What is occupational therapy's role in transitions to prevent hospital readmissions?
Answer
One of them is definitely making sure that medications are reconciled. Typically, nursing would do this when someone is leaving an institution. However, when you are looking at medications being reconciled, you also have to think about whether they can open the container, do they know what times to take it, do they know if they need to take the medication before or after eating? When they are in the hospital their routine, habits, and roles have been changed. This is a great opportunity for occupational therapists to take a leadership role in helping people lay out a plan for their first week home. Do not forget to incorporate different things like a change in medication or diet. For example, if someone has CHF and has to weigh themselves, this needs to be incorporated into their daily routine.
Other things are home exercise programs or home activity programs. We need to help them incorporate this into a daily routine. We can also work with the patient before they leave the acute care hospital or whatever setting to identify risk factors and also incorporate this into caregiver training. Do you have the key information in a personal health record? There are many of these that are available online that could be used. Are you educating in a manner in which the patients and families understand? What happens if there is going to be a change in caregivers? Have you created a backup plan for caregivers and caregiver education so there is continuity and no break in care.
Marla R. Robinson, MSc, OTR/L, BCPR, BT-C, FAOTA
Marla Robinson is the assistant director of inpatient therapy at the University of Chicago Medical Center. She oversees the day-to-day operations for inpatient acute pediatric and adult acute care hospitals. Her clinical work is with pediatric and adult acute care burn rehabilitation. She has research interests in burn rehabilitation. She served on the development committee for the Burn Therapist Certification for the American Burn Association and was part of the first cohort of Burn Therapists-Certified. Marla has served on the Illinois Occupational Therapy Licensure Board as chair and as co-chair of the Chicago Area Council of OT Directors. Marla has served AOTA in many capacities. She served on the AOTA Board for Advanced and Specialty Certification as a member and chair, Chair of the Commission of Continuing Competence and Professional Development, AOTA representative for National Quality Forum for Patient-Reported Outcomes, AOTA representative for the Joint Commission Professional Technical Advisory Committee for Hospitals, AOTA representative for Society of Critical Care Medicine Task Force Long Term Consequences of PICs, Fellowship Site Reviewer, Chair of the Taskforce on Mentoring and as co-chair of the Chicago Area Council of OT Directors.
Marla speaks nationally on burn rehabilitation and OTs role in preventing hospital readmissions. She is passionate about continuing competence and ongoing professional development for occupational therapy practitioners. She has authored book chapters on continuing competence, leading and managing in healthcare systems, and acute care management of gastrointestinal issues.
Pamela Roberts, PhD, MSHA, OTR/L, SCFES, FAOTA, CPHQ, FNAP, FACRM is the Executive Director in the Office of the Chief Medical Officer and Professor and Executive Director of Physical Medicine and Rehabilitation at Cedars‐Sinai. She is also Sr Director of Quality, Outcomes, and Research at California Rehabilitation Institute. Dr. Roberts works in interprofessional roles involving operations, quality, education, and research. In these roles, she systematically impacts patient care throughout the continuum. She is the co‐director of the Division of Informatics in the Department of Biomedical Sciences and co‐director of the Clinical Informatics Fellowship program. In these endeavors, she seeks to advance the development and use of information technology for discovery, education, decision‐making, research, health care delivery and individual academic growth, as well as to catalyze inquiry and discovery across the Cedars‐Sinai enterprise. She also teaches at the University of Southern California and guest lectures at other local universities. She is involved in the National Quality Forum (NQF) in facilitating development of quality measures and All‐Cause Admissions and Readmissions Steering Committee. Other involvement includes: American Congress of Rehabilitation Medicine as President, Past Chair of the Program Committee and Past‐Chair of the Stroke Interdisciplinary Special Interest Group, American Occupational Therapy Association, American Council of Occupational Therapy Education ACOTE chair, past chair of the California Hospital Association Center for Medical Rehabilitation Services, and past member of the California Hospital Association Board of Trustees and Post‐ Acute Care board. Dr. Roberts has served as principal and co‐investigator on a variety of interprofessional research projects and has provided a variety of workshops and consultations on rehabilitation, quality management, informatics, and health services research topics regionally, nationally, and internationally. Further, her published research focuses on the utilization of large data to influence treatment models and outcomes.
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