Week 6 Flashcards
The Evidence-Based Management Process
Step 1: Frame a question related to a decision that has to be made.
Step 2: Acquire evidence that may contain information relevant to the question.
Step 3: Assess the evidence for accuracy, comprehensiveness, applicability, and actionability.
Step 4: Present and weigh the evidence.
Step 5: Apply the evidence to the decision.
Step 6: Evaluate the results
Classifying Levels of Evidence from
Strongest to Weakest
-IA = Systematic review of homogeneous RCTs (similar population, intervention, etc.) with or
without meta-analysis
-IB = Well-designed individual RCT (not a pilot or feasibility study with a small sample size)
-IIA = Systematic review of cohort studies
-II B = Individual prospective cohort study, small lower-quality RCT (e.g., fewer than 30 participants per group; pilot and feasibility studies); ecological studies; and two-group,
nonrandomized studies
-IIIA = Systematic review of case-control studies
-IIIB = Individual retrospective case-control study; one-group, nonrandomized pre-/post-
test study; cohort studies
-IV = Case series (and low-quality cohort and case-control study)
-V = Expert opinion without explicit critical appraisal
The 10 emerging practice areas for 21st century
- Ergonomic consulting
- Driver Rehab & training
- Home Modification
- Low Vision
- Community Private Practice
- Assistive Device Development
- Welfare to Work
- Health & Wellness Consulting
- Ticket to work services
- Psychosocial needs of children & youth
Intrapreneurship
- Harnessing the resources within an
organization to develop, improve, promote, extend, or enhance a new existing program
Ex. Adding a driver rehab program to an OT department in a hospital
Corporate Infusion
- The introduction of new services or
programs from outside a business in an effort to make them permanent features of a corporate entity.
*Ex. Ergonomic consultation in a manufacturing plant or injury prevention program on work sites
Organizational Infusion
- Services or programs infused into not for profit or government agency.
- Same concept as corporate infusion but different business setting
- Ex. ADL skill training to homeless shelters or adapting leisure activities for disabled in community recreational programs
Policy Infusion
- Social action strategy: to mandate the provision of certain services or programs in designated
organizations and sites through legislative or policy actions - Example: IDEA (Individuals & Disabilities Education Act)
Types of Entrepreneurships:
AGENCY
- Agency: Contracted Direct Service
Therapists work with patients, clients, students, or residents as an independent contractor - Provides allotted hours or visits
- bills for their services
- gets paid by the hour or visit
- Most therapists pursue this type of entrepreneurship.
- Not be supervised or told how to carry our their tasks by any client or agency
Types of Entrepreneurships:
Client – Paid Direct Service
- This is the classic form of private practice. Therapists market their services to private payers or insurance companies.
- The patient or client receives the therapy
- The insurance company or Medicare, Medicaid, or
Workers Comp pays therapist - The therapist must be networking to continuously get referrals.
- The therapist can partner with other therapists to get more referrals.
- Easy to have a flexible schedule.
Types of Entrepreneurships:
Ownership & Management of Multitherapist Service Business
- Be able to manage staff
- Find open jobs to keep business going
- Have therapists to provide services
- Ensure clients that high quality therapists are available
- Deal with business issues:
- Marketing
- Contracts
- Labor Laws
- Liability
- Tax Issues
Types of Entrepreneurships:
Consultation
- Using OT skills as knowledge base to advise others
- Provide ergonomic consulting for manufacturers
- Consulting with teachers in the schools
- Easy, flexible schedule
- But, there is usually a lot of prep time needed
Types of Entrepreneurships:
Product Development
- OTs can market skills to manufacturers on low and high tech devices
- Assist with training in durable medical equipment.
- Sales and product development for splinting materials/products
Types of Entrepreneurships:
Educational Seminars
- As an expert in a specific area, or
researched a topic extensively, you can teach others about this topic for a fee - All therapists need continuing education credits, so a speaker can train others for a fee to help develop clinical expertise.
- OTs can also provide seminars for the community
Types of Entrepreneurships:
Private Practice Settings
-Pediatric practices, sensory gyms
-Autism after school, play environmental clubs
-Hand therapy centers
-Working with Domestic Violence Centers (teaching women to manage $$$, make decisions, solve problems etc..)
-Working in prisons (preparing for discharge)
Competencies Needed for Emerging
Practice Areas
Knowledge
Critical Reasoning
Interpersonal Abilities
Performance Skills
Ethical Reasoning
Traits, Qualities, & Characteristics,
of Individual
Four Strategies are needed by managers to develop emerging practices:
- Identify Opportunities
* Brainstorming to formulate an idea, or talking with peers about a niche area where a need may be uncovered - Strategic Planning
* After a niche has been identified and the idea is viable, you need to plan how to proceed (set goals, organization type, evaluation) - Garnering Resources
* Finances, donations, grants, loans, venture capitalists, etc - Establishing Partnerships
* Establish a group for mutual cooperation and responsibility
Precede-Proceed Model of Program Development
- process of assessment and planning before a program is put in
place = PRECEDE - the implementation of the program = PROCEED
- Purpose – help understand complexity of a health problem AND
provide focus in addressing the targeted need (has several phases) - The best method for OTs to use to develop a new program or business.
- Predisposing
- Reinforcing
- Enabling
- Constructs in
- Education
- Diagnosis and
- Evaluation
+ - Policy
- Regulatory
- Organizational
- Constructs in
- Educational and
- Environmental
- Development
PHASE 1 of Precede Proceed Model
Social Assessment and situational
analysis
* Identifies a need or
problem that relates to the
health in a community, or
quality of life, or social
factor affecting a health
problem.
Phase 2 of Precede Proceed Model
Epidemiological Assessment
* focuses on the extent of
health problems in the
community.
* Who is affected in the
community?
* How extensively does the
health problem affect
community?
Phase 3 of Precede Proceed Model
Behavioral and Environmental
Assessment
* Risk factors identified related
to behavioral and
environmental risk factors
* Behavioral risk factors :
people
* Environmental risk factors:
conditions that surround them
Phase 4 of Precede Proceed Model
Educational and Ecological
Assessment
* What approaches work best to
promote behavior changes:
* Predisposing factors
* Attitudes, beliefs, values,
perceptions
* Enabling factors
* Skills, resources, barriers that
exist that facilitate or limit
behavior
* Reinforcing factors
* Rewards to give for getting
particular behavior
Phase 5 of Precede Proceed Model
Administration and Policy
Assessment
* Exploration of supports and
infrastructure needed to make
program a success
* Supports and infrastructure: Funding, Established policies &
procedures, Community involvement
* Focus of Phase 5 is budget, space,
timeline, personnel
* Practical, detailed
Phase 6 of Precede Proceed Model
Implementation
* Program implementation
* Oversee processes and
procedures developed in
Phase 5
* Maintain records to ensure
that financials and program
outcomes are appropriate
and accurately documented
Phase 7, 8, 9 of Precede Proceed Model
Program Evaluation
* 7- Process evaluation
* Was program implemented as
planned?
* Did it do what the goals stated?
* 8- impact evaluation
* Short term impact or change
made by the program
* Changes in knowledge about
health problems?
* 9- Outcome evaluation
* Long term impact of the program
* Did the program actually change
behaviors?
* Impact on the community