Evidence supports assessing occupational performance within the context of a familiar environment and highlights the potential for this to provide a holistic overview of an occupational being (Harris et al., 2008; Atwal et al., 2011 and Wales et al., 2012). The need for standardised checklists, assessments and policies governing DPHV practice was cited by a large number of participants, many reporting that this would improve practice, as it would establish clear guidelines regarding patient type suitable for a visit, “streamlining the criteria-having set criteria for who we do/do not do visits with”. (Patient with COPD and CHF). Content analysis was use to analyse qualitative data. Visit emeraldpublishing.com/platformupdate to discover the latest news and updates, Answers to the most commonly asked questions here. 27 No. Chibnall, C. (2011), “Area home assessments beneficial in discharge planning following stroke? Basic Rehab Admission Criteria Be able to tolerate 3 hours of therapy daily of 2 or 3 therapies; Occupational (ot) Physical (pt) or Speech (st) Therapies • Have a discharge plan to the community. The study by Drummond et al. 1, pp. (2011) in which a screening tool was developed to identify patients who would require a home visit prior to discharge. Within an Irish context, DPHV appear to be highly valued and are completed routinely. 245-252. Barras, S. (2005), “A systematic and critical review of the literature: the effectiveness of occupational therapy home assessment on a range of outcome measures”, Australian Occupational Therapy Journal, Vol. 79 No. It is evident from this study that the DPHV is a lengthy process with over half of the participants in this study reporting a home visit timeframe of 1 h to 1 h 30 min. 248-256. A systematic review conducted by Barras in 2005 found no conclusive evidence to support the effectiveness of home visits in discharge planning. There are a limited number of small trials investigating OT clinical practice in relation to carrying out DPHVs (Wales et al., 2012). Initially the patient rated pain at 10/10 and at discharge 1/10 to occasionally 8/10. Our results fill this knowledge gap by suggesting the relevance to apply an occupational therapist-led discharge planning intervention (HOME) to this growing patient population who are at higher risk of poor outcomes [62, 63]. (2008) and Atwal et al. Renforth et al. Vasimordai, M., Turunen, H. and Bondas, T. (2013), “Content analysis and thematic analysis: implications for conducting a qualitative descriptive study”, Nursing and Health Sciences, Vol. Search results Jump to search results. Interviews with occupational therapists and field notes revealed the following five themes: Looking at the total picture; prioritizing client-centered collaborations; emphasizing cognitive functioning; enhancing occupational engagement; and framing assumptions about elderly discharge planning. The outcomes are designed to guide care providers, the client, and care partners in planning for discharge. In all, 52 sites were approached to participate in the study; however, only 23 agreed to participate and met the inclusion criteria. Indicators for an OT assessment may include sudden life change or injury. Occupational therapy (OT) intervention often includes carrying out discharge planning home visits (DPHV) (Harris et al., 2008). The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode. However, according to Weeks et al. Within an Irish context, there are currently no recommendations or guidelines to advise best practice for Occupational Therapists carrying out DPHVs. (2015), “Pre-discharge home assessment visits in assisting patient’s return to community living: a systematic review and meta analysis”, Journal of Rehabilitation Medicine, Vol. 5, pp. 289-299. Better transport options such as a designated car/van or timely taxi services were also suggested as ways to increase direct time spent on visits. (2004) in their study of pre discharge home visits from a community hospital, noted that 93 per cent of patients would be provided with equipment post visit. (2012) found that the average time spent on DPHV was 223 min, this included report writing and preparation time for the visit. In a survey of home visit practice in Australia, Lannin et al. a minimum of one visit per month. Drummond, A.E.R., Whitehead, P., Fellows, E.C. 289-307. Consent was obtained via the completion of the questionnaire. Lockwood, K.J., Taylor, N.F. This study aims to investigate current clinical practice during home visits and the value that occupational therapists’ attribute to home visits within an Irish context. It is associated with increased patient satisfaction, reduced length of stay in hospitals and reduced rates of re-admission (Sheppard et al., 2013). © 2019, Aisling Jane Davis and Patricia Mc Clure. Can he be alone during the day when I work? This paper examines the moral basis of discharge planning, relating it to the four fundamental bio‐ethical principles of respect for autonomy, beneficence, non‐maleficence and justice. 95-113. https://doi.org/10.1108/IJOT-10-2018-0015. In all, 77.00 per cent of participants reported taking between 15 and 45 min to prepare for a home visit. Occupational therapy (OT) intervention often includes carrying out discharge planning home visits (DPHV) (Harris et al., 2008). In all, 16.00 per cent of participants worked in smaller settings (rehabilitation or convalescence) that had less than 100 beds. The administration of the assessment requires communication and collaborations between the client, care partners, and healthcare providers. Numerous participants cited the need for increased standardisation of the home visit process with many advising the need for standardised checklists, policies and procedures. Well in short simultaneous evaluation, intervention, and discharge planning can be completed in 1 day because patients may be discharged to another setting before the therapist returns for follow ups. This section aims to explore participants’ attitudes towards pre discharge home visits. CL489N (082019) Occupational Therapy Discharge Report Page 1 of 8 Occupational Therapy Discharge Report If applicable, please select the Lock button before submitting the form. 47 No. 5 No. The caregiver really responded to being part of the planning. 