This course sets the stage for understanding occupational therapy's role in the acute care setting, and how discharge planning and recommendations have evolved as an essential part of a patient's road to recovery and rehabilitation. The paradigm shift in OT services from Assessment-Intervention-Discharge Planning to Assessment-Discharge Planning is discussed. Occupational therapy practitioners must consider both the internal and external factors when making discharge recommendations to minimize the risk of adverse events and readmissions. Finally, this course reviews the different types of settings that patients may be transferred to after discharge along with their criteria, to help the OT practitioner effectively problem solve in making the most appropriate recommendation.
Suzanne Holm OTD, OTR, BCPR
Suzanne E. Holm, OTD, OTR/L, BCPR is a licensed occupational therapist, board certified in Physical Rehabilitation, and educator with more than twenty-five years of clinical experience in adult rehabilitation and acute care settings. She is the Occupational Therapy Academic Program Coordinator and Assistant Professor at Regis University in Denver, Colorado and oversees Creighton University's entry-level…Read full bio
Helene Smith-Gabai PhD, OTR/L, BCPR
Helene Smith-Gabai is currently working as an assistant professor in a master's level occupational therapy program at Brenau University. She earned her OTD in 2004 and her Ph.D. in 2016 at Nova Southeastern University. Her dissertation study was on the discharge planning practices of occupational therapists who practice in the acute care setting. She is…Read full bio
1. Historical Context of Occupational Therapy Discharge Planning
Chapter one provides a brief historical review of how the profession of occupational therapy became part of the services provided to hospitalized patients. There is also discussion of how the advent of managed care significantly changed the way services are provided in the acute care setting, and why there has been a paradigm shift in OT services from Assessment-Intervention-Discharge Planning to Assessment-Discharge Planning. What is meant by discharge planning is also reviewed.
2. The OT Process and Purpose of Discharge Planning in Acute Care
This chapter describes the general OT process, benefits, and goals of discharge planning within the acute care setting, including factors both internal and external practitioners consider when making discharge recommendations. It also describes the general knowledge, abilities, and clinical reasoning skills needed to make appropriate and effective discharge recommendations. Also reviewed are Medicare’s list of 13 diagnoses that qualify for an acute inpatient rehabilitation stay.
3. Discharge Dispositions and Criteria
To make an appropriate discharge recommendation, practitioners need to have a good understanding of the different discharge dispositions that are available, including their requirements for admission. Practitioners also need to be aware of the activity demands of each practice setting and potential impact on a patient’s occupational performance, progress, and prognosis. This chapter reviews the different types of settings that patients may be transferred to after discharge, and their specific criteria in order to help practitioners effectively make the most appropriate recommendation.
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