Thank you to our guest blogger Hailey Jungerman, Covell Care Intern and Colorado State University Senior.
Occupational therapists play an important part in keeping patients out of the hospital. They do so by encouraging safety in independence. One thing that I have heard repeatedly in shadowing OTR Dave of Covell Care is, “And we want you to be safe while doing so.” He is always referring to the daily activities of his clients and encouraging that they can do the things they want to, but making it more safe for the ability of the client.
In a journal about OT preventing readmissions, OTR Pamela Roberts and OTR Marla Robinson say that “19.4% will be readmitted within 30 days and 51.6% within 1 year” (254). This is important because it shows a need. We NEED to help in reducing this rate. They also state that OT has an important role in early identification of risk and early engagement in risk-reduction strategies (254). The earlier that patients start with OT after a hospital visit, the more likely that it will help in preventing readmission.
Roberts and Robinson state that OT can prevent hospital acquired conditions (HACs) and falls while in the hospital (255). Being in a hospital increases risk of fall due to unfamiliar environment and confusion. If a patient is to fall, then there is a fear of falling which can in turn lead to further disability from reduction in activity due to fear (Roberts and Robinson 255). This is why OT is so important in all settings of care. OT should be seeing patients that are high-risk for falls and hospital admission to prevent admission as well as in hospital settings and care immediately following a hospital visit to reduce readmission risk.
Another journal restates the importance of safety by asking “can the patient be discharged safely into her or his environment?” and if not that occupational therapists can look at 6 important interventions that can reduce readmission (Rogers et al.):
1) Provide recommendations and training for caregivers.
2) Determine whether patients can safely live independently, or require rehabilitation or nursing.
3) Address existing disabilities with assistive devices so patients can safely perform activities of daily living.
4) Perform home safety assessments before discharge to suggest modifications.
5) Asses cognition and the ability to physically manipulate things like medication containers, and provide training when necessary
6) Work with physical therapists to increase intensity of inpatient rehabilitation.
The only thing to be added is that therapists should work the whole care team to ensure safety and monitor success of therapy which may include occupational therapy, physical therapy, speech therapy, personal training, nursing, etc. Occupational therapy is necessary in assessing safety in activities of daily living. When safety is encouraged, the more independent a person can be and the less likely they will end up in the hospital.
Roberts, Pamela S., and Marla R. Robinson. “Occupational Therapy’s Role in Preventing Acute Readmissions.” American Journal of Occupational Therapy, vol. 68, no. 3, 2014, pp. 254–259., doi:10.5014/ajot.2014.683001.
Rogers, Andrew T., et al. “Higher Hospital Spending on Occupational Therapy Is Associated With Lower Readmission Rates.” Medical Care Research and Review, vol. 74, no. 6, 2 Sept. 2016, pp. 668–686., doi:10.1177/1077558716666981.