58 No. The researcher aimed to achieve saliency with the questions so they would be relevant, important and of interest to the participants (OECD, 2012). Therefore, one of the most important roles occupational therapy practitioners in this setting perform is their role in discharge planning. Discharge planning in an outpatient setting is often much simpler than in inpatient settings. 31. 387-397. [The] nurse practitioner supported additional days for education. The urgent need for consistency in clinical practice has also been identified by many authors (Atwal et al., 2008; Barras et al., 2010; Sampson et al., 2014) and one would hope that professional bodies may develop procedures to guide and advise practice. 396-340. Thank you for your interest in the DPAT. Information was gathered regarding clinical areas assessed during visits in a Likert scale format. 1, pp. Research suggests that DPHVs are costly and high-risk interventions (Rousseau et al., 2013). Discharge planning is the process by which the hospital team considers what support might be required by the patient in the community, refers the patient to these services, and then liaises with these services to manage the patient’s discharge. For this section of the questionnaire, the researcher was guided by a study by Barras et al. Hoy, J., Twigg, V. and Pearson, E.J.M. 2, pp. Departmental size varied with over 40.00 per cent of participants working in a department of 21-25+ occupational therapists while 34.50 per cent of participants worked in a department of fewer than 10 occupational therapists. Data collection was carried out by using a survey questionnaire (postal and electronic options). ADLs are critically important for occupational therapy practitioners to consider in evaluation, intervention, and discharge planning. risk of aggression and risk of medical issue for patient. However, there is a dearth of evidence to support or refute their efficacy and limited policies or standards to guide clinical practice. Qualitative data identified benefits, risks, recommendations to improve home visit practice and clinical criteria for home visits. The questions aim to explore the participants perceived benefits and risks of completing visits, the criteria for patients’ suitability for visits and how participants perceive a visit to have been successful. (2015) found low to moderate quality evidence that DPHVs can increase participation in activities of daily livings (ADLs) and reduce falls risk. Discharge planning is a complex and challenging process for health-care professionals, patients, and carers. FOR: Cognitive Behavioral, because the pt’s thoughts, physiology, emotions, and behaviors will be addressed in the handout and will affect follow-through with the treatment plan. It is the only study of its kind in an Irish setting, and it could be used as a knowledge base regarding current practice on DPHV and occupational therapists’ clinical reasoning regarding home visits. Several studies explore Occupational Therapists’ perceptions of pre discharge home visit practice, Nygard et al. 34. Glossary from OTPF 2ed; History of OT; OT Practice Framework; Theories; Pediatric OT. Diagnoses; Evaluation . Reflecting on practice: are home visit prior to discharge worthwhile in geriatric patient care? 398-405. As it is not possible to determine the number of Occupational Therapists within the study population, it is difficult to ascertain whether the 122 participants of the study are representative of the population targeted. The tool measures critical factors known to contribute to failed discharges. Following a thorough literature review for this study, it was found that there has not been a study to date that has investigated or commented on the risk factors to occupational therapists during DPHV. activities of daily living consist of three areas which include personal activities of daily livings or personal activities of daily living (self-care), domestic activities of daily livings or domestic activities of daily living (domestic tasks such as cleaning, meal prep, laundry) and instrumental activities of daily livings or instrumental activities of daily living which refer to activities that are necessary to live independently in the community (shopping, finances, medication management) (Schell et al., 2013). (2008), “Occupational therapists’ perceptions of pre discharge home assessments with older adults in acute care”, British Journal of Occupational Therapy, Vol. OT Discharge Planning is popular when a patient has sudden change in mobility, a need for more support or has a long period of recovery. There are a number of standardised home assessment tools available, including the SAFER Tool (the Safety Assessment of Function and Environment for Rehabilitation), HEAP (Home Environment Assessment Protocol) and HAP (Home Assessment Profile). (2010) aimed to establish a “core/essential” and “ideal world” criteria for assessment during DPHV. (2013), Willard and Spackman’s Occupational Therapy, Lippincott Williams & Wilkins. Squat balance initially was poor and at discharge had improved to good. There is a clear need to streamline and justify clinical practice on DPHV within an Irish context. The questionnaire was piloted with a sub sample of Occupational Therapists from a mix of target sites to ensure its usability. occupational therapy practitioner2 documents the occupational therapy services and “abides by the time frames, format, and standards established by the practice settings, government agencies, external accreditation programs, payers, and AOTA documents” (p. S108). Firstly, staying focused on your recovery always means thinking about transitioning to a lower level of care, reminding your treatment team about your pending discharge will keep them motivated to put together the best possible plan. Hibberd, J. With evidence reporting that the financial cost of DPHVs is increasing, this highlights the growing need to justify these interventions. -Occupational therapist working in rehabilitation, I was able to stop a discharge today. Law, M., Cooper, B., Strong, S., Stewart, D., Rigby, P. and Letts, L. (1996), “The person- environment- occupational model: a transactive approach to occupational performance”, Canadian Journal of Occupational Therapy, Vol. High numbers of participants identified the opportunity to assess patients within their own, familiar environment as a benefit of DPHV, for example, one participant stated “you see the patient in their own physical environment. 4, pp. A study by Hoy et al. and Harding, K.E. 326-336. These results would be in line with the findings from this study, however the participants in this study required substantially less time to prepare for a visit with 88 per cent of the participants requiring less than 45 min. 2, pp. 396-402. To download the DPAT, we are asking you to complete a form containing information regarding you, your institution and potential use of the DPAT. Table I consists of 43 clinical practice questions that were included in the survey questionnaire. If the patient has a sudden change in function or health, the hospital may refer to Occupational Therapy. Numerous participants cited the need for increased resources on DPHVs, with many participants highlighting the value of having an OT Assistant present on visits to assist with “measurements, fit equipment, assist patient to mobilise”. It was clear that the time spent on documentation is an issue for participants as several suggested ways to reduce this, such as “Secretarial back up to complete reports or help organise visits.” Collaboration with community services and MDT members was cited as a way to improve practice, “involve the community occupational therapist early as well as public health nurses and other community base teams to minimise the revolving door type patients and maximise sustainability of home discharges” (Table VI). This did not include travel times and refers to the direct intervention in the home. (2011) reported an average home visit time of 1 h 20 min. Harris et al. Twelve partcipants reported taking less than 15 min and two participants report their home visit preparation takes 1 h+ to complete. If the gatekeeper was agreeable to the researcher accessing participants, an electronic link to the questionnaire was disseminated to staff members by the gatekeeper via the SPHINX data analysis package (SPHINXonline 4.8, 2016) or paper copies sent to each target site. Living alone and/or lack of supports was also mentioned as an indicator for a DPHV, “lives alone, elderly, minimal supports, vulnerable”. In the study by Nygard et al. Pre discharge occupational therapy home assessment visits: towards and evidence base, The home visiting process for older people in the in patient immediate care services, Occupational therapy home assessments: more than just a visit? therapy’s role in hospital readmissions, discharge planning and the impact that occupational therapy has on quality of health measures throughout the continuum of care. Occupational Therapists (OT’s), Physiotherapists (PT’s) and rehabilitation assistants who assess the patients ongoing care and therapy needs at home. (2014). This is similar to the findings from a study by Atwal et al. 3 No. SPHINXonline 4.8 (2016), “SPHINX data analysis package”, available at: www.sphinxonline.com/v4/login.aspx or www.lesphinx-developpement.fr/en/. A viewpoint. A study by Hibberd (2008) found that the average cost of a DPHV was £135, while a more recent study by Sampson et al. Another issue in relation to DPHVs as discussed in the literature is the lack of evidence-based protocols governing the practice (Atwal et al., 2008; Sampson et al., 2014). There are a number of reasons why being relentless around your discharge planning is important. 59-63. The aim of the questionnaire was to investigate clinical practice during DPHV and clinical reasoning guiding Occupational Therapists. The researcher wished to investigate practice with regards to recommendations post visit, as studies by Renforth et al. The OT will look at a wide range of factors that impact a patient's daily life and their ability to care for themselves on returning home. They are resource-intensive (Sampson et al., 2014) and often require two therapists to attend a visit. It also identified the necessity for best practice guidelines to be established, to ensure that patient’s safety and independence on discharge are not compromised. Particular attention was paid to the principles of good survey design especially with regards to the question wording and sequence, with general questions preceding specific questions (McColl et al., 2001). Information was provided in verbal and written format regarding the study and the requirement from participants. Dad was so independent before. Poor discharge planning can lead to poor patient Atwal, A., Spipotopoulou, G., Stradden, J., Fellow, V., Anako, E., Robinson, L. and McIntyre, A. In all, 67 participants reported taking between 30 min and 1 h to complete reports. The aim of this study was to investigate current clinical practice during DPHV within and Irish context and to explore therapist’s attitudes towards same. Progressive community reintegration, consultation with vocational rehabilitation staff, and resources are provided for the client and family. Outpatient occupational therapists typically focus on recommendations for diet changes, exercise programs, activity modifications, stress management techniques, and sleeping positions. Occupational therapists play an integral role in the discharge planning process and determining whether a patient can safely return to their home environment (Lockwood et al., 2015). -Daughter responsible for father discharging from rehabilitation, Page last updated 10:47 AM, July 10, 2020, DentonMCL Building 810P.O. 3, pp. Ensuring safe discharge is a core element of quality health-care provision.