Discharge Planning Part 1: Introduction to OT in Acute Care

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.