Welcome to the Trump Rehabilitation Centre The Search for a New Vision.
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Transcript of Welcome to the Trump Rehabilitation Centre The Search for a New Vision.
Welcome to theTrump Rehabilitation Centre
The Search for a New Vision
WANTED
Head Occupational Therapist
Overview
Rehabilitation Center & research institute current practices.
Vision for future Holism & client-centeredness. Research & evidence based practice.
Conclusion
Current Practices
Focus on client’s individual occupational performance components. Ex. Lifting teapot off
shelf.
Research is not occupationally based.
Vision
Holistic approach to occupational therapy. Client-centered practice.
Focus on research in occupation. Evidence based practice.
Holistic Approach
A person is a whole being — mind, body & spirit.
Client-centered practice enables treatment of the whole person.
Canadian Model of Occupational Performance — accepted model in Canada. CAOT (1997).
Physical Institutional
SocialCultural
Environment
Canadian Model of Occupational Performance
Occupation
ProductivityS
elf-c
are
Leisure
PersonSpirituality
Cognitive Physical
Affective
Benefits of Holistic Approach
Comparative Study Buddenberg & Schkade (1998). Rehab for hip fractures in elderly patients. Biomechanical versus Holistic Treatment.
ResultsHolistic treatment greater improvement on
client chosen tasks.
Benefits of Holistic Approach
Comparative Study Jackson & Schkade (2000). Rehab for hip fractures in elderly patients. Biomechanical versus Holistic Treatment.
ResultsHolistic treatment higher improvement rate.Holistic treatment greater client satisfaction.
Benefits of Holistic Approach
Case Study Capitulo & Silverberg (2001). Mount Sinai Medical Center, New York. Provider-Centered Patient-Centered
delivery model of care.
Results of changeImproved quality of care.Increased patient & staff satisfaction.Decreased costs.
Benefits of Client-Centered Approach
Case Study Rebeiro (2000). Hospital mental health services. Not client-centered.
Client raised issues:Focus was on illness rather than individual.Lack of choice.Not part of decision making process.Lack of partnership in treatment.Decreased therapeutic value of occupation.
Benefits of Client-Centered Approach
Continuous Quality Care Improvement Model (CQI) McLaughlin & Kaluzny (2000). Patient-centered care provides optimal services
compared with site-centered. 1960s, 80s: Patient-centered; not EBP. 1980s, 90s: EBP, but site-centered.
Focus of Model Goals set by patient. Treat patient, not impairment. Practical in light of financial constraints.
CQI Model
Mass Customization Module: A treatment component.
Ex. Psychotherapy, splinting, etc.
Client selects modules. Modular approach supported by EBP. Decreases need for later services. Assures long-term effect on quality of life.
CQI Example: Client Pathway
Psychotherapy
Functional Assessment
Splinting
Orthotics
Hand TherapyAssistive Devices
Work HardeningPsychotherapy
Hand Therapy
Orthotics
Splinting
Research on Occupation
“Occupational therapists… will advance occupation and participation through… utilization of research knowledge.”
Leadership Forum (2003).
Evidence-based practice.
Evidence Based Practice
“Evidence-based practice (EBP) encourages the integration of high quality quantitative and qualitative research, with the clinician's clinical expertise and the client's background, preferences and values to implement interventions that produced the desired outcome. " Sackett et al. (1996).
Benefits of Research on Occupation
Perspective Law (1998). Importance of evidence based practice
Financial accountability.Maximize benefit for allowed cost.Fosters client-centered perspective.Ensures best practice.
Benefits of Research on Occupation
Perspective Dubouloz, Egan,
Zweck, & Vallerano (1998).
Evidence Based Practice identifies clients most likely to benefit from services.
Perspective Stewart (1999). Evidence Based
Practice enables therapists to set goals and measure outcomes.
Concluding Remarks
A holistic approach to treatment will benefit the client, the therapist, and the organization.
Research on occupation supports EBP, and will lead to improved credibility of the organization, decreased costs, and improved intervention outcomes.
Discussion
What did you think of Monika's vision? Do you think we should
hire her? Why? Why not?
Monika, you’re HIRED!