe we’re going back and saying, “Was my theory correct? Is there something else going on that I’m missing here?” And going through that process of testing things out, using your observation skills, re-evaluating as you need to, always working then toward occupation as end.
62
Q

Multiple factors impact intervention and outcomes including…

A
  • The individual client, setting, and context and environment.
  • You must be able to develop evidence-based, theory-driven, client-centered approaches to intervention and outcomes for each client.
63
Q

Evaluation is an…

A

Ongoing process and is present throughout the intervention and outcome portion of the OT process

64
Q

OTPF Intervention and Outcomes Sections

A
65
Q

Determine Need for Continuation/ Discontinuation of Services (intervention review)

A
  • It is important for an OT to be able to modify their plan and intervention in a quick and efficient manner in order to meet the ongoing needs of the client.
  • The therapist also needs to determine if there is continued need for skilled OT intervention.
  • It can often be difficult to determine if it is time for discharge from services. This can be made easier by ensuring the therapist is choosing relevant outcome measures and writing strong, efficient, client-centered goals.
  • It is also at this stage that a therapist can reassess whether there is a need for referral to another professional or set of services.
66
Q

Outcomes can be defined in two different ways:

A
  1. Some outcomes can be measured and directly reflected in attainment of the established, concrete treatment goals.
  2. Other outcomes are more experiential and impact how the client engages in occupation as well as how they engage in their habits, roles, routines, and rituals